Arman Zereshkian1, Xingshan Cao2, Martine Puts3, Krista Dawdy2, Lisa Di Prospero4, Shabbir Alibhai5, Matthew Neve6, Ewa Szumacher7. 1. Undergraduate Medical Education, University of Toronto, Toronto, Ontario, Canada. Electronic address: arman.zereshkian@mai.utoronto.ca. 2. Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada. 3. Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. 4. Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada; Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada. 5. Department of Medicine, UHN, University of Toronto, Toronto, Ontario, Canada. 6. Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada. 7. Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada; Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada.
Abstract
PURPOSE: Clinical judgement may not be sufficient to detect relevant problems in older cancer patients. We investigated what Geriatric Assessment tools (GA) are used by Canadian radiation oncologists (CROs) to treat non-metastatic prostate cancer patients aged 80 years and older. METHODS: A 27-item cross-sectional survey was developed with input from a multidisciplinary team and distributed electronically to Genitourinary (GU) CROs via LimeSurvey. Survey contents included: demographics, treatment choice based on components of GA, and how GA tools are used in clinic. Descriptive statistics were used to analyze multiple-choice data, with Open-ended question being coded and analyzed for emerging themes. RESULTS: 154 GU CRO's were contacted, 44 responded (29%). Active surveillance was the choice of therapy in older low risk prostate cancer patients regardless of factors used in a GA assessment (97%). Results in intermediate and high-risk older prostate cancer patients were more heterogenous. Functional status and comorbidities were the most important factor in the decision-making-process (94%, 91%). Sixty-six percent of CROs did not use any GA tools; yet 77% felt comfortable to very comfortable treating older patients. Eighty-eight percent felt there were some to very few guidelines in helping them to treat older patients. Barriers to using GA included lack of knowledge, time, support, and resources. CONCLUSIONS: GAs are not commonly utilized by CROs. Majority of CROs felt comfortable treating older patients with prostate cancer, regardless of guidelines/evidence in this population. This may have negative implications on patient care. CROs are however open to referring patients for a formal GA.
PURPOSE: Clinical judgement may not be sufficient to detect relevant problems in older cancerpatients. We investigated what Geriatric Assessment tools (GA) are used by Canadian radiation oncologists (CROs) to treat non-metastatic prostate cancerpatients aged 80 years and older. METHODS: A 27-item cross-sectional survey was developed with input from a multidisciplinary team and distributed electronically to Genitourinary (GU) CROs via LimeSurvey. Survey contents included: demographics, treatment choice based on components of GA, and how GA tools are used in clinic. Descriptive statistics were used to analyze multiple-choice data, with Open-ended question being coded and analyzed for emerging themes. RESULTS: 154 GU CRO's were contacted, 44 responded (29%). Active surveillance was the choice of therapy in older low risk prostate cancerpatients regardless of factors used in a GA assessment (97%). Results in intermediate and high-risk older prostate cancerpatients were more heterogenous. Functional status and comorbidities were the most important factor in the decision-making-process (94%, 91%). Sixty-six percent of CROs did not use any GA tools; yet 77% felt comfortable to very comfortable treating older patients. Eighty-eight percent felt there were some to very few guidelines in helping them to treat older patients. Barriers to using GA included lack of knowledge, time, support, and resources. CONCLUSIONS: GAs are not commonly utilized by CROs. Majority of CROs felt comfortable treating older patients with prostate cancer, regardless of guidelines/evidence in this population. This may have negative implications on patient care. CROs are however open to referring patients for a formal GA.
Authors: Darryl Outlaw; Maya Abdallah; Luiz A Gil-Jr; Smith Giri; Tina Hsu; Jessica L Krok-Schoen; Gabor Liposits; Tânia Madureira; Joana Marinho; Ishwaria M Subbiah; Gina Tuch; Grant R Williams Journal: Semin Radiat Oncol Date: 2022-04 Impact factor: 5.934