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Presented by Prof Lore Decoster, medical oncologist (UZ Brussels) and board member and Belgian representative of the International Society of Geriatric Oncology
Two studies were presented, addressing patient preferences in the context of oncology treatment. Elderly cancer patients often prioritize factors beyond mere survival, such as maintaining independence and alleviating symptoms. This inclination is particularly pronounced among individuals with already some degree of functional dependency or lacking an extensive social support network.
In a cross-sectional study aimed at elucidating patient priorities, all newly diagnosed patients attending the geriatric oncology clinic completed a survey featuring open-ended questions. Despite the inherent challenges of analyzing responses to open-ended inquiries, it was disclosed that the foremost priorities of older cancer patients were their family, followed by independence, and thirdly, their QoL. Notably, survival did not emerge as a predominant priority.
In another study, a serious illness guide was employed to facilitate discussions between healthcare providers and patients, aiming to ascertain patient priorities in their cancer treatment. Once again, the primary concerns for these patients were QoL and the preservation of functional independence. Based on these findings, one-third of the patients in this study received adaptations to their treatment protocols, deviating from the standard of care based on their personalized priorities. This highlights the potential impact of discussing priorities with patients on the ultimate treatment decisions.
Engaging in open discussions with patients holds significant importance in managing expectations and exploring therapeutic options. In this context, the integration of a geriatric assessment for patients proves valuable. The G-oncoCOACH study demonstrates that a geriatric assessment, encompassing various biological parameters alongside discussions about functional and geriatric issues, provides a comprehensive view of the patient’s true health status and enhances overall communication. Enhanced insight into the patient’s health status and improved communication regarding priorities could, in turn, influence treatment decisions.
References:
Mac Eochagain, Colm et al. (2023) “What matters to you?” Patient-reported treatment goals in geriatric oncology: A cross-sectional survey. Journal of Geriatric Oncology, Volume 0, Issue 0, 101641
Sedhom R. et al. (2023) Goals, Values, and Priorities of Older Adults with Cancer in a Community Practice. Journal of Geriatric Oncology, Volume 14, Issue 8, S8
Kenis, C. et al. (2023) RCT for CGA effectiveness on QoL in older patients with solid tumors + systemic therapy: G-oncoCOACH. Journal of Geriatric Oncology, Volume 14, Issue 8, S6 – S7