Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country
Introduction: Cancer is a malady of old age. Older people lose autonomy and independence due to age-associated functional decline and adverse consequences of comorbidity. The impact of these variables has an effect on treatment decisions in older cancer patients. Methods: In an observational study,...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of the Indian Academy of Geriatrics |
| Subjects: | |
| Online Access: | http://www.jiag.in/article.asp?issn=0974-3405;year=2021;volume=17;issue=1;spage=2;epage=8;aulast=Kandel |
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| author | Ramesh Kandel Joyita Banerjee Manicka Saravanan Prasun Chatterjee Avinash Chakrawarty S N Dwivedi Bidhu Kalyan Mohanti Aparajit Ballav Dey |
| author_facet | Ramesh Kandel Joyita Banerjee Manicka Saravanan Prasun Chatterjee Avinash Chakrawarty S N Dwivedi Bidhu Kalyan Mohanti Aparajit Ballav Dey |
| author_sort | Ramesh Kandel |
| collection | DOAJ |
| description | Introduction: Cancer is a malady of old age. Older people lose autonomy and independence due to age-associated functional decline and adverse consequences of comorbidity. The impact of these variables has an effect on treatment decisions in older cancer patients. Methods: In an observational study, 290 cancer patients aged 60 years or more were evaluated before the initiation of the treatment. They were subjected to a geriatric assessment by various validated assessment tools. Management decisions were as per the prevailing hospital practice. Results: The median age at the diagnosis was 65 years and two-third were males. Lung cancer was the most common (49.3%) diagnosis. The major comorbidities seen were hypertension (34.14%), diabetes (20.34%), and COPD (15%). Depression (57%), cognitive impairment (37%), malnourishment (34%), and vision problem (20%) were common age-related issues observed. Seventy-one percent were dependent in one or more domains of activities of daily living. Eighty-one percent had Eastern Cooperative Oncology Group status score between 0 and 2 (thereby eligible for treatment). In multivariable analysis, good functional status (P < 0.001) and performance status by Karnofsky's Performance Status Scale (P < 0.001) were associated with receiving treatment. Conclusion: Improvement in pretreatment functional status by initial geriatric assessment and requisite interventions may improve the access to and consideration of older cancer patients for standard treatment and care in oncology clinics. |
| first_indexed | 2024-12-19T21:40:22Z |
| format | Article |
| id | doaj.art-de1ab0fa724c4e03a0d85a83c9393f0f |
| institution | Directory Open Access Journal |
| issn | 0974-3405 0974-2484 |
| language | English |
| last_indexed | 2024-12-19T21:40:22Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of the Indian Academy of Geriatrics |
| spelling | doaj.art-de1ab0fa724c4e03a0d85a83c9393f0f2022-12-21T20:04:40ZengWolters Kluwer Medknow PublicationsJournal of the Indian Academy of Geriatrics0974-34050974-24842021-01-011712810.4103/jiag.jiag_3_21Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income countryRamesh KandelJoyita BanerjeeManicka SaravananPrasun ChatterjeeAvinash ChakrawartyS N DwivediBidhu Kalyan MohantiAparajit Ballav DeyIntroduction: Cancer is a malady of old age. Older people lose autonomy and independence due to age-associated functional decline and adverse consequences of comorbidity. The impact of these variables has an effect on treatment decisions in older cancer patients. Methods: In an observational study, 290 cancer patients aged 60 years or more were evaluated before the initiation of the treatment. They were subjected to a geriatric assessment by various validated assessment tools. Management decisions were as per the prevailing hospital practice. Results: The median age at the diagnosis was 65 years and two-third were males. Lung cancer was the most common (49.3%) diagnosis. The major comorbidities seen were hypertension (34.14%), diabetes (20.34%), and COPD (15%). Depression (57%), cognitive impairment (37%), malnourishment (34%), and vision problem (20%) were common age-related issues observed. Seventy-one percent were dependent in one or more domains of activities of daily living. Eighty-one percent had Eastern Cooperative Oncology Group status score between 0 and 2 (thereby eligible for treatment). In multivariable analysis, good functional status (P < 0.001) and performance status by Karnofsky's Performance Status Scale (P < 0.001) were associated with receiving treatment. Conclusion: Improvement in pretreatment functional status by initial geriatric assessment and requisite interventions may improve the access to and consideration of older cancer patients for standard treatment and care in oncology clinics.http://www.jiag.in/article.asp?issn=0974-3405;year=2021;volume=17;issue=1;spage=2;epage=8;aulast=Kandelcomorbidityfunctional statusgeriatric oncologyperformance statustreatment |
| spellingShingle | Ramesh Kandel Joyita Banerjee Manicka Saravanan Prasun Chatterjee Avinash Chakrawarty S N Dwivedi Bidhu Kalyan Mohanti Aparajit Ballav Dey Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country Journal of the Indian Academy of Geriatrics comorbidity functional status geriatric oncology performance status treatment |
| title | Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country |
| title_full | Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country |
| title_fullStr | Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country |
| title_full_unstemmed | Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country |
| title_short | Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country |
| title_sort | challenges and determinants in the management of the older patients with cancer report from a low and middle income country |
| topic | comorbidity functional status geriatric oncology performance status treatment |
| url | http://www.jiag.in/article.asp?issn=0974-3405;year=2021;volume=17;issue=1;spage=2;epage=8;aulast=Kandel |
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