1
|
O’Sullivan CC, Vierkant RA, Larson NL, Smith ML, Chauhan C, Couch FJ, Olson JE, D’Andre S, Jatoi A, Ruddy KJ. Advocate-BREAST80+: A Comprehensive Patient and Advocate-Led Study to Enhance Breast Cancer Care Delivery and Patient-Centered Research in Women Aged ≥80 Years. Cancers (Basel) 2024; 16:2494. [PMID: 39061134 PMCID: PMC11274918 DOI: 10.3390/cancers16142494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/26/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥80 years (P80+). Identifying and addressing unmet needs are critical. AIMS Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80-). METHODS In 12/2021, a REDCap survey was electronically circulated to 6918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care. RESULTS Overall, 2437 participants responded (35% response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80- (p < 0.01). Notably, P80+ were significantly less satisfied with information about the short and long-term side effects of BC therapies and managing toxicities. P80+ were also less likely to have participated in a clinical trial (p < 0.001) or to want to do so in the future (p = 0.0001). CONCLUSIONS Although P80+ experienced less anxiety and symptom-related distress compared with P80-, they were significantly less satisfied with information regarding the side effects of BC therapies and their management. P80+ were significantly less likely to have participated in a clinical trial or be open to considering this option. Future studies should address educational needs pertaining to side effects and barriers to research participation in P80+.
Collapse
Affiliation(s)
- Ciara C. O’Sullivan
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (S.D.); (A.J.); (K.J.R.)
| | - Robert A. Vierkant
- Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (R.A.V.); (N.L.L.); (J.E.O.)
| | - Nicole L. Larson
- Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (R.A.V.); (N.L.L.); (J.E.O.)
| | - Mary Lou Smith
- Research Advocacy Network, Plano, TX 75093, USA;
- Patient Advocate, Mayo Clinic Breast Cancer Specialized Program of Research Excellence (SPORE), Mayo Clinic, Rochester, MN 55905, USA;
| | - Cynthia Chauhan
- Patient Advocate, Mayo Clinic Breast Cancer Specialized Program of Research Excellence (SPORE), Mayo Clinic, Rochester, MN 55905, USA;
| | - Fergus J. Couch
- Department of Experimental Pathology & Laboratory Medicine, Mayo Clinic, Rochester, MN 55905, USA;
| | - Janet E. Olson
- Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (R.A.V.); (N.L.L.); (J.E.O.)
| | - Stacy D’Andre
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (S.D.); (A.J.); (K.J.R.)
| | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (S.D.); (A.J.); (K.J.R.)
| | - Kathryn J. Ruddy
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (S.D.); (A.J.); (K.J.R.)
| |
Collapse
|
2
|
Strohschein FJ, Qi S, Davidson S, Link C, Watson L. A Retrospective Age Analysis of the Ambulatory Oncology Patient Satisfaction Survey: Differences in Satisfaction across Dimensions of Person-Centred Care and Unmet Needs among Older Adults Receiving Cancer Treatment. Curr Oncol 2024; 31:1483-1503. [PMID: 38534946 PMCID: PMC10969488 DOI: 10.3390/curroncol31030113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 05/26/2024] Open
Abstract
Over half of all new cancer cases in Alberta are diagnosed among people aged 65+ years, a group that encompasses vast variation. Patient-reported experience measures are routinely collected within Cancer Care Alberta; however, the specific consideration of the needs and concerns of older Albertans with cancer is lacking. In 2021, 2204 adults who had received treatment at a cancer centre in Alberta completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS). In this study, we explored the age differences in satisfaction across six dimensions of person-centred care and in the proportions of unmet needs across eight types of issues, with specific attention to older adults. Using three age groups (18-39, 40-64, 65+), only the physical comfort dimension showed significantly lower satisfaction among those aged 65+ years. Using five age groups (18-39, 40-64, 65-74, 75-84, 85+), significantly lower levels of satisfaction were found related to 'physical comfort' for those aged 65-74 and 75-84, 'coordination and continuity of care' for those aged 75-84 and 85+, and 'information, communication, and education' for those aged 85+. Therefore, grouping together all older adults aged 65+ years obscured lower levels of satisfaction with some dimensions of person-centred care among those aged 75-84 and 85+ years. Unmet needs generally increased with age for all types of issues, with significant differences across age groups for emotional, financial, social/family, and sexual health issues. The lower levels of satisfaction and higher proportions of unmet needs call for tailored interventions to promote optimal care experiences and outcomes among older adults receiving cancer care in Alberta and their families.
Collapse
Affiliation(s)
- Fay J. Strohschein
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Siwei Qi
- Applied Research & Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Claire Link
- Applied Research & Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Linda Watson
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Applied Research & Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| |
Collapse
|
3
|
Galve-Calvo E, Alonso-Babarro A, Martínez-García M, Pi-Figueras M, Villalba G, Alonso S, Contreras J. Narrative Review of Multidisciplinary Management of Central Nervous Involvement in Patients with HER2-Positive Metastatic Breast Cancer: Focus on Elderly Patients. Adv Ther 2023; 40:3304-3331. [PMID: 37291377 DOI: 10.1007/s12325-023-02538-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/10/2023]
Abstract
The tumor biology of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) promotes the development of central nervous system (CNS) metastases, with 25% of patients with HER2-positive BC developing CNS metastases. Furthermore, the incidence of HER2-positive BC brain metastases has increased in the last decades, likely because of the improved survival with targeted therapies and better detection methods. Brain metastases are detrimental to quality of life and survival and represent a challenging clinical problem, particularly in elderly women, who comprise a substantial proportion of patients diagnosed with BC and often have comorbidities or an age-related decline in organ function. Treatment options for patients with BC brain metastases include surgical resection, whole-brain radiation therapy, stereotactic radiosurgery, chemotherapy, and targeted agents. Ideally, local and systemic treatment decisions should be made by a multidisciplinary team, with input from several specialties, based on an individualized prognostic classification. In elderly patients with BC, additional age-associated conditions, such as geriatric syndromes or comorbidities, and the physiologic changes associated with aging, may impact their ability to tolerate cancer therapy and should be considered in the treatment decision-making process. This review describes the treatment options for elderly patients with HER2-positive BC and brain metastases, focusing on the importance of multidisciplinary management, the different points of view from the distinct disciplines, and the role of oncogeriatric and palliative care in this vulnerable patient group.
Collapse
Affiliation(s)
- Elena Galve-Calvo
- Medical Oncology Service, Hospital Universitario Basurto (OSI Bilbao-Basurto), Avda. Montevideo 18, 48013, Bilbao, Bisczy, Spain.
| | | | | | | | | | | | - Jorge Contreras
- Radiation Oncology Department, Hospital Carlos Haya, Málaga, Spain
| |
Collapse
|
4
|
Retrospective analysis of VES-13 questionnaires in the Senior Women's Breast Cancer Clinic at Sunnybrook Health Sciences, Toronto, Ontario, Canada. J Geriatr Oncol 2022; 13:541-544. [DOI: 10.1016/j.jgo.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/08/2021] [Accepted: 01/10/2022] [Indexed: 11/21/2022]
|
5
|
Zereshkian A, Forman J, Menjak I, Mehta R, Bristow B, Trudeau M, Gibson L, Neve MV, Norris M, Pasetka M, Wright FW, Rice K, McCullock F, Karim A, Szumacher E. Assessment of communication gaps among referring physicians and the multi-disciplinary team at the senior women breast Cancer clinic (SWBCC), Sunnybrook health sciences Centre, Toronto, Ontario, Canada. J Geriatr Oncol 2020; 12:676-679. [PMID: 33071212 DOI: 10.1016/j.jgo.2020.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Arman Zereshkian
- Undergraduate Medical Education, University of Toronto, Toronto, Ontario, Canada
| | - Jamie Forman
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Ines Menjak
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Rajin Mehta
- Department of Geriatric Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Bonnie Bristow
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Maureen Trudeau
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Leslie Gibson
- Department of Occupational Therapy Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Matthew V Neve
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mireille Norris
- Department of Geriatric Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mark Pasetka
- Department of Pharmacy Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Frances W Wright
- Department of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Katie Rice
- Department of Social Work, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Fiona McCullock
- Department of Nursing, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | | | - Ewa Szumacher
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada.
| |
Collapse
|
6
|
Overcash J, Ford N, Kress E, Ubbing C, Williams N. Comprehensive Geriatric Assessment as a Versatile Tool to Enhance the Care of the Older Person Diagnosed with Cancer. Geriatrics (Basel) 2019; 4:geriatrics4020039. [PMID: 31238518 PMCID: PMC6630523 DOI: 10.3390/geriatrics4020039] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/14/2019] [Accepted: 06/20/2019] [Indexed: 12/27/2022] Open
Abstract
The comprehensive geriatric assessment (CGA) is a versatile tool for the care of the older person diagnosed with cancer. The purpose of this article is to detail how a CGA can be tailored to Ambulatory Geriatric Oncology Programs (AGOPs) in academic cancer centers and to community oncology practices with varying levels of resources. The Society for International Oncology in Geriatrics (SIOG) recommends CGA as a foundation for treatment planning and decision-making for the older person receiving care for a malignancy. A CGA is often administered by a multidisciplinary team (MDT) composed of professionals who provide geriatric-focused cancer care. CGA can be used as a one-time consult for surgery, chemotherapy, or radiation therapy providers to predict treatment tolerance or as an ongoing part of patient care to manage malignant and non-malignant issues. Administrative support and proactive infrastructure planning to address scheduling, referrals, and provider communication are critical to the effectiveness of the CGA.
Collapse
Affiliation(s)
- Janine Overcash
- The College of Nursing, The Ohio State University, 1585 Neil Ave, Newton Hall, Columbus, OH 43201, USA.
| | - Nikki Ford
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| | - Elizabeth Kress
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| | - Caitlin Ubbing
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| | - Nicole Williams
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| |
Collapse
|
7
|
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]
|