Are the UK oncology trainees adequately informed about the needs of older people with cancer?

Kalsi, Tania; Payne, Susanna; Brodie, Hazel; Mansi, Janine; Wang, Yanzhong; Harari, Danielle

doi:10.1038/bjc.2013.204

Cited by 38 publications

(24 citation statements)

References 29 publications

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“…However, most medical oncologists have never received specific training on the particular needs of older people with cancer (Kalsi et al . ) and elderly patients have reported that their individual situation, including concurrent diseases and psychosocial status should receive more attention in the treatment decision‐making process (Bostkankervereniging Nederland ).…”

Section: Introductionmentioning

confidence: 99%

“…Tailoring of care is needed, based on a thorough evaluation of the patient's overall health status in addition to tumour characteristics and the patient's preferences. However, most medical oncologists have never received specific training on the particular needs of older people with cancer (Kalsi et al 2013) and elderly patients have reported that their individual situation, including concurrent diseases and psychosocial status should receive more attention in the treatment decision-making process (Bostkankervereniging Nederland 2012).…”

Section: Introductionmentioning

confidence: 99%

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Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists

Jonker

Smorenburg

Schiphorst

et al. 2014

Eur J Cancer Care (Engl)

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To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists

Jonker

Smorenburg

Schiphorst

et al. 2014

Eur J Cancer Care (Engl)

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“…Oncologists have also been found to have had limited preparation for the task. In a survey of 64 oncology trainees in the UK, two‐thirds (66%) had received no training in the needs of older people with cancer . Best practice in the assessment and supportive care of elderly people with dementia might usefully be adapted to the context of cancer care, facilitating treatment and aiding with the management of cancer symptoms and treatment side effects.…”

Section: Discussionmentioning

confidence: 99%

People with dementia: what is known about their experience of cancer treatment and cancer treatment outcomes? A systematic review

et al. 2016

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Objective: The objective of the study is to report a systematic review of what is currently known about the experience of cancer treatment and cancer treatment in adults with dementia.Methods: The analytic plan and inclusion/exclusion criteria were specified in advance of the search process in a protocol.Searches were conducted in MEDLINE, CINAHL, PsycINFO and the Cochrane Library for publications about people with cancer and a pre-existing dementia. Limits were English language; 2000 to 12/2015; adults; >18 years old.The search identified 5214 titles and abstracts that were assessed against eligibility criteria and 101 were selected for full-text examination by two researchers who agreed inclusion of nine papers, extracted data independently then conducted a content analysis and narrative synthesis.Results: Nine studies conducted in four resource rich countries were included in the review. These studies evidence that when compared with other cancer patients, those with dementia are diagnosed at a later stage, receive less treatment, are more likely to experience complications from treatment and have poorer survival.The experience of supportive care and preferences of people with dementia receiving cancer services and cancer treatment have not been investigated. Research into how the cancer team manage the particular needs of people with dementia and their family members has been limited to one study that reported how a cancer team managed the particular needs of seven people with dementia.Conclusion: Further work is needed to establish practice guidelines for the management of cancer in people with dementia.

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“…As displayed by this survey, in neuro oncology clinics this is yet to occur with 80% of respondents not performing a cognitive or frailty test routinely. The reasons for this are likely multifactorial including a lack of time and awareness [10] but a key aspect may be the lack of a standardised and well validated tool for this cohort. The need for geriatric assessment screening tools within neuro oncology is validated by the participants, 50% of whom who felt a screening assessment changed their decision making half of the time.…”

Section: Discussionmentioning

confidence: 99%

Glioblastoma in the elderly — How do we choose who to treat?

Lorimer¹,

Saran

Chalmers

et al. 2016

Journal of Geriatric Oncology

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Glioblastoma (GBM) is the commonest primary malignant brain tumour among the adult population. Incidence peaks in the 7 th and 8 th decades of life and as our global population ages, rates are increasing. GBM is an almost universally fatal disease with life expectancy in the range of 3-5 months amongst the elderly.The assessment of elderly GBM patients prior to treatment decisions is poorly researched and unstandardized. In order to begin tackling this issue we performed a cross-sectional survey across all UK based consultant neuro oncologists to review their current practice in assessing elderly GBM patients.There were 56 respondents from a total of 93 recipients (60% response rate). All respondents confirmed that at least some patients aged 70 or over were referred to their clinics from the local multidisciplinary team meeting (MDT). Only 18% of consultants routinely performed a cognitive or frailty screening test at initial consultation. Of those who performed a screening test, the majority reported that the results of the test changed their treatment decision in approximately 50% of cases. Participants ranked performance status as the most important factor in determining treatment decisions.Considering the heterogeneity of this patient population, we argue that performance status is a crude measure of vulnerability within this cohort. Elderly GBM patients represent a unique clinical scenario because of the complexity of distinguishing neuro oncology related symptoms from general frailty. There is a need for specific geriatric assessment models tailored to the elderly neuro oncology population in order to facilitate treatment decisions.

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Are the UK oncology trainees adequately informed about the needs of older people with cancer?

Cited by 38 publications

References 29 publications

Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists

Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists

People with dementia: what is known about their experience of cancer treatment and cancer treatment outcomes? A systematic review

Glioblastoma in the elderly — How do we choose who to treat?

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