Pavilion Publishing and Media Ltd
Blue Sky Offices Shoreham, 25 Cecil Pashley Way, Shoreham-by-Sea, West Sussex, BN43 5FF, UNITED KINGDOM
Tel: +44 (0)1273 434 943
Email: [email protected]
Older oncology adults want more transparent communication with their care providers, including what to expect from treatment, how their quality of life might change, and how their families can be involved in care planning, according to new research.
The study, published in Journal of Geriatric Oncology, aimed to understand preferences of older patients with advanced bladder cancer related to their communication with providers and navigation of care planning.
It found that oncologists should prioritise setting clear expectations for treatment, involving family in care planning, and communicating honestly about expected changes to quality of life and functional status.
The researchers said that the median age for receiving a bladder cancer diagnosis is 73, and a significant number of those living with the disease are in their 70s and 80s. A longstanding stereotype in cancer care is that older patients favor a more paternalistic style of care, one in which they defer to the authority of a care provider and may not ask many questions or seek more in-depth information.
“What we learned is we need to work to find ways to engage patients very early on in the treatment process,” says study author Elizabeth Kessler, MD, a University of Colorado Cancer Center member and associate professor of medical oncology in the CU School of Medicine. “We need to continue to work on ways to allow for these discussions.”
Experiences of living with cancer
The research originated, in part, from Kessler’s previous studies that have been supported by an American Cancer Society clinician scientist award. In one study, she and her co-researchers analysed data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, finding that the majority of older adults with advanced bladder cancer don’t receive anti-cancer treatment.
“If that’s happening, if we look at just the claims data and see that’s happening, there has to be so much more to the why,” Kessler said. “Is it because of ageism? Because patients don’t want treatment? We wanted to learn more about what patient priorities are as we’re thinking through how that initial treatment planning is set up for patients.”
Kessler and her co-researchers interviewed ten older advance bladder cancer patients through focus groups and individually. Many of those surveyed had previously received a diagnosis of localised bladder cancer that had either recurred or progressed.
Among the themes that emerged from interviewing the study participants was a consistent desire for early, honest, and transparent communication from caregivers. They expressed a desire for information about what to expect with changes to their physical abilities, mobility, and independence.
Researchers further found that study participants didn’t feel that discussions of their prognosis and treatment had to happen only with medical doctors, but could happen with nurses, physician assistants, or other informed members of their care team.