Improving treatment for ‘end-stage’ patients through integrated management
It has been shown that elderly cancer patients with poor cancer progression (prognosis) suffer from various symptoms, such as gait disturbance, before being diagnosed with cancer.
This is the result of an analysis by a research team at the University of California, San Francisco (UCSF) using data from the US Health Retirement Study (HRS) related to claims for senior health insurance (Medicare) from 1998 to 2016. The research team analyzed 2,105 participants (average age 76 years, women 53%) over the age of 65 who were diagnosed with cancer, which had a poor prognosis, making it difficult to live for less than a year. Among the participants, 34% had lung cancer and 21% had gastrointestinal cancer, and their survival was 9.6 months.
The study found that before being diagnosed with cancer, regarding 65% of participants had great difficulty climbing stairs, 36% had had a fall in the last two years, and 32% had poor memory. It means that he was diagnosed with cancer with a poor prognosis following experiencing symptoms such as various functional disorders, gait disturbance, pain caused by a fall, and memory loss.
In addition, 49% of the participants did not fill out an advance directive for life-sustaining treatment, and 35% lived alone. Functional disability and falls were the most common among those over 85 years of age before claiming the elderly medical insurance. 65-74 years of age were less likely to write an advance directive on life-sustaining treatment, and women were more likely to experience pain and physical disabilities than men.
Professor Maggie Zeng (oncology and hematology) at UCSF School of Medicine, the corresponding author of the study, said, “For all the elderly with poor cancer prognosis, primary care physicians, geriatricians, and palliative care workers routinely manage the underlying disease or symptoms properly. It has to be evaluated,” he said. Through such integrated management, the overall treatment of elderly cancer patients with poor prognosis should be improved.
The results of this study (The epidemiology of preexisting geriatric and palliative conditions in older adults with poor prognosis cancers) were published in the Journal of the American Geriatrics Society, and Eurekalert, a portal run by the American Association for the Advancement of Science. )’ introduced.
