Kim Valerie S, Carrozzi Anthony, Papadopoulos Efthymios, Tejero Isabel, Thiruparanathan Thirisangi, Perlis Nathan, Hope Andrew J, Jang Raymond W, Alibhai Shabbir M H
Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada.
Cancers (Basel). 2024 Apr 12;16(8):1477. doi: 10.3390/cancers16081477.
Older adults with cancer often present with distinct complexities that complicate their care, yet the language used to discuss their management at multidisciplinary cancer conferences (MCCs) remains poorly understood. A mixed methods study was conducted at a tertiary cancer centre in Toronto, Canada, where MCCs spanning five tumour sites were attended over six months. For presentations pertaining to a patient aged 75 or older, a standardized data collection form was used to record their demographic, cancer-related, and non-cancer-related information, as well as the presenter's specialty and training level. Descriptive statistics and thematic analysis were employed to explore MCC depictions of older patients ( = 75). Frailty status was explicitly mentioned in 20.0% of presentations, but discussions more frequently referenced comorbidity burden (50.7%), age (33.3%), and projected treatment tolerance (30.7%) as surrogate measures. None of the presentations included mentions of formal geriatric assessment (GA) or validated frailty tools; instead, presenters tended to feature select GA domains and subjective descriptions of appearance ("looks to be fit") or overall health ("relatively healthy"). In general, MCCs appeared to rely on age-focused language that may perpetuate ageism. Further work is needed to investigate how frailty and geriatric considerations can be objectively incorporated into discussions in geriatric oncology.
患有癌症的老年人往往存在独特的复杂情况,这使得他们的护理变得复杂,但在多学科癌症会议(MCCs)上用于讨论其治疗的语言仍未得到充分理解。在加拿大多伦多的一家三级癌症中心进行了一项混合方法研究,在六个月的时间里参加了涵盖五个肿瘤部位的MCCs。对于与75岁及以上患者相关的报告,使用标准化的数据收集表记录他们的人口统计学、癌症相关和非癌症相关信息,以及报告人的专业和培训水平。采用描述性统计和主题分析来探讨MCCs对老年患者(≥75岁)的描述。在20.0%的报告中明确提到了虚弱状态,但讨论中更频繁地提及合并症负担(占50.7%)、年龄(占33.3%)和预计的治疗耐受性(占30.7%)作为替代指标。没有一份报告提及正式的老年医学评估(GA)或经过验证的虚弱工具;相反,报告人倾向于突出GA的某些领域以及对外表(“看起来健康”)或整体健康(“相对健康”)的主观描述。总体而言,MCCs似乎依赖于以年龄为重点的语言,这可能会使年龄歧视长期存在。需要进一步开展工作来研究如何将虚弱和老年医学方面的考虑客观地纳入老年肿瘤学的讨论中。