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Diaz FC, Hamparsumian A, Loh KP, Verduzco-Aguirre H, Abdallah M, Williams GR, Hsu T, Soto-Perez-de-Celis E, Elias R. Geriatric Oncology: A 5-Year Strategic Plan. Am Soc Clin Oncol Educ Book 2024; 44:e100044. [PMID: 38709980 DOI: 10.1200/edbk_100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
The increasing rate of the older adult population across the world over the next 20 years along with significant developments in the treatment of oncology will require a more granular understanding of the older adult population with cancer. The ASCO Geriatric Oncology Community of Practice (COP) herein provides an outline for the field along three fundamental pillars: education, research, and implementation, inspired by ASCO's 5-Year Strategic Plan. Fundamental to improving the understanding of geriatric oncology is research that intentionally includes older adults with clinically meaningful data supported by grants across all career stages. The increased knowledge base that is developed should be conveyed among health care providers through core competencies for trainees and continuing education for practicing oncologists. ASCO's infrastructure can serve as a resource for fellowship programs interested in acquiring geriatric oncology content and provide recommendations on developing training pathways for fellows interested in pursuing formalized training in geriatrics. Incorporating geriatric oncology into everyday practice is challenging as each clinical setting has unique operational workflows with barriers that limit implementation of valuable geriatric tools such as Geriatric Assessment. Partnerships among experts in quality improvement from the ASCO Geriatric Oncology COP, the Cancer and Aging Research Group, and ASCO's Quality Training Program can provide one such venue for implementation of geriatric oncology through a structured support mechanism. The field of geriatric oncology must continue to find innovative strategies using existing resources and partnerships to address the pressing needs of the older adult population with cancer to improve patient outcomes.
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Affiliation(s)
- Fernando C Diaz
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
- Division of Geriatrics, University of North Carolina, Chapel Hill, NC
| | - Anahid Hamparsumian
- Geriatric Research Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Haydeé Verduzco-Aguirre
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maya Abdallah
- Section of Hematology/Oncology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA
| | - Grant R Williams
- Lewis and Faye Manderson Cancer Center at DCH Regional Medical Center, Tuscaloosa, AL
- Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Tina Hsu
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rawad Elias
- Division of Hematology-Oncology, UMass Chan Medical School-Baystate, Springfield, MA
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Schiaffino MK, Schumacher JR, Nalawade V, Nguyen PTN, Yakuta M, Gilbert PE, Dale W, Murphy JD, Moore AA. The disproportionate burden of Alzheimer's disease and related dementias (ADRD) in diverse older adults diagnosed with cancer. J Geriatr Oncol 2023; 14:101610. [PMID: 37666209 PMCID: PMC11086668 DOI: 10.1016/j.jgo.2023.101610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/26/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Older adults living with Alzheimer's disease and related dementias (ADRD) who are then diagnosed with cancer are an understudied population. While the role of cognitive impairment during and after cancer treatment have been well-studied, less is understood about patients who are living with ADRD and then develop cancer. The purpose of this study is to contribute evidence about our understanding of this vulnerable population. MATERIALS AND METHODS This was a retrospective cohort study of a linked, representative family of databases of cancer registries and Medicare administrative claims that make up the SEER-Medicare database. Older adults ages 68 and older with a first primary cancer type: breast, cervical, colorectal, lung, oral, or prostate were eligible for inclusion (N = 337,932). Prevalence estimates of ADRD across cancer types and a 5% non-cancer comparison sample were compared by patient factors. RESULTS The overall prevalence of patients who had an ADRD diagnosis anytime in the three years prior to their cancer diagnosis was 5.6%. Patients with ADRD were more likely to be female, older (over age 75), a racial/ethnic minority, single, with multiple chronic conditions, and a tumor diagnosed early (stage I) or were unstaged. Black patients with colorectal and oral cancer had the highest and second highest prevalence of ADRD compared to White patients (13.46% vs 7.95% and 12.64% vs 7.82% respectively, p < .0001). We observed the highest prevalence of ADRD among Black patients for breast (11.85%), cervical (11.98%), lung (8.41%), prostate (4.83), and the 5% sample (9.50%, p > .0001). DISCUSSION The higher prevalence of ADRD among Black and Latine older adults with cancer not only aligns with the trend observed in our non-cancer comparison sample, but also, these findings demonstrate the compounded risk experienced by minoritized older adults over the life course. The greater than expected prevalence of patients with ADRD who go on to develop cancer demonstrates better assessment of cognition is urgently needed. Accurate identification of these vulnerable populations is critical to improve assessment, care coordination, and address inequities in screening and treatment planning.
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Affiliation(s)
- Melody K Schiaffino
- School of Public Health, San Diego State University, San Diego, CA, USA; Center for Health Equity, Education, and Research, School of Medicine, UC San Diego, La Jolla, CA, USA; Division of Radiation Medicine and Applied Sciences, School of Medicine, UC San Diego, La Jolla, CA, USA; Division of Geriatrics, Gerontology, and Palliative Medicine, UC San Diego, CA, USA.
| | - Jessica R Schumacher
- Department of Surgery, School of Medicine, UNC Chapel Hill, Chapel Hill, NC, USA.
| | - Vinit Nalawade
- Division of Radiation Medicine and Applied Sciences, School of Medicine, UC San Diego, La Jolla, CA, USA.
| | - Phuong Thi Ngoc Nguyen
- Interdisciplinary Graduate Program in Informatics, University of Iowa, Iowa City, IA, USA.
| | - Melissa Yakuta
- San Diego Health and Human Services Agency, San Diego, CA, USA.
| | - Paul E Gilbert
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - William Dale
- Department of Supportive Care Medicine, City of Hope, Duarte, CA, USA.
| | - James D Murphy
- Center for Health Equity, Education, and Research, School of Medicine, UC San Diego, La Jolla, CA, USA; Division of Radiation Medicine and Applied Sciences, School of Medicine, UC San Diego, La Jolla, CA, USA.
| | - Alison A Moore
- Division of Geriatrics, Gerontology, and Palliative Medicine, UC San Diego, CA, USA.
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Gregorio DJ, Powers B, Datta P, Arora SP. Geriatric oncology needs assessment of an interdisciplinary oncology team in a collaborative veterans affairs setting. J Am Geriatr Soc 2023; 71:3624-3627. [PMID: 37345894 DOI: 10.1111/jgs.18488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/21/2023] [Accepted: 05/28/2023] [Indexed: 06/23/2023]
Affiliation(s)
- David J Gregorio
- Mays Cancer Center, The University of Texas Health San Antonio, San Antonio, Texas, USA
- Department of Veterans Affairs (VA), South Texas Veterans Health Care System, Audie L. Murphy Veterans Memorial Hospital, San Antonio, Texas, USA
| | - Becky Powers
- Mays Cancer Center, The University of Texas Health San Antonio, San Antonio, Texas, USA
- Department of Veterans Affairs (VA), South Texas Veterans Health Care System, Audie L. Murphy Veterans Memorial Hospital, San Antonio, Texas, USA
| | - Paromita Datta
- Mays Cancer Center, The University of Texas Health San Antonio, San Antonio, Texas, USA
- Department of Veterans Affairs (VA), South Texas Veterans Health Care System, Audie L. Murphy Veterans Memorial Hospital, San Antonio, Texas, USA
| | - Sukeshi Patel Arora
- Mays Cancer Center, The University of Texas Health San Antonio, San Antonio, Texas, USA
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Wall SA, Olin R, Bhatt V, Chhabra S, Munshi P, Hacker E, Hashmi S, Hassel H, Howard D, Jayani R, Lin R, McCurdy S, Mishra A, Murthy H, Popat U, Wood W, Rosko AE, Artz A. The Transplantation Ecosystem: A New Concept to Improve Access and Outcomes for Older Allogeneic Hematopoietic Cell Transplantation Patients. Transplant Cell Ther 2023; 29:632.e1-632.e10. [PMID: 37137442 DOI: 10.1016/j.jtct.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is increasingly offered to older adults with hematologic malignancies, even though nonrelapse mortality remains a major concern in older patients owing to more comorbidities and greater frailty compared with their younger counterparts. The importance of patient fitness, a well-matched donor, and disease control to the success of allogeneic HCT have been well documented; however, these factors fail to account for the impact of the complex transplantation ecosystem (TE) that older adult HCT candidates must navigate. We propose a definition of the TE modeled after the social determinants of health. Furthermore, we outline a research agenda aimed at increasing understanding of the roles of individual social determinants of transplantation health in the larger ecosystem and how they may benefit or harm older adult HCT candidates. Herein we define the TE and its individual tenets, the social determinants of transplantation health. We review the available literature while incorporating the expertise of the membership of the American Society for Transplantation and Cellular Therapy (ASTCT) Special Interest Group for Aging. The membership of the ASTCT Special Interest Group for Aging identify knowledge gaps and strategies to address them for each of the described social determinants of transplantation health. The ecosystem is an essential but underappreciated pillar for transplant access and success. We put forth this novel research agenda seeking to gain a better understanding of the complexity of HCT in older adults and develop strategies to improve access to HCT, survival, and quality of life.
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Affiliation(s)
- Sarah A Wall
- Division of Hematology, Ohio State University, Columbus, OH.
| | - Rebecca Olin
- Division of Hematology & Oncology, University of California San Francisco, San Francisco, CA
| | - Vijaya Bhatt
- Division of Hematology & Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Saurabh Chhabra
- Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Pashna Munshi
- Division of Oncology, Georgetown University Medical Center, Washington, DC
| | - Eileen Hacker
- Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shahrukh Hashmi
- Division of Hematology, Mayo Clinic Minnesota, Rochester, MN
| | - Hailey Hassel
- National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Dianna Howard
- Division of Hematology & Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Reena Jayani
- Division of Hematology & Oncology, Vanderbilt University Medical Center, Nashville, TN
| | - Richard Lin
- Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Shannon McCurdy
- Division of Hematology & Oncology, University of Pennsylvania, Philadelphia, PA
| | - Asmita Mishra
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | - Hemant Murthy
- Division of Hematology & Oncology, Mayo Clinic, Jacksonville, FL
| | - Uday Popat
- Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - William Wood
- Division of Hematology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ashley E Rosko
- Division of Hematology, Ohio State University, Columbus, OH
| | - Andrew Artz
- Division of Hematology & Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA
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Khoury EG, Nuamek T, Heritage S, Fulton-Ward T, Kucharczak J, Ng C, Kalsi T, Gomes F, Lind MJ, Battisti NML, Cheung KL, Parks R, Pearce J, Baxter MA. Geriatric Oncology as an Unmet Workforce Training Need in the United Kingdom-A Narrative Review by the British Oncology Network for Undergraduate Societies (BONUS) and the International Society of Geriatric Oncology (SIOG) UK Country Group. Cancers (Basel) 2023; 15:4782. [PMID: 37835476 PMCID: PMC10571920 DOI: 10.3390/cancers15194782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula.
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Affiliation(s)
- Emma G. Khoury
- Academic Cancer Sciences Unit, University of Southampton, Southampton SO16 6YD, UK
| | - Thitikorn Nuamek
- Medical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK; (T.N.)
| | | | - Taylor Fulton-Ward
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Joanna Kucharczak
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 OSP, UK
| | - Cassandra Ng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Tania Kalsi
- Department of Ageing of Health, Guy’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
- School of Life Course and Population Sciences, King’s College London, London WC2R 2LS, UK
| | - Fabio Gomes
- Medical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK; (T.N.)
| | - Michael J. Lind
- Queens Centre for Oncology and Haematology, Hull and East Yorkshire NHS Trust, Hull HU16 5JQ, UK
- Cancer Research Group, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Nicolò M. L. Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Kwok-Leung Cheung
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Ruth Parks
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Jessica Pearce
- Leeds Institute of Medical Research at St James’, University of Leeds, Leeds LS2 9JT, UK
| | - Mark A. Baxter
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD2 1SY, UK
- Tayside Cancer Centre, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD2 1SG, UK
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Arora SP, Puts M. Lessons learned from organizing International Society of Geriatric Oncology (SIOG) geriatric assessment workshops. J Geriatr Oncol 2023; 14:101528. [PMID: 37230931 DOI: 10.1016/j.jgo.2023.101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Sukeshi Patel Arora
- Division of Hematology/Oncology, Department of Medicine, Mays Cancer Center, University of Texas Health San Antonio, 7979 Wurzbach Rd., MC 8232, San Antonio, TX 78229, USA.
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College street suite 130, Toronto M5P1T8, ON, Canada.
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Hsu T, Elias R, Swartz K, Chapman A. Developing Sustainable Cancer and Aging Programs. Am Soc Clin Oncol Educ Book 2023; 43:e390980. [PMID: 37155945 DOI: 10.1200/edbk_390980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Geriatric assessment (GA) has been shown to decrease toxicity from systemic therapy, improve completion of chemotherapy, and reduce hospitalizations in older adults with cancer. Given the aging of the cancer population, this has the potential to have a positive impact on the care of a large swath of patients seen. Despite endorsement by several international societies, including the American Society of Clinical Oncology, uptake of GA has been low. Lack of knowledge, time, and resources has been cited as reasons for this. Although challenges to developing and implementing a cancer and aging program vary depending on the health care context, GA is adaptable to every health care context from low- to high-resource settings, as well as those in which geriatric oncology is a well-established or just emerging field. We provide an approach for clinicians and administrators to develop, implement, and sustain aging and cancer programs in a doable and sustainable way.
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Affiliation(s)
- Tina Hsu
- The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada
| | - Rawad Elias
- Hartford HealthCare Cancer Institute, Hartford, CT
- University of Connecticut School of Medicine, Farmington, CT
| | - Kristine Swartz
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Jefferson Health, Philadelphia, PA
| | - Andrew Chapman
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Jefferson Health, Philadelphia, PA
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Parker PA, Alici Y, Nelson C, Banerjee SC, Coyle N, Roth AJ, Manna R, Alexander K, Gonzalez J, Ewert R, Schofield E, Li Y, Korc-Grodzicki B. Geriatric Oncology Cognition and Communication (Geri-Onc CC): An interactive training for healthcare professionals. J Geriatr Oncol 2023; 14:101484. [PMID: 36989939 PMCID: PMC10106423 DOI: 10.1016/j.jgo.2023.101484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/03/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION The number of older adults with cancer continues to increase. Many national and international organizations have called for the development of training opportunities for healthcare professionals (HCPs) to meet the unique needs of older adults with cancer and their families. MATERIALS AND METHODS We developed and implemented the Geriatric Oncology Cognition and Communication (Geri-Onc CC) training program for HCPs of all disciplines. This program included a two-day, intensive didactic and experiential training followed by six bi-monthly booster videoconference calls. We describe the format and content of this training, the preliminary results of program evaluation, as well as changes in knowledge, self-efficacy, and attitudes toward older adults pre- to post-training. RESULTS We describe data from the first six cohorts of HCPs who attended the training (n = 113). Participants rated the training highly favorably and reported that it met their training goals Mean = 4.8 (1-5 Scale). They also demonstrated a significant increase in their knowledge about geriatric oncology [(Pre-Mean = 6.2, standard deviation [SD] = 1.7; Post-Mean 6.8, SD = 1.6), p = 0.03] and self-efficacy in their ability to utilize the knowledge and skills they learned in the course [(Pre-Mean = 3.3, SD = 0.7; Post-Mean 4.5, SD = 0.4), p < 0.001]. There were no significant changes in attitudes toward older adults (p > 0.05), which were already very positive before the training. DISCUSSION There is a strong need for training in geriatric oncology. We have demonstrated that implementing this training was feasible, highly regarded, and positively impacted knowledge and self-efficacy regarding utilization of the knowledge and skills learned in the training.
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Affiliation(s)
- Patricia A Parker
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA.
| | - Yesne Alici
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Christian Nelson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Smita C Banerjee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Nessa Coyle
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Roth
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Ruth Manna
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Koshy Alexander
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | | | - Rebecca Ewert
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Yuelin Li
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Beatriz Korc-Grodzicki
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
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Manogna D, Lipof JJ, Baran AM, Said B, Becker MW, Mendler JH, Aljitawi OS, O'Dwyer KM, Huselton E, Burack R, Blaney M, Liesveld JL, Loh KP. Referral to and receipt of allogeneic hematopoietic stem cell transplantation in older adults with acute myeloid leukemia. J Geriatr Oncol 2023; 14:101403. [PMID: 36372724 PMCID: PMC9975032 DOI: 10.1016/j.jgo.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Recent data have shown improved outcomes in selected older adults with acute myeloid leukemia (AML) following allogeneic hematopoietic stem cell transplantation (HSCT). Nonetheless, practice patterns for referring and performing HSCT vary. We aimed to evaluate referral, utilization, and reasons for not referring/proceeding to HSCT in older adults with AML. MATERIALS AND METHODS This is a single center retrospective analysis of patients aged ≥60 years diagnosed with AML evaluating rates of HSCT referral and utilization. Fisher's exact test was used to compare rates of referral and utilization across age groups and years of diagnosis. RESULTS Median age of the 97 patients was 70 years (range 61-95); 30% (29/97) were referred for HSCT and of these, 69% (20/29) received HSCT. Common documented reasons (can be multiple) for not referring were performance status (n = 21), advanced age (n = 16), patient refusal (n = 15), refractory disease (n = 14), and prohibitive comorbidity (n = 6). Among patients who were referred but did not receive HSCT (n = 9/29), documented reasons for not proceeding with HSCT were refractory disease (n = 5), advanced age (n = 2), and prohibitive comorbidity (n = 2). HSCT referral and utilization rates significantly decreased with age (p < 0.01) but were generally stable over time from 2014 to 2017 (p = 0.40 for referral and p = 0.56 for utilization). DISCUSSION Despite improvements in supportive care and HSCT techniques, HSCT referral and utilization rates remained low among older adults with AML but stable over time.
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Affiliation(s)
- Dharmini Manogna
- Department of Hematology and Oncology, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Jodi J Lipof
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Andrea M Baran
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Bassil Said
- Department of Hematology and Oncology, Stony Brook University, Long Island, New York, USA.
| | - Michael W Becker
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Jason H Mendler
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Omar S Aljitawi
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Kristen M O'Dwyer
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Eric Huselton
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Richard Burack
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Margaret Blaney
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Jane L Liesveld
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA.
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David V, Hsu T, Mithoowani S, Fraser G, Mian H. What do hematology residents know about caring for older adults with cancer? A National Survey of Canadian hematology residents' knowledge and interests. J Geriatr Oncol 2022; 13:1236-1240. [PMID: 36050270 DOI: 10.1016/j.jgo.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/17/2022] [Accepted: 08/24/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION As the Canadian population ages, older adults comprise an increasing proportion of those diagnosed and treated for hematologic malignancies. A geriatric oncology curriculum has been recognized as a top priority in the care of older patients with cancer. It is not clear, however, whether hematology trainees receive training in geriatric oncology. We sought to understand residents' views and needs for a geriatric oncology curriculum during hematology residency in Canada. MATERIALS AND METHODS We conducted a cross-sectional needs assessment of hematology trainees enrolled in a Canadian residency or advanced fellowship training program within hematology. The survey, which was piloted with three non-hematology residents to ensure user-friendliness, used a combination of Likert scale, multiple-choice, and open-ended questions. The survey comprised three sections: (1) demographic data, (2) current state of geriatric oncology training (amount, content) and (3) attitudes towards learning about geriatric oncology and preferred curriculum components and identified needs. The survey was administered by the study team and distributed electronically to program directors in June 2020. The program directors were asked to forward the survey to trainees registered within their Division of Hematology. Data were analyzed descriptively. RESULTS Twenty-nine hematology residents participated (41.4% estimated response rate). Most respondents had not received geriatric oncology teaching (58.6%, n = 17) and have never been taught about geriatric oncology assessment tools (72.4%, n = 21) during hematology residency. Most respondents felt that their program should deliver a geriatric oncology curriculum (96.6%, n = 28). Respondents were most interested in learning about use of geriatric assessment tools for pre-treatment chemotherapy decision-making (86.2%, n = 25), prediction of chemotherapy toxicity (82.8%, n = 24), and to facilitate conversations regarding treatment initiation, continuation, or termination (79.3%, n = 23). DISCUSSION Our study highlights the paucity of geriatric oncology training in hematology residency training programs. Our results highlight both the need and interest for a future dedicated geriatric oncology curriculum integrated into hematology training and provide guidance about which topics are most valued by trainees.
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Affiliation(s)
- Victoria David
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Tina Hsu
- Division of Medical Oncology, University of Ottawa, Ottawa, Ontario, Canada
| | - Siraj Mithoowani
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Graeme Fraser
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Hira Mian
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
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11
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Webb T, Verduzco-Aguirre HC, Rao AR, Ramaswamy A, Noronha V. Addressing the Needs of Older Adults With Cancer in Low- and Middle-Income Settings. Am Soc Clin Oncol Educ Book 2022; 42:1-10. [PMID: 35427187 DOI: 10.1200/edbk_349829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The number of older adults in the world is projected to increase steeply over the next 30 years; most older adults will live in low- and middle-income countries. This will have a direct impact on the global cancer burden, as cancer is largely a disease of aging. A revolution in the way we care for older adults in low- and middle-income settings is needed to meet rapidly rising demands. Regardless of a nation's relative wealth or resources, implementing the geriatric assessment in cancer care has presented a challenge because of omission of the principles of geriatric oncology from formal training and continuing education, lack of time, and a shortage of qualified personnel. To meet the challenge of caring for older adults globally, we must: (1) re-imagine aging-focused training for providers and nurses, (2) create and strengthen collaborations/partnerships between geriatric oncology teams and aging-service organizations, and (3) increase advocacy for age-friendly health care policy. By harnessing technology, the reach of specialized oncology education and care can be extended even-or especially-to low- and middle-income settings.
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Affiliation(s)
- Tracy Webb
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC
| | | | - Abhijith Rajaram Rao
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Anant Ramaswamy
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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12
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Morris L, Turner S, Thiruthaneeswaran N, O'Donovan A, Simcock R, Cree A, Phillips J, Alibhai S, Puts M, Szumacher E, Lane H, Berger A, Agar M. An International Expert Delphi Consensus to Develop Dedicated Geriatric Radiation Oncology Curriculum Learning Outcomes. Int J Radiat Oncol Biol Phys 2022; 113:934-945. [DOI: 10.1016/j.ijrobp.2022.04.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
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13
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Improving the Education of Radiation Oncology Professionals in Geriatric Oncology: Where Are We and Where Should We Be? Semin Radiat Oncol 2022; 32:109-114. [DOI: 10.1016/j.semradonc.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Gajra A, Jeune-Smith Y, Fortier S, Feinberg B, Phillips E, Balanean A, Klepin HD. The Use and Knowledge of Validated Geriatric Assessment Instruments Among US Community Oncologists. JCO Oncol Pract 2022; 18:e1081-e1090. [PMID: 35263162 DOI: 10.1200/op.21.00743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The use of a standardized geriatric assessment (GA) to inform treatment decisions in older adults with cancer improves quality of life, reduces treatment-related toxicity, and is guideline-recommended. This study aimed to assess community oncologists' knowledge and utilization of GAs. METHODS Between September 2019 and February 2020, practicing US-based oncologists were invited to attend live meetings and complete web-based surveys designed to collect information on treatment decision making and various practice-based challenges in oncology care. RESULTS Among the 349 oncologists surveyed, 74% practiced in a community setting. Sixty percent did not use a formal GA to inform treatment decisions for any of their older patients; the most common reasons for not using a GA were "Too cumbersome to incorporate into routine practice" (44%) and "Adds no value beyond the comprehensive history and physical exam" (36%). Validated GA instruments used in routine clinical practice included: Mini-Mental State Exam (54%), Comprehensive Geriatric Assessment (23%), Cancer and Aging Research Group toxicity tool (12%), and Chemotherapy Risk Assessment Scale for High-Age Patients tool (9%). Nineteen percent of oncologists were not aware of any validated GA instruments. Eastern Cooperative Oncology Group performance status and comorbidities were the most frequently used assessment factors to inform treatment decisions (88% and 73%, respectively). CONCLUSION Many oncologists have not incorporated GA tools because of perceptions that GAs are difficult to implement or do not add any value. Increasing education of the benefits of GA-directed therapy could help to increase GA utilization among community oncologists.
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Affiliation(s)
- Ajeet Gajra
- Cardinal Health Specialty Solutions, Dublin, OH
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15
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Seedor RS, Meeker CR, Lewis B, Handorf EA, Filchner KA, Varadarajan R, Hensold J, Padmanabhan A, Negin B, Blankstein K, Chawla NR, Song W(F, Epstein J, Winn J, Goldstein L, Dotan E. OUP accepted manuscript. Oncologist 2022; 27:e133-e141. [PMID: 35641214 PMCID: PMC8895742 DOI: 10.1093/oncolo/oyab032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/24/2021] [Indexed: 11/14/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Rino S Seedor
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Jefferson Health, Philadelphia, PA, USA
| | - Caitlin R Meeker
- Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Bianca Lewis
- Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Kelly A Filchner
- Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Ramya Varadarajan
- Medical Oncology Hematology Consultants, Christiana Care Helen F. Graham Cancer Center & Research Institute, Newark, DE, USA
| | | | - Aruna Padmanabhan
- Medical Oncology Department, Fox Chase Cancer Center at Temple University Hospital, Philadelphia, PA, USA
| | - Benjamin Negin
- Southern Oncology Hematology Associates, Vineland, NJ, USA
| | | | - Neha R Chawla
- AtlantiCare Cancer Care Institute, Egg Harbor Township, NJ, USA
| | | | - Jessica Epstein
- Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jennifer Winn
- Medical Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Lori J Goldstein
- Medical Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Efrat Dotan
- Medical Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA
- Corresponding author: Efrat Dotan, MD, Department of Medical Oncology, 333 Cottman Avenue Fox Chase Cancer Center, Philadelphia, PA 19128, USA. Tel: +1 215 728 2500;
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Nicolas C, Balardy L, Antoine V, Albarède J, Azria D, Cristol L, Ferreira E, Gérard S, Jeandel C, Louit C, Tranier A, Ufkes R, Bauvin E, Morel C, Mourey L. Spreading geriatric oncology culture through professional caregivers: Results of a French massive open online course (MOOC). J Geriatr Oncol 2021; 13:94-99. [PMID: 34462239 DOI: 10.1016/j.jgo.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 11/19/2022]
Abstract
Geriatric oncology is based on the synergy between several professionals whose common goal is to improve care for older patients with cancer. This requires sharing a common core of knowledge to facilitate collaboration between them. To date, training in geriatric oncology has been limited in scope and difficult to access for caregivers, particularly nurses and healthcare aides. To meet this need, a massive open online course (MOOC), in geriatric oncology has been developed in France. This kind of course aims to provide simultaneous access for a large number of participants and to foster communication with the pedagogical team through discussion forums. The first session of the MOOC, which has been set up in the Occitania region of France, went online nationwide from March 6 to June 23, 2020. Despite the SARS CoV-2 global health crisis, 1020 people subscribed to the first session and 417 (40.9%) were certified at the end of the course. Most are nurses (35.2%) and work outside Occitania (56.3%). A survey revealed a high satisfaction level regarding relevance of lessons (97.9%), pedagogical quality of teaching team (97.9%), knowledge acquisition (93.6%), meeting learners' needs (90.4%) and practical value of the course (88.3%). This preliminary experience demonstrates the ability of this MOOC to spread the culture of geriatric oncology and the educational potential of this new type of online training.
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Affiliation(s)
- Charlotte Nicolas
- Réseau Régional de Cancérologie Onco-Occitanie, Toulouse, France; Coordination Unit for Geriatric Oncology (UCOG) Midi-Pyrenees, France.
| | - Laurent Balardy
- Coordination Unit for Geriatric Oncology (UCOG) Midi-Pyrenees, France; Departments of Geriatrics, Internal Medicine and Oncogeriatry Unit, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Valery Antoine
- Department of Geriatric Medicine, Centre Hospitalier Universitaire de Nîmes, Univ Montpellier, Nîmes, France; UA11 Institute Desbrest of Epidemiology and Public Health, INSERM, Univ Montpellier, Montpellier, France; Coordination Unit for Geriatric Oncology (UCOG) Languedoc-Roussillon, France
| | - Julie Albarède
- Réseau Régional de Cancérologie Onco-Occitanie, Toulouse, France; Coordination Unit for Geriatric Oncology (UCOG) Midi-Pyrenees, France
| | - David Azria
- Réseau Régional de Cancérologie Onco-Occitanie, Toulouse, France; Coordination Unit for Geriatric Oncology (UCOG) Languedoc-Roussillon, France; Department of Radiation Oncology, Institut du Cancer de Montpellier, Montpellier, France
| | - Laurence Cristol
- Coordination Unit for Geriatric Oncology (UCOG) Languedoc-Roussillon, France; Department of Geriatric Oncology, Institut du Cancer de Montpellier, Montpellier, France
| | - Ernestine Ferreira
- Coordination Unit for Geriatric Oncology (UCOG) Languedoc-Roussillon, France; Department of Geriatrics, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Stéphane Gérard
- Departments of Geriatrics, Internal Medicine and Oncogeriatry Unit, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Claude Jeandel
- Coordination Unit for Geriatric Oncology (UCOG) Languedoc-Roussillon, France; Department of Geriatrics, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Camille Louit
- Departments of Geriatrics, Internal Medicine and Oncogeriatry Unit, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Alexandrine Tranier
- Departments of Geriatrics, Internal Medicine and Oncogeriatry Unit, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Rosanne Ufkes
- Department of Geriatrics, Centre Hospitalier de Muret, Muret, France
| | - Eric Bauvin
- Réseau Régional de Cancérologie Onco-Occitanie, Toulouse, France
| | - Charlotte Morel
- Réseau Régional de Cancérologie Onco-Occitanie, Toulouse, France
| | - Loïc Mourey
- Coordination Unit for Geriatric Oncology (UCOG) Midi-Pyrenees, France; Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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Chapman AE, Elias R, Plotkin E, Lowenstein LM, Swartz K. Models of Care in Geriatric Oncology. J Clin Oncol 2021; 39:2195-2204. [PMID: 34043453 PMCID: PMC10476747 DOI: 10.1200/jco.21.00118] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 12/27/2022] Open
Affiliation(s)
- Andrew E. Chapman
- Department of Medical Oncology, Sidney Kimmel Cancer Center/Jefferson Health, Philadelphia, PA
| | - Rawad Elias
- Department of Medical Oncology, Hartford Healthcare Cancer Institute, Hartford, CT
| | - Elana Plotkin
- Provider Education, Association of Community Cancer Centers, Rockville, MD
| | - Lisa M. Lowenstein
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kristine Swartz
- Division of Geriatrics and Palliative Care, Department of Family and Community Medicine, Sidney Kimmel Medical College/Jefferson Health, Philadelphia, PA
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Nipp RD, Subbiah IM, Loscalzo M. Convergence of Geriatrics and Palliative Care to Deliver Personalized Supportive Care for Older Adults With Cancer. J Clin Oncol 2021; 39:2185-2194. [PMID: 34043435 PMCID: PMC8260927 DOI: 10.1200/jco.21.00158] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/07/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ryan D. Nipp
- Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Ishwaria M. Subbiah
- Department of Palliative, Rehabilitation and Integrative Medicine, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
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Dale W, Williams GR, R MacKenzie A, Soto-Perez-de-Celis E, Maggiore RJ, Merrill JK, Katta S, Smith KT, Klepin HD. How Is Geriatric Assessment Used in Clinical Practice for Older Adults With Cancer? A Survey of Cancer Providers by the American Society of Clinical Oncology. JCO Oncol Pract 2020; 17:336-344. [PMID: 33064058 DOI: 10.1200/op.20.00442] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE For patients with cancer who are older than 65 years, the 2018 ASCO Guideline recommends geriatric assessment (GA) be performed. However, there are limited data on providers' practices using GA. Therefore, ASCO's Geriatric Oncology Task Force conducted a survey of providers to assess practice patterns and barriers to GA. METHODS Cancer providers treating adult patients including those ≥ 65 years completed an online survey. Questions included those asking about awareness of ASCO's Geriatric Oncology Guideline (2018), use of validated GA tools, and perceived barriers to using GA. Descriptive statistics and statistical comparisons between those aware of the Guideline and those who were not were conducted. Statistical significance was set at P < .05. RESULTS Participants (N = 1,277) responded between April 5 and June 5, 2019. Approximately half (53%) reported awareness of the Guideline. The most frequently used GA tools, among those aware of the Guideline and those who were not, assessed functional status (69% v 50%; P < .001) and falls (62% v 45%; P < .001). Remaining tools were used < 50% of the time, including tools assessing weight loss, comorbidities, cognition, life expectancy, chemotherapy toxicity, mood, and noncancer mortality risk. GA use was two to four times higher among those who are aware of the Guideline. The most frequent barriers for those who reported being Guideline aware were lack of resources, specifically time (81.7%) and staff (77.0%). In comparison, those who were unaware of the Guideline most often reported the following barriers: lack of knowledge or training (78.4%), lack of awareness about tools (75.2%), and uncertainty about use of tools (75.0%). CONCLUSION Among providers caring for older adults, 52% were aware of the ASCO Guideline. Some domains were assessed frequently (eg, function, falls), whereas other domains were assessed rarely (eg, mood, cognition). Guideline awareness was associated with two to four times increased use of GA and differing perceived barriers. Interventions facilitating Guideline-consistent implementation will require various strategies to change behavior.
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Affiliation(s)
- William Dale
- City of Hope National Medical Center, Duarte, CA
| | | | | | | | | | | | - Sweatha Katta
- American Society of Clinical Oncology, Alexandria, VA
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20
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Never too old to learn new tricks: Surveying Canadian healthcare professionals about learning needs in caring for older adults with cancer. J Geriatr Oncol 2020; 12:262-273. [PMID: 32891617 DOI: 10.1016/j.jgo.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The number of older adults with cancer is growing but little is known about healthcare professionals' (HCPs) perceptions of their readiness to care for older adults with cancer. The Canadian Network on Aging and Cancer together with the Canadian Association of Nurses in Oncology, Oncology and Aging Special Interest Group, conducted a survey to assess geriatric oncology learning needs of Canadian HCPs and explore any differences in needs between nurses and physicians. METHODS An online survey was distributed to Canadian HCP, which assessed respondent confidence and desire to learn about domains related to geriatric oncology, current clinical practice and sociodemographic information. Descriptive statistics and chi-square tests were used to characterize participant characteristics, learning needs and compare learning needs of physicians vs. nurses. RESULTS Respondents (n = 154) were mostly physicians (n = 78, 51%) or nurses (n = 56, 36%). Respondents reported not being confident addressing mental health issues (75%), polypharmacy (71%), geriatric oncology care models (69%), and return to baseline function post-treatment (67%). Physicians reported more confidence than nurses in managing comorbidities (72% vs. 49%, p < 0.05), having difficult conversations (90% vs. 68%, p < 0.001), and addressing ageism (76% vs. 58%, p < 0.05), while nurses reported more confidence with managing mobility limitations (64% vs 42%, p < 0.05), fall prevention (72% vs. 26%, p < 0.01) and supporting caregivers (74% vs 52%, p < 0.05). Nurses wanted to learn more about geriatric oncology than physicians for 10 domains (p < 0.05). CONCLUSION There is a need for interprofessional educational initiatives that address differences between nurses and physicians in clinical areas of confidence and learning needs.
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21
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Hsu T, Soto-Perez-de-Celis E, Burhenn PS, Korc-Grodzicki B, Wildes TM, Kanesvaran R, Maggiore RJ. Educating healthcare providers in geriatric oncology – A call to accelerate progress through identifying the gaps in knowledge. J Geriatr Oncol 2020; 11:1023-1027. [DOI: 10.1016/j.jgo.2019.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/25/2019] [Indexed: 02/02/2023]
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22
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Hamaker ME, van Huis-Tanja LH, Rostoft S. Optimizing the geriatrician's contribution to cancer care for older patients. J Geriatr Oncol 2020; 11:389-394. [DOI: 10.1016/j.jgo.2019.06.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/28/2019] [Accepted: 06/26/2019] [Indexed: 12/20/2022]
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Rittberg R, Sutherland J, Huynh E, Green S, Wiens A, Stirling M, Dawe DE. Assessing the learning needs of the multidisciplinary team on geriatric oncology and frailty. J Geriatr Oncol 2019; 10:829-831. [DOI: 10.1016/j.jgo.2018.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/21/2018] [Accepted: 12/12/2018] [Indexed: 12/27/2022]
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24
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MacKenzie AR, Barsevick AM, Myers R, Hegarty SE, Keith SW, Patel S, Lapinsky E, Schoppe J, Williams U, Chapman AE. Treatment plan consistency with guidelines for older adults with cancer. J Geriatr Oncol 2019; 10:832-834. [DOI: 10.1016/j.jgo.2019.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
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25
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Puts M, Hsu T, Szumacher E, Dawe D, Fitch M, Jones J, Fulop T, Alibhai S, Strohschein F. Never too old to learn new tricks: surveying Canadian health care professionals about learning needs in caring for older adults with cancer. ACTA ACUST UNITED AC 2019; 26:71-72. [PMID: 31043803 DOI: 10.3747/co.26.4833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Cancer is the leading cause of death in Canada [...]
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Affiliation(s)
- M Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON
| | - T Hsu
- The Ottawa Hospital Cancer Centre and Department of Medicine, University of Ottawa, Ottawa, ON
| | - E Szumacher
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - D Dawe
- Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB.,Department of Internal Medicine, University of Manitoba, Winnipeg, MB
| | - M Fitch
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON.,Canadian Partnership Against Cancer, Toronto, ON
| | - J Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
| | - T Fulop
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC
| | - S Alibhai
- Medicine, Toronto General Hospital, University Health Network, Toronto, ON.,Faculty of Medicine and Institute of Health Management, Policy and Evaluation, University of Toronto, Toronto, ON
| | - F Strohschein
- Ingram School of Nursing, McGill University, Montreal, QC.,Oncology and Aging Special Interest Group, Canadian Association of Nurses in Oncology, Vancouver, BC
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Thillainadesan J, Ng L, Cunningham I, Wong Doo N, Naganathan V. Characteristics of older people in an inpatient haematology unit: A descriptive study. Australas J Ageing 2018; 37:293-299. [PMID: 29989278 DOI: 10.1111/ajag.12560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To characterise older inpatients in a haematology unit. METHODS Hospital case-mix data of haematology separations of all ages (n = 7419) and more extensive data restricted to older patients (age ≥75 years, n = 1025) were evaluated. RESULTS From 2000 to 2014, there was a 200% increase in those aged ≥85 years who were more likely to have a geriatric syndrome as the principal diagnosis (P < 0.05), have delirium (P < 0.05), receive less intensive treatment (P < 0.001) and be discharged to a nursing home (P < 0.001). Compared to younger inpatients, those aged ≥75 years were more likely to be emergency admissions (48% vs 37%, P < 0.001) and die during the admission (8% vs 4%, P < 0.001). CONCLUSION Haematologists care for older inpatients who are complex with multidisciplinary health service needs. There may be value in conducting comprehensive geriatric assessments in this setting.
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Affiliation(s)
- Janani Thillainadesan
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Ng
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Ilona Cunningham
- Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Concord Hospital, Sydney, New South Wales, Australia
| | - Nicole Wong Doo
- Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia
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Role of the geriatrician, primary care practitioner, nurses, and collaboration with oncologists during cancer treatment delivery for older adults: A narrative review of the literature. J Geriatr Oncol 2018; 9:398-404. [DOI: 10.1016/j.jgo.2018.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/09/2018] [Accepted: 04/25/2018] [Indexed: 12/20/2022]
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