Although more than half of cancers are diagnosed in adults age 65 and older, oncologists are still learning how best to individualize therapies for older adults. Wilmot’s team focuses on improving the treatment decision-making and quality of life for this population and their caregivers.
“At Wilmot Cancer Institute, we have one of the few geriatric oncology clinical and research programs in the country,” says Supriya Mohile, M.D., M.S., associate professor of Hematology/Oncology who leads Wilmot’s Geriatric Oncology team. “In addition to having four physicians dually certified in geriatrics and oncology, we have a robust team including researchers and trainees in geriatric oncology, nursing, psychiatry, and palliative care. It was wonderful for our team to have our research acknowledged and highlighted at this international meeting of experts in geriatric oncology.”
Mohile presented findings from two studies using a geriatric assessment tool. This tool evaluates a variety of factors such as health and medical conditions, physical ability, issues with memory or falling, cancer symptoms, medications that could affect chemotherapy and a patient’s home care situation. It is used to inform the oncology team as they develop the patient’s care plans.
In one study, Mohile looked at whether impairments such as physical performance and cognition recorded using the geriatric assessment were associated with anxiety and depression in caregivers. Analyzing data from 349 pairs of patients age 70 and older and their caregivers, Mohile found that patient distress was associated with caregiver anxiety, and the patient’s functional and nutritional status were associated with caregiver depression.
In a second study of data from 342 older adults with advanced cancers, Mohile, presenting on behalf of Marie Flannery, PhD, examined the variability in their reported quality of life. She focused on the role of symptom severity, and she found that both geriatric impairments and symptom burden had significant influence on the patients’ quality of life.
Other presenters from Wilmot included:
- Melissa Loh, M.D., who was a finalist for the SIOG Young Investigator Award for her study, found that exercise decreased anxiety in older adults with cancer who are receiving chemotherapy. She also found that reduced inflammation may have played a role in these changes.
- Ronald Maggiore, M.D., assistant professor of Hematology/Oncology, who presented on the feasibility of enrolling vulnerable older adults in clinical trials. Although older adults represent the majority of cancer patients, they often are under-represented in clinical trials. Maggiore analyzed the enrollment of vulnerable older adults in a clinical trial. He found that enrollment was feasible, especially with the use of geriatric assessment as part of routine study screening.
- Nikesha Gilmore, Ph.D., a senior health project coordinator, used data from a large study directed by Michelle Janelsins, Ph.D., MPH, found that chemotherapy exacerbates frailty in cancer patients. Frailty is an age-related syndrome characterized by weakness, and previous studies have shown that inflammation is one of its significant physiologic features. Gilmore found that high levels of inflammatory markers called cytokines in women 50 and older with breast cancer before they received chemotherapy were associated with frailty after chemo.
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