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Cancers
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Treatment Outcomes in Older Adults with Cancer
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Treatment Outcomes in Older Adults with Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 8059

Special Issue Editor

Dr. Mackenzi Pergolotti

E-Mail Website
Guest Editor
ReVital Cancer Rehabilitation, Mechanicsburg, PA, USA
Interests: cancer rehabilitation; occupational; physical and speech therapy; function; cancer-related cognitive decline; physical function; physical health; health related quality of life; patient reported measure and scale development

Special Issue Information

Dear Colleagues,

Cancer is a disease that presents during aging. By 2030, more that 70% of adults with cancer will be over the age of 65. Many older adults can have complex healthcare needs at time of diagnosis, including comorbid conditions and pre-existing physical or cognitive impairments, a decreased functional ability and an increased risk of falling. This puts older adults at a disadvantage as they prepare to recover from cancer treatment. Yet, aging is a heterogenous process, and in some cases, older adults are quite robust, but due to their age and potential ageism, they do not receive proper treatment. Gaps in understanding the treatment outcomes of older adults with cancer and the impact of supportive services to address the needs of this population remain. This Special Issue will highlight outcomes in older adults with cancer, covering innovative models, approaches and results in cancer treatment and the impact of supportive services.

Dr. Mackenzi Pergolotti
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • older adults with cancer
  • geriatric oncology
  • geriatric assessment
  • supportive care
  • palliative care
  • cancer rehabilitation
  • nutrition
  • physical activity
  • functional status
  • survivorship

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Published Papers (5 papers)

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Research

14 pages, 895 KiB  
Article
Characteristics, Treatment and Outcomes of Stage I to III Colorectal Cancer in Patients Aged over 80 Years Old
by Melissa R. Yeo and Ioannis A. Voutsadakis
Cancers 2025, 17(2), 247; https://doi.org/10.3390/cancers17020247 - 14 Jan 2025
Viewed by 861
Abstract
Background: Colorectal cancer primarily affects older adults and poses treatment challenges due to age-related comorbidities and frailty, which hinder surgical and chemotherapy options for many elderly patients. This study aims to analyze treatment and disease patterns in elderly colorectal cancer patients, aged over [...] Read more.
Background: Colorectal cancer primarily affects older adults and poses treatment challenges due to age-related comorbidities and frailty, which hinder surgical and chemotherapy options for many elderly patients. This study aims to analyze treatment and disease patterns in elderly colorectal cancer patients, aged over 80 years old, to inform personalized therapies that accommodate their unique clinical needs and improve their outcomes. Patients and Methods: The medical records of all patients aged 80 years old and above, and those aged 65 to 75 years old, who were diagnosed with colorectal cancer at a cancer center in Canada over a seven year period, were retrospectively reviewed. Results: No significant differences in the initial presentation, location, grade or stage at colorectal cancer diagnosis were observed between age groups. Patients aged 80 years old and above were less likely to receive neoadjuvant and adjuvant chemotherapy treatments for stage II disease (19.2% versus. 58.6%, p = 0.002; 7.9% versus. 40.0%, p = 0.002). There were also differences in the intensity of chemotherapy received and the frequency of dose reductions (76.0% vs. 10.0%, p = 0.0001), neoadjuvant and adjuvant radiation therapy (34.6% vs. 65.5%, p = 0.02) and surgical management (83.7% vs. 95.3%, p = 0.006). Despite these differences in treatments, recurrence rates were not statistically significant between the two groups. However, overall survival was reduced in the older age group. Conclusions: Treatment plans for patients aged 80 years old and above should be tailored to the patient’s colorectal cancer presentation, comorbidity status and life expectancy, weighing the impact of cancer treatments on the patient’s short- and long-term outcomes. Full article
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
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35 pages, 915 KiB  
Article
Advocate-BREAST80+: A Comprehensive Patient and Advocate-Led Study to Enhance Breast Cancer Care Delivery and Patient-Centered Research in Women Aged ≥80 Years
by Ciara C. O’Sullivan, Robert A. Vierkant, Nicole L. Larson, Mary Lou Smith, Cynthia Chauhan, Fergus J. Couch, Janet E. Olson, Stacy D’Andre, Aminah Jatoi and Kathryn J. Ruddy
Cancers 2024, 16(14), 2494; https://doi.org/10.3390/cancers16142494 - 9 Jul 2024
Viewed by 1372
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 [...] Read more.
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+. Full article
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
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11 pages, 400 KiB  
Article
Pre-Frailty and Frailty in Hospitalized Older Adults: A Comparison Study in People with and without a History of Cancer in an Acute Medical Unit
by Chad Yixian Han, Raymond Javan Chan, Huah Shin Ng, Yogesh Sharma, Alison Yaxley, Claire Baldwin and Michelle Miller
Cancers 2024, 16(12), 2212; https://doi.org/10.3390/cancers16122212 - 13 Jun 2024
Cited by 1 | Viewed by 1216
Abstract
A prospective observational study was conducted in a cohort of older adults ≥65 years (n = 329), admitted to the acute medical unit (AMU) of a tertiary hospital, to describe and compare characteristics including frailty status and clinical outcomes. Multivariable models compared [...] Read more.
A prospective observational study was conducted in a cohort of older adults ≥65 years (n = 329), admitted to the acute medical unit (AMU) of a tertiary hospital, to describe and compare characteristics including frailty status and clinical outcomes. Multivariable models compared older adults with and without a history of cancer to determine characteristics associated with frailty and pre-frailty. An adjusted Poisson regression model was used to compare the length of hospital stay (LOS) between the two groups. About one-fifth (22%) of the cohort had a history of cancer. The most common cancer types were prostate (n = 20), breast (n = 13), lung (n = 8) and gastrointestinal (n = 8). There was no difference in the prevalence of pre-frailty/frailty among patients with or without a history of cancer (58% vs. 57%, p > 0.05). Pre-frailty/frailty was associated with polypharmacy (OR 8.26, 95% CI: 1.74 to 39.2) and malnutrition (OR 8.91, 95% CI: 2.15 to 36.9) in patients with a history of cancer. Adjusted analysis revealed that the risk of having a longer LOS was 24% higher in older adults with a history of cancer than those without (IRR 1.24, 95% CI 1.10 to 1.41, p < 0.001). Clinicians in the AMU should be aware that older adults with a history of cancer have a higher risk of a longer LOS compared to those without. Full article
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
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14 pages, 771 KiB  
Article
Exploring the Language Used to Describe Older Patients at Multidisciplinary Cancer Conferences
by Valerie S. Kim, Anthony Carrozzi, Efthymios Papadopoulos, Isabel Tejero, Thirisangi Thiruparanathan, Nathan Perlis, Andrew J. Hope, Raymond W. Jang and Shabbir M. H. Alibhai
Cancers 2024, 16(8), 1477; https://doi.org/10.3390/cancers16081477 - 12 Apr 2024
Cited by 1 | Viewed by 1303
Abstract
Older adults with cancer often present with distinct complexities that complicate their care, yet the language used to discuss their management at multidisciplinary cancer conferences (MCCs) remains poorly understood. A mixed methods study was conducted at a tertiary cancer centre in Toronto, Canada, [...] Read more.
Older adults with cancer often present with distinct complexities that complicate their care, yet the language used to discuss their management at multidisciplinary cancer conferences (MCCs) remains poorly understood. A mixed methods study was conducted at a tertiary cancer centre in Toronto, Canada, where MCCs spanning five tumour sites were attended over six months. For presentations pertaining to a patient aged 75 or older, a standardized data collection form was used to record their demographic, cancer-related, and non-cancer-related information, as well as the presenter’s specialty and training level. Descriptive statistics and thematic analysis were employed to explore MCC depictions of older patients (n = 75). Frailty status was explicitly mentioned in 20.0% of presentations, but discussions more frequently referenced comorbidity burden (50.7%), age (33.3%), and projected treatment tolerance (30.7%) as surrogate measures. None of the presentations included mentions of formal geriatric assessment (GA) or validated frailty tools; instead, presenters tended to feature select GA domains and subjective descriptions of appearance (“looks to be fit”) or overall health (“relatively healthy”). In general, MCCs appeared to rely on age-focused language that may perpetuate ageism. Further work is needed to investigate how frailty and geriatric considerations can be objectively incorporated into discussions in geriatric oncology. Full article
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
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22 pages, 951 KiB  
Article
Predictors of Survival, Treatment Modalities, and Clinical Outcomes of Diffuse Large B-Cell Lymphoma in Patients Older Than 70 Years Still an Unmet Medical Need in 2024 Based on Real-World Evidence
by Luís Alberto de Pádua Covas Lage, Rita Novello De Vita, Lucas Bassolli de Oliveira Alves, Mayara D’Auria Jacomassi, Hebert Fabrício Culler, Cadiele Oliana Reichert, Fábio Alessandro de Freitas, Vanderson Rocha, Sheila Aparecida Coelho Siqueira, Renata de Oliveira Costa and Juliana Pereira
Cancers 2024, 16(8), 1459; https://doi.org/10.3390/cancers16081459 - 11 Apr 2024
Cited by 3 | Viewed by 2505
Abstract
Background: Diffuse large B-cell lymphoma (DLBCL) especially affects the older population. Old (≥60 years) and very old age (≥80 years) DLBCL patients often present high-risk molecular alterations, lower tolerability to conventional immunochemotherapy, and poor clinical outcomes. In this scenario, attenuated therapeutic strategies, such [...] Read more.
Background: Diffuse large B-cell lymphoma (DLBCL) especially affects the older population. Old (≥60 years) and very old age (≥80 years) DLBCL patients often present high-risk molecular alterations, lower tolerability to conventional immunochemotherapy, and poor clinical outcomes. In this scenario, attenuated therapeutic strategies, such as the R-MiniCHOP and R-MiniCHOP of the elderly regimens, have emerged for this particularly fragile population. However, the responses, clinical outcomes, and toxicities of these regimens currently remain poorly understood, mainly because these individuals are not usually included in controlled clinical trials. Methods: This retrospective, observational, and single-center real-world study included 185 DLBCL, NOS patients older than 70 years treated at the largest oncology center in Latin America from 2009 to 2020. We aimed to assess the outcomes, determine survival predictors, and compare responses and toxicities between three different primary therapeutic strategies, including the conventional R-CHOP regimen and the attenuated R-MiniCHOP and R-MiniCHOP of the elderly protocols. Results: The median age at diagnosis was 75 years (70–97 years), and 58.9% were female. Comorbidities were prevalent, including 19.5% with immobility, 28.1% with malnutrition, and 24.8% with polypharmacy. Advanced clinical stage was observed in 72.4%, 48.6% had bulky disease ≥7 cm, 63.2% had B-symptoms, and 67.0% presented intermediate–high/high-risk IPI. With a median follow-up of 6.3 years, the estimated 5-year OS and PFS were 50.2% and 44.6%, respectively. The R-MiniCHOP of the elderly regimen had a lower ORR (p = 0.040); however, patients in this group had higher rates of unfavorable clinical and laboratory findings, including hypoalbuminemia (p = 0.001), IPI ≥ 3 (p = 0.013), and NCCN-IPI ≥ 3 (p = 0.002). Although associated with higher rates of severe neutropenia (p = 0.003), the R-CHOP regimen promoted increased OS (p = 0.003) and PFS (p = 0.005) in comparison to the attenuated protocols. Additionally, age ≥ 75 years, high levels of LDH, B-symptoms, advanced clinical stage (III/IV), neutrophilia, and low lymphocyte/monocyte ratio were identified as poor prognostic factors in this cohort. Conclusions: In this large and real-life Latin American cohort, we demonstrated that patients with DLBCL, NOS older than 70 years still do not have satisfactory clinical outcomes in 2024, with half of cases not reaching 5 years of life expectancy after diagnosis. Although the conventional R-CHOP offers response and survival advantages over attenuated regimens, its myelotoxicity is not negligible. Therefore, the outcomes reported and the prognostic factors here identified may assist clinicians in the appropriate selection of therapeutic strategies adapted to the risk for old and very old DLBCL patients. Full article
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
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