Special Issue "Oncology Care and Research in the Elderly"

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (30 May 2018) | Viewed by 26884

Special Issue Editor

Dr. Doris Y. P. Leung
E-Mail Website
Guest Editor
School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
Interests: palliative and end-of-life care; geriatric oncology; educational and health psychology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The cancer burden continues to rise globally, especially in the elderly, as incidence rates increase with age for most cancers. Although many cancer prevention interventions have been implemented, many older people still engage in cancer-related risky behaviors and do not take cancer preventive measures as recommended. Reports have also demonstrated that older people are more likely to be diagnosed with cancer via an emergency hospital visit rather than recognizing symptoms and actively seeking medical support at an early stage. The increasing number of cancer patients and survivors with long lifespans, and the high cost of cancer treatments, have also shifted cancer care from the hospital to the community, leading to an unprecedented dependence on career support for high quality care.

This Special Issue welcomes submissions that focus on identifying personal, social and environmental factors in changing cancer-related risky behaviors, promoting cancer preventive measures, raising awareness of cancer symptoms and supporting caregiving in cancer, and develop and test evidence-based interventions to inform the best practice of prevention and supportive care in cancer among older adults. This Special Issue provides an open access opportunity to publish research articles, reviews, opinions, letters, and case reports to this important filed of research. It is hope that this Special Issue will advance our understanding of cancer prevention and care in older adults and help identify effective strategies to reduce the cancer burden and promote better quality care.

Dr. Doris Y.P. Leung
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 short 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. Geriatrics 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 1400 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

  • Cancer Screening
  • Cancer Prevention
  • Lifestyle
  • Cancer Information seeking behaviors
  • Cancer Information scanning behaviors
  • Carer
  • Evidence-based interventions in cancer care
  • Palliative care in cancer
  • Supportive care in cancer
  • Rehabilitation
  • Cancer survivors

Published Papers (7 papers)

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Research

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Communication
Optimising Clinical Trial Design in Older Cancer Patients
Geriatrics 2018, 3(3), 34; https://doi.org/10.3390/geriatrics3030034 - 22 Jun 2018
Cited by 15 | Viewed by 3601
Abstract
Cancer is predominantly a disease of older patients, with over half of those aged over 65 years of age being diagnosed with cancer at some stage. Despite comprising a significant proportion of the patients that we see in clinical practice, there is a [...] Read more.
Cancer is predominantly a disease of older patients, with over half of those aged over 65 years of age being diagnosed with cancer at some stage. Despite comprising a significant proportion of the patients that we see in clinical practice, there is a lack of representation of older patients in cancer clinical trials. This is mainly due to restrictive trial inclusion criteria that prevent older patients from participating. Also, trial endpoints, such as overall survival, may not represent the most important and most meaningful endpoints for older patients. The latter may place more significance on quality of life and other outcomes such as functional independence. Baseline assessment using Comprehensive Geriatric Assessment, may provide a better framework for quantifying patient outcomes for varying degrees of fitness or frailty. This short communication makes the case for more age appropriate endpoints, such as quality of life, toxicity and functional independence, and that novel trial designs are necessary to inform evidence-based care of older cancer patients. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)
Article
“Sacred Work”: Reflections on the Professional and Personal Impact of an Interdisciplinary Palliative Oncology Clinical Experience by Social Work Learners
Geriatrics 2018, 3(1), 6; https://doi.org/10.3390/geriatrics3010006 - 03 Feb 2018
Cited by 2 | Viewed by 3255
Abstract
This study explored the impact of an oncology palliative care clinical experience with older adults on social work learners. A three-member research team conducted a qualitative content analysis of reflective writings. 27 Master of Science in Social Work students enrolled in an interprofessional [...] Read more.
This study explored the impact of an oncology palliative care clinical experience with older adults on social work learners. A three-member research team conducted a qualitative content analysis of reflective writings. 27 Master of Science in Social Work students enrolled in an interprofessional palliative oncology curriculum and completed a reflective writing assignment to summarize the clinical scenario, analyze the patient/family care provided, and describe the impact of the experience. Using a constant comparison approach based on grounded theory, the research team analyzed the reflections to come to consensus related to the overall impact of the experience. Two overarching themes (professional and personal impact) and 11 subthemes (appreciation of interdisciplinary teams, recognition of clinical skills of other disciplines, insight into clinical skills of the social worker, perception of palliative care, embracing palliative care principles, centrality of communication, importance of social support, family as the unit of care, countertransference, conflict between personal values and patient/family values, and emotional reactions) were identified. Experiential learning opportunities for social work learners in interprofessional palliative care build appreciation for and skills in applying palliative care principles including teamwork, symptom control, and advanced care planning along with a commitment to embrace these principles in future practice. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)
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Article
Factors Influencing Global Health Related Quality of Life in Elderly Cancer Patients: Results of a Secondary Data Analysis
Geriatrics 2018, 3(1), 5; https://doi.org/10.3390/geriatrics3010005 - 30 Jan 2018
Cited by 10 | Viewed by 4312
Abstract
Cancer treatment for elderly patients is often complicated by poor physical condition, impaired functioning and comorbidities. Patient reported health related quality of life (HRQOL) can contribute to decisions about treatment goals and supportive therapy. Knowledge about factors influencing HRQOL is therefore needed for [...] Read more.
Cancer treatment for elderly patients is often complicated by poor physical condition, impaired functioning and comorbidities. Patient reported health related quality of life (HRQOL) can contribute to decisions about treatment goals and supportive therapy. Knowledge about factors influencing HRQOL is therefore needed for the development of supportive measures and care pathways. An exploratory secondary data analysis on 518 assessments of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC QLQ-C30) and the elderly module (EORTC QLQ-ELD14) was performed to identify factors predictive for global HRQOL. Preliminary simple and multivariable regression analyses were conducted resulting in a final model comprising sociodemographic and disease specific variables and scales of the QLQ-C30 and QLQ-ELD14. Age, sex and disease related variables explained only part of the variance of global HRQOL (adjusted R2 = 0.203). In the final model (adjusted R2 = 0.504) fatigue, social function, burden of illness and joint stiffness showed possible influence on global HRQOL. Fatigue, social function and burden of illness seem to have the largest impact on global HRQOL of elderly cancer patients. Further prospective studies should examine these domains. Actionable symptoms should be given special attention to initiate targeted supportive measures aiming to maximize HRQOL of older cancer patients. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)
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Article
Cancer-Related Information Seeking and Scanning Behaviors among Older Chinese Adults: Examining the Roles of Fatalistic Beliefs and Fear
Geriatrics 2017, 2(4), 38; https://doi.org/10.3390/geriatrics2040038 - 03 Dec 2017
Cited by 9 | Viewed by 3577
Abstract
Effective communication in health information plays an important role in health promotion and cancer prevention. Cancer-related information acquisition can happen via active and purposeful seeking, but may also happen less purposely via the routine use of media and interactions with other people (called [...] Read more.
Effective communication in health information plays an important role in health promotion and cancer prevention. Cancer-related information acquisition can happen via active and purposeful seeking, but may also happen less purposely via the routine use of media and interactions with other people (called scanning). We examined seeking and scanning behaviors regarding cancer prevention in older Chinese adults, identified commonly used sources of information of such behaviors, and examined their associations with fatalistic beliefs and cancer fear. A convenience sample of 224 community-dwelling adults aged ≥60 were recruited between May and July in 2013 in Hong Kong. Results suggested that cancer information scanning (79.5%) was more common than information seeking (30.4%) among our participants. Health professional was the most popular source for both scanning (78.7%) and seeking (58.8%) behaviors regarding cancer information. Fatalistic beliefs was significantly and negatively associated with seeking behaviors (OR = 0.50) but not scanning behaviors, and cancer fear showed no relationship with either behavior. This study shows that the cancer information seeking and scanning behaviors were still suboptimal in this age group and adds to the knowledge regarding the associations between fatalistic beliefs and fear with cancer information seeking and scanning behaviors among older Chinese adults. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)
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Communication
A Continuing Mission to Optimize the Care of Older Women with Breast Cancer
Geriatrics 2017, 2(4), 37; https://doi.org/10.3390/geriatrics2040037 - 20 Nov 2017
Viewed by 3009
Abstract
The majority of cases of breast cancer occur in the older population who are often un-represented in clinical trials. Given the growing ageing population globally, it becomes urgent and important to identify an optimal approach so that older women with breast cancer are [...] Read more.
The majority of cases of breast cancer occur in the older population who are often un-represented in clinical trials. Given the growing ageing population globally, it becomes urgent and important to identify an optimal approach so that older women with breast cancer are neither under- or over-treated. An inter-disciplinary research program is ongoing to investigate differing tumor biology according to age, and the potential use of a geriatric assessment tool, aiming to help select older women with primary breast cancer for a personalized and optimal treatment. Full considerations of the biology of the patient’s cancer and the geriatric domains of the patient must be taken into account when making treatment decisions. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)

Review

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Review
The Management of Older Adults with Pancreatic Adenocarcinoma
Geriatrics 2018, 3(4), 85; https://doi.org/10.3390/geriatrics3040085 - 26 Nov 2018
Cited by 2 | Viewed by 3556
Abstract
Pancreatic cancer is the eleventh most common cancer, yet it is the third leading cause of mortality. It is also largely a disease of older adults, with the median age of 71 at diagnosis in the US, with <1% of diagnoses occurring prior [...] Read more.
Pancreatic cancer is the eleventh most common cancer, yet it is the third leading cause of mortality. It is also largely a disease of older adults, with the median age of 71 at diagnosis in the US, with <1% of diagnoses occurring prior to age 50. Current NCCN guidelines recommend surgery for localized disease, followed by adjuvant therapy and/or consideration of enrollment in a clinical trial. For metastatic disease, current guidelines recommend clinical trial enrollment or systemic chemotherapy based on results from the landmark ACCORD-11 and MPACT trials. However, these trials focused heavily on younger, more fit patients, with the ACCORD-11 trial excluding patients over age 75 and the MPACT trial having 92% of its patients with a Karnofsky performance score >80. This article summarizes the available evidence in current literature in regards to the best treatment options for older adults, who represent the majority of pancreatic cancer diagnoses. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)
Review
Advance Care Planning for Older People with Cancer and Its Implications in Asia: Highlighting the Mental Capacity and Relational Autonomy
Geriatrics 2018, 3(3), 43; https://doi.org/10.3390/geriatrics3030043 - 20 Jul 2018
Cited by 19 | Viewed by 5236
Abstract
With dramatically increasing proportions of older people, global ageing has remarkably influenced healthcare services and policy making worldwide. Older people represent the majority of patients with cancer, leading to the increasing demand of healthcare due to more comorbidities and inherent frailty. The preference [...] Read more.
With dramatically increasing proportions of older people, global ageing has remarkably influenced healthcare services and policy making worldwide. Older people represent the majority of patients with cancer, leading to the increasing demand of healthcare due to more comorbidities and inherent frailty. The preference of older people with cancer are often ignored, and they are considered incapable of making choices for themselves, particularly medical decisions. This might impede the provision of their preferred care and lead to poor healthcare outcomes. Advance care planning (ACP) is considered an effective intervention to assist older people to think ahead and make a choice in accordance with their wishes when they possess capacity to do so. The implementation of ACP can potentially lead to positive impact for patients and families. However, the assessment of mental capacity among older adults with cancer might be a crucial concern when implementing ACP, as loss of mental capacity occurs frequently during disease deterioration and functional decline. This article aims to answer the following questions by exploring the existing evidence. How does ACP develop for older people with cancer? How can we measure mental capacity and what kind of principles for assessment we should apply? What are the facilitators and barriers when implementing an ACP in this population? Furthermore, a discussion about cultural adaptation and relevant legislation in Asia is elucidated for better understanding about its cultural appropriateness and the implications. Finally, recommendations in relation to early intervention with routine monitoring and examination of capacity assessment in clinical practice when delivering ACP, reconciling patient autonomy and family values by applying the concept of relational autonomy, and a corresponding legislation and public education should be in place in Asia. More research on ACP and capacity assessment in different cultural contexts and policy frameworks is highlighted as crucial factors for successful implementation of ACP. Full article
(This article belongs to the Special Issue Oncology Care and Research in the Elderly)
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