A5038508194- Frailty in Older Adults
- Cancer survivorship and care
- Nutrition and Health in Aging
- Palliative Care and End-of-Life Issues
- Health Systems, Economic Evaluations, Quality of Life
- Cancer-related cognitive impairment studies
- Childhood Cancer Survivors' Quality of Life
- Patient-Provider Communication in Healthcare
- Cancer Treatment and Pharmacology
- Prostate Cancer Treatment and Research
- Prostate Cancer Diagnosis and Treatment
- Economic and Financial Impacts of Cancer
- Occupational and environmental lung diseases
- Global Cancer Incidence and Screening
- Pharmaceutical Practices and Patient Outcomes
- Patient Dignity and Privacy
- Bladder and Urothelial Cancer Treatments
- Family Support in Illness
- Glioma Diagnosis and Treatment
- Brain Metastases and Treatment
- Multiple Myeloma Research and Treatments
- Colorectal Cancer Treatments and Studies
- Medication Adherence and Compliance
- Chronic Disease Management Strategies
- Multiple and Secondary Primary Cancers
University of Rochester Medical Center
2016-2025
University of Rochester
2015-2024
Cancer Institute (WIA)
2022-2024
Kantonsspital Baselland
2023
Amsterdam University Medical Centers
2023
National Cancer Institute
2018-2022
American Society of Clinical Oncology
2015-2018
City Of Hope National Medical Center
2009-2018
City of Hope
2009-2018
Strong Memorial Hospital
2018
Older adults are vulnerable to chemotherapy toxicity; however, there limited data identify those at risk. The goals of this study risk factors for toxicity in older and develop a stratification schema toxicity.Patients age ≥ 65 years with cancer from seven institutions completed prechemotherapy assessment that captured sociodemographics, tumor/treatment variables, laboratory test results, geriatric variables (function, comorbidity, cognition, psychological state, social activity/support,...
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review medical literature. Results A total 68 studies met eligibility criteria form evidentiary basis for recommendations. Recommendations In ≥ 65 years receiving chemotherapy, geriatric (GA) should be used identify that are not routinely...
Purpose Older adults are at increased risk for chemotherapy toxicity, and standard oncology assessment measures cannot identify those risk. A predictive model toxicity was developed (N = 500) that consisted of geriatric questions other clinical variables. This study aims to externally validate this in an independent cohort 250). Patients Methods age ≥ 65 years with a solid tumor, fluent English, who were scheduled receive new regimen recruited from eight institutions. Risk calculated (low,...
The American Society of Clinical Oncology (ASCO) convened a subcommittee to develop recommendations on improving the evidence base for treating older adults with cancer in response critical need identified by Institute Medicine. Older experience majority diagnoses and deaths make up survivors. are also fastest growing segment US population. However, this population is sparse, because underrepresented clinical trials, trials designed specifically rare. result that clinicians have less how...
To provide evidence-based recommendations to oncologists and others on potentially curative therapy for patients with localized pancreatic cancer.ASCO convened a panel of medical oncology, radiation surgical palliative care, advocacy experts conducted systematic review literature from January 2002 June 2015. Outcomes included overall survival, disease-free progression-free adverse events.Nine randomized controlled trials met the criteria.A multiphase computed tomography scan abdomen pelvis...
Abstract Adults aged 85 years and older, the “oldest old,” are fastest‐growing age group in United States, yet relatively little is known about their cancer burden. Combining data from National Cancer Institute, North American Association of Central Registries, Center for Health Statistics, authors provide comprehensive information on occurrence adults older. In 2019, there will be approximately 140,690 cases diagnosed 103,250 deaths among oldest old States. The most common cancers these...
Purpose Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory not fully understood. Some previous cancer-related research limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use normative data, generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients Methods cancer from community oncology clinics age-matched noncancer...
<h3>Importance</h3> Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) communication interventions have been reported. <h3>Objective</h3> To determine whether a combined intervention involving oncologists, patients with caregivers would promote to estimate effects on shared understanding, patient-physician relationships, QOL, the last 30 days life....
Selecting the most appropriate end points for clinical trials is important to assess value of new treatment strategies. Well-established research exist in oncology but may not be as relevant older cancer population because competing risks death and potentially increased impact therapy on global functioning quality life. This article discusses specific their advantages disadvantages individuals. Randomized or single-arm phase II can provide insight into range efficacy toxicity populations...
Background: Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes vulnerable older adults with cancer, growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus an expert panel on the use GA in and develop algorithms GA-guided processes. Methods: The Delphi technique, well-recognized structured reiterative process reach consensus, was used....
Older patients with cancer and their caregivers worry about the effects of treatment on aging-related domains (eg, function cognition). Quality conversations oncologists concerns could improve patient-centered outcomes. A geriatric assessment (GA) can capture evidence-based conditions associated poor clinical outcomes toxic effects) for older cancer.To determine whether providing a GA summary GA-guided recommendations to communication concerns.This cluster-randomized trial enrolled 541...
Purpose To update the Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Practice Guideline published on May 31, 2016. The October 2016 focuses solely new evidence that pertains to clinical question 4 guideline: What is appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection their primary tumor? Methods recently results a randomized phase III study prompted this guideline. high quality reported and potential its...
BACKGROUND Frailty has been suggested as a construct for oncologists to consider in treating older cancer patients. Therefore, the authors assessed potential of creating deficit‐accumulation frailty index (DAFI) from largely self‐administered comprehensive geriatric assessment (CGA). METHODS Five hundred patients aged ≥65 years underwent CGA before receiving chemotherapy. A DAFI was constructed, resulting 51‐item scale, and cutoff values were examined robust/nonfrail (cutoff value, 0.0 <...
Limited tools exist to predict the risk of chemotherapy toxicity in older adults with early-stage breast cancer.Patients age ≥ 65 years stage I-III cancer from 16 institutions treated neoadjuvant or adjuvant were prospectively evaluated for geriatric and clinical features predictive grade 3-5 toxicity. Logistic regression best-subsets selection was used identify incorporate independent predictors into a model weighted variable scoring. Model performance using area under ROC curve (AUC)...
This perspectives paper provides an overview of how to read and interpret a Sankey, examples using symptom data from older adults with advanced cancer, synopsis medical literature, comments on creating the diagram for presentation data. From prior reports our own, we conclude Sankeys are excellent tool visualizing changing status patients cancer. Older adult is used as example dispalyed in range Sankey flow diagrams. Because there large heterogeneity aging, different subgroups can be...
Abstract BACKGROUND. Impairments in geriatric domains adversely affect health outcomes of the elderly. The Comprehensive Geriatric Assessment (CGA) is a key component treatment approach for older cancer patients, but it time consuming. In this pilot study, authors evaluated validity brief, functionally based screening tool, Vulnerable Elders Survey‐13 (VES‐13), identifying patients with prostate (PCa) impairment oncology clinic setting. METHODS. Patients PCa aged ≥70 years who actively were...