A novel way of assessing health and vulnerability in older newly diagnosed cancer patients: An ongoing prospective pilot study

Abstract

20707 Background: Oncologists may have difficulty in determining appropriate treatment and predicting complications in older patients. In this regard, the concept of frailty may be a useful way to characterize their health, functional status and vulnerability. Methods: Objectives: 1) To evaluate the recruitment and retention strategy and the feasibility of the selected measurement tools. 2) To describe the health and vulnerability of older cancer patients and the adverse outcomes of treatment. In this pilot prospective cohort study, baseline interviews are conducted before the start of cancer treatment. Second and third face-to-face interviews are conducted at 3 and 6 months in which oncology data and data on treatment toxicity are abstracted from the medical chart. Telephone interviews are conducted at 1.5 and 4.5 months. Study Population: Cancer patients aged 65 and older referred to the Segal Cancer Center with a new diagnosis of breast, colorectal or lung cancer, lymphoma or myeloma, able to give informed consent, life expectancy>3 months, who have not received cancer treatment in the previous five years. Data collected: Sociodemographics, health (comorbidity, medication use and self-rated health), cancer related information (e.g. type of cancer, stage and treatment regime), functional status (ECOG, ADL, IADL, functional limitations), frailty markers (nutrition, cognition, mood, mobility, strength, energy, physical activity) and quality of life. The primary outcome measures are changes in vulnerability/frailty and treatment toxicity. The secondary outcome measure is use of health care services. Results: 93 patients are included: mean age 73.3, 27 men and 66 women (response 72%). Diagnoses: breast 35, lung 27, colorectal 13, lymphoma 14, multiple myeloma 4. Proposed treatment plan: surgery 42, chemotherapy 30, combination radio/chemotherapy 6, radiotherapy 7, hormonal therapy 2, watchful waiting 5. The majority (86%) had ≥ 1 frailty marker at baseline, 33 (35%) had IADL disability and 8 (9%) had ADL disability. Conclusions: This pilot study will contribute to the best design for a longitudinal prospective study on health and functional status in older newly diagnosed patients. No significant financial relationships to disclose.