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Improving the quality of life of geriatric cancer patients with a structured multidisciplinary intervention: A randomized controlled trial

Published online by Cambridge University Press:  22 May 2007

MARIA I. LAPID ,
TERESA A. RUMMANS,. ,
PAUL D. BROWN ,
MARLENE H. FROST ,
MARY E. JOHNSON ,
MASHELE M. HUSCHKA ,
JEFF A. SLOAN ,
JARRETT W. RICHARDSON ,
JEAN M. HANSON  and
MATTHEW M. CLARK
MARIA I. LAPID
Affiliation:
Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
TERESA A. RUMMANS,.
Affiliation:
Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
PAUL D. BROWN
Affiliation:
Department of Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota
MARLENE H. FROST
Affiliation:
Department of Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota
MARY E. JOHNSON
Affiliation:
Department of Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota
MASHELE M. HUSCHKA
Affiliation:
Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
JEFF A. SLOAN
Affiliation:
Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
JARRETT W. RICHARDSON
Affiliation:
Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
JEAN M. HANSON
Affiliation:
Department of Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota
MATTHEW M. CLARK
Affiliation:
Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
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Abstract

Objective: To examine the potential impact of elderly age on response to participation in a structured, multidisciplinary quality-of-life (QOL) intervention for patients with advanced cancer undergoing radiation therapy.

Methods: Study design was a randomized stratified, two group, controlled clinical trial in the setting of a tertiary care comprehensive cancer center. Subjects with newly diagnosed cancer and an estimated 5-year survival rate of 0%–50% who required radiation therapy were recruited and randomly assigned to either an intervention group or a standard care group. The intervention consisted of eight 90-min sessions designed to address the five QOL domains of cognitive, physical, emotional, spiritual, and social functioning. QOL was measured using Spitzer uniscale and linear analogue self-assessment (LASA) at baseline and weeks 4, 8, and 27.

Results: Of the 103 study participants, 33 were geriatric (65 years or older), of which 16 (mean age 72.4 years) received the intervention and 17 (mean age 71.4 years) were assigned to the standard medical care. The geriatric participants who completed the intervention had higher QOL scores at baseline, at week 4 and at week 8, compared to the control participants.

Significance of results: Our results demonstrate that geriatric patients with advanced cancer undergoing radiation therapy will benefit from participation in a structured multidisciplinary QOL intervention. Therefore, geriatric individuals should not be excluded from participating in a cancer QOL intervention, and, in fact, elderly age may be an indicator of strong response to a QOL intervention. Future research should further explore this finding.

Keywords

GeriatricCancerQuality of life
Type
Research Article
Information
Palliative & Supportive Care , Volume 5 , Issue 2 , June 2007 , pp. 107 - 114
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

Aapro, M., Extermann, M., & Repetto, L. (2000). Evaluation of the elderly with cancer. Annals of Oncology, 11(Suppl. 3), 223–229.Google Scholar
Balducci, L. & Extermann, M. (2000). Cancer and aging. An evolving panorama. Hematology—Oncology Clinics of North America, 14, 1–16.Google Scholar
Bellg, A., Resnick, B., Minicucci, D., et al. (2004). Enhancing treatment fidelity in health beavhior change studies: Best practices and recommendations from the NIH Behavior Change Consortium. Health Psychology, 23, 443–451.Google Scholar
Bretscher, M., Rummans, T., Sloan, J., et al. (1999). Quality of life in hospice patients. A pilot study. Psychosomatics, 40, 309–313.Google Scholar
Brown, P., Clark, M.M., Atherton, P., et al. (2006). Will improvement in quality of life (QOL) impact fatigue in patients receiving radiation therapy for advanced cancer? American Journal of Clinical Oncology, 29, 52–58.Google Scholar
Cella, D. (1996). Quality of life outcomes: Measurement and validation. Oncology (Huntington), 10(Suppl. 11), 233–246.Google Scholar
Clark, M.M., Rummans, T., Sloan, J., et al. (2006). Quality of life of caregivers of patients with advanced-stage cancer. American Journal of Hospice & Palliative Medicine, 23, 185–191.Google Scholar
Classen, C., Diamond, S., Soleman, A., et al. (1993). Brief Supportive-Expressive Group Therapy for Women with Primary Breast Cancer: A Treatment Manual. Stanford, CA: Psychosocial Treatment Laboratory.
Cunningham, A. (1991). Skills for healing: Part II of the healing journey. In The Healing Journey Program. Toronto, Ontario: The Ontario Cancer Institute/Princess Margaret Hospital.
Esbensen, B.A., Osterlind, K., Roer, O., et al. (2004). Quality of life of elderly persons with newly diagnosed cancer. European Journal of Cancer Care, 13, 443–453.Google Scholar
Fawzy, F. & Fawzy, N. (1994). A structured psychoeducational intervention for cancer patients. General Hospital Psychiatry, 16, 149–192.Google Scholar
Grunberg, S., Groshen, S., Steingass, S., et al. (1996). Comparison of conditional quality of life terminology and visual analogue scale measurements. Quality of Life Research, 5, 65–72.Google Scholar
Gudex, C., Dolan, P., Kind, P., et al. (1996). Health state valuations from the general public using the Visual Analogue Scale. Quality of Life Research, 5, 521–531.Google Scholar
Ingram, S.S., Seo, P.H., Martell, R.E., et al. (2002). Comprehensive assessment of the elderly cancer patient: The feasibility of self-report methodology. Journal of Clinical Oncology, 20, 770–775.Google Scholar
Mozley, C.G., Huxley, P., Sutcliffe, C., et al. (1999). ‘Not knowing where I am doesn't mean I don't know what I like’: Cognitive impairment and quality of life responses in elderly people. International Journal of Geriatric Psychiatry, 14, 776–783.Google Scholar
Nezu, A., Nezu, C., Friedman, S., et al. (1998). Helping Cancer Patients Cope: A Problem-Solving Approach. Washington, DC: American Psychological Association.
Osoba, D. (2002). A taxonomy of the uses of health-related quality-of-life instruments in cancer care and the clinical meaningfulness of the results. Medical Care, 40(Suppl. 6), III31–III38.Google Scholar
Repetto, L., Fratino, L., Audisio, R.A., et al. (2002). Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: An Italian Group for Geriatric Oncology Study. Journal of Clinical Oncology, 20, 494–502.Google Scholar
Repetto, L., Venturino, A., Vercelli, M., et al. (1998). Performance status and comorbidity in elderly cancer patients compared with young patients with neoplasia and elderly patients without neoplastic conditions. Cancer, 82, 760–765.Google Scholar
Rummans, T.A., Clark, M.M., Sloan, J.A., et al. (2006). Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: A randomized controlled trial. Journal of Clinical Oncology, 24, 635–642.Google Scholar
Sloan, J., Symonds, T., Vargas-Chanes, D., et al. (2003). Practical guidelines for assessing the clinical significance of health-related quality of life changes within clinical trials. Drug Information Journal, 37, 23–31.Google Scholar
Spitzer, W., Dobson, A., Hall, J., et al. (1981). Measuring the quality of life of cancer patients: A concise QL-index for use by physicians. Journal of Chronic Diseases, 34, 585–597.Google Scholar
Thome, B. & Hallberg, I.R. (2004). Quality of life in older people with cancer—A gender perspective. European Journal of Cancer Care, 13, 454–463.Google Scholar
Townsley, C., Pond, G.R., Peloza, B., et al. (2005). Analysis of treatment practices for elderly cancer patients in Ontario, Canada. Journal of Clinical Oncology, 23, 3802–3810.Google Scholar