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A B S T R A C T S
S105
P116
CHEMOTHERAPY TREATMENT DECISION-MAKING
EXPERIENCES OF OLDER ADULTS WITH CANCER, THEIR
FAMILY MEMBERS, CANCER SPECIALISTS AND FAMILY
PHYSICIANS: A MIXED METHODS STUDY
M. Puts
1,
*, S. Sattar
1
, K. McWatters
1
, K. Lee
1
, M. Kulik
1
,
M. E. Macdonald
1
, R. Jang
2
, E. Amir
2
, M. Krzyzanowska
2
,
N. Leighl
2
, M. Fitch
1
, A. Joshua
2,3
, P. Warde
4
, A. Tourangeau
1
,
S. Alibhai
5,6
1
Nursing, University of Toronto,
2
Medical Oncology, University
Health Network, Toronto, Canada,
3
Medical Oncology, Kinghorn
Cancer Centre, Sydney, Australia,
4
Radiation Oncology,
5
Medicine,
University Health Network,
6
Medicine, University of Toronto,
Toronto, Canada
Introduction:
Although comorbidities, frailty, and
functional impairment are common in older adults with
cancer,
little is known about how these factors are considered
during the treatment decision-making process by OAs, their
families, and health care providers.
Objectives:
The aims of this study were to examine the
treatment decision making process from the perspectives
of older adults and their family members, cancer specialists
and family physicians, as well to explore how comorbidity,
frailty, and functional status influenced the decision-making
process.
Methods:
A mixed methods multi-perspective longitudinal
study using semi-structured interviews and surveys with 29
older adults aged
70 years with advanced prostate, breast,
colorectal, or lung cancer, 24 of their family members, 13
oncologists, and 15 family physicians was conducted. The
sample was stratified on age (70-79 and 80+). All interviews
were analyzed using thematic analysis.
Results:
There was no difference in the treatment decision-
making experience based on age. Most older adultss felt that
they should have the final say in the treatment decision,
but strongly valued their oncologists’ opinion. “Trust in my
oncologist” and “chemotherapy as the last resort to prolong
life” were the most important reasons to accept treatment.
Families indicated a need to improve communication between
them, the patient and the specialist, particularly around goals
of treatment. Comorbidity and potential side-effects did
not play a major role in the treatment decision-making for
patients, families, or oncologists. Family physicians reported
no involvement in decisions but desired to be more involved.
Conclusion:
This first study using multiple perspectives
showed neither frailty nor comorbidity played a role in the
treatment decision-making process. Efforts to improve
communication was identified as an opportunity that may
enhance quality of care.
Disclosure of interest:
None declared
Keywords:
Chemotherapy, communication, frailty, functional
status, treatment decisions
P117
DEVELOPING A NATIONAL AGENDA ON CANCER AND
AGING: THE CANADIAN NETWORK ON AGING AND CANCER
(CNAC)
M. Puts
1,
*, T. Hsu
2
, E. Szumacher
3
, S. Sattar
1
, S. Toubasi
1
,
C. Rosario
4
, C. Mariano
5
, E. Brain
6
, S. Mohile
7
, H. Muss
8
,
W. Duggleby
9
, D. Wan-Chow-Wah
10
, C. Wong
11
, M. Trudeau
12
,
S. Alibhai
4,13
1
Nursing, University of Toronto, Toronto,
2
Medical Oncology, The
Ottawa Hospital Cancer Centre, Ottawa,
3
Radiation Oncology,
Sunnybrook Health Sciences Centre,
4
Medicine, University of
Toronto, Toronto,
5
Medical Oncology, Royal Columbian Hospital,
Vancouver, Canada,
6
Medical Oncology, Institut Curie, Paris,
France,
7
Medical Oncology, University of Rochester Medical Center,
Rochester,
8
Medical Oncology, School of Medicine UNC-Chapel
Hill, Chapel Hill, USA,
9
Nursing, Uiversity of Alberta, Edmonton,
10
Division of Geriatric Medicine, McGill University Health Centre,
Montreal,
11
Geriatric Medicine, St. Michael’s Hospital,
12
Medical
Oncology, Sunnybrook Health Sciences Centre,
13
Medicine,
University Health Network, Toronto, Canada
Introduction:
The Canadian population is aging and the
risk of developing cancer increases with age. Several countries
have formed collaborative networks that champion research
for improvement of clinical outcomes, however, none exists
in Canada. A meeting of leaders in geriatrics and oncology
was convened to develop a national research agenda as well
as establish a national collaborative network of researchers
and clinicians interested in cancer and aging to expand the
evidence base for older adults with cancer in Canada.
Objectives:
Objectives of the first Cancer and Aging Network
meeting were:
1. To review the present landscape of research in the area of
cancer and aging
2. To identify issues of high research priority within the field
of cancer and aging
3. To identify current barriers to geriatric oncology research
and develop and implement potential solutions
4. To develop a collaborative multidisciplinary research
network between investigators across Canada who are
interested in fostering research and improving health
outcomes for older adults with cancer
5. To learn from successful efforts in other countries to
stimulate the geriatric oncology research agenda.
Methods:
Researchers and clinicians across Canada
interested in cancer and aging, as well as leaders from key
cancer, geriatric, and funding organizations in Canada were
invited to attend the inaugural Canadian Network on Aging
and Cancer held in Toronto on April 27, 2016. International
leaders from the Cancer and Aging Research Group and the
International Society of Geriatric Oncology (SIOG) were also
invited.
Results:
60 clinicians, researchers and trainees attended,
including physicians (medical oncologists, radiation
oncologists, geriatricians, hematology-oncologists), nurses,
and pharmacists. Canadian clinical, educational, and research
accomplishments and ongoing endeavours within the field
of cancer and aging were reviewed. Participants agreed that
Canada should have a national collaborative network focused