Older Adults With Cancer
The Baby Boomer generation—born between the years 1946 and 1964—currently accounts for more than 76 million Americans, all of whom will be older than 65 in the next decade. With an aging population comes health complications and growing comorbidities. Cancer is often referred to as a disease of the aging, and healthcare providers will need to be equipped to treat the impending wave of older adults with cancer. Oncology nurses are at the frontlines of that care and play a key role in the successful treatment of older patients with cancer using evidence-based interventions and age-specific care.
Psychological Distress Is Interdependent in Patients With Cancer and Their Caregivers
About 30% of all cancer survivors and their caregivers have reported psychological distress, which encompasses diagnoses of depression, anxiety, and overwhelming stress. For both survivors and caregivers, psychological distress can negatively impact different aspects of treatment, care, and well-being. In fact, patients with lower levels of psychological distress have been shown to recover quicker, exhibit fewer symptoms, and even have lower mortality rates after treatment.
What Assessment Tools Are Used for Patients With Cancer and Psychiatric Diagnoses?
When patients with cancer also suffer from psychiatric diagnoses, it can present unique challenges to healthcare professionals. Because oncology nurses build relationships with patients while addressing issues, understanding the obstacles to practice is key to providing the best possible care. By having a keen understanding of symptoms, assessment procedures, and necessary response skills, oncology nurses can work together with the mental health team to provide holistic care throughout the cancer journey.
A Matter of Mind: When Patients With Cancer Have Psychiatric Comorbidities
Nearly 20% of Americans experience mental illness in a given year, according to the National Alliance on Mental Illness. With diagnoses such as schizophrenia, bipolar disorder, or major depression, about one in every 25 Americans suffers from a serious mental illness that directly affects major life activities. The prevalence of mental illness in the United States can have a downstream effect on cancer care and patient outcomes, and with these statistics, oncology nurses may encounter patients with cancer who have pre-existing psychiatric disorders. Healthcare providers in fields outside of psychology need to be prepared to address the unique needs and individualized care required to support this patient population during and beyond cancer treatment.
Comorbidities Negatively Impact Breast Cancer Survival
Missouri has a high breast cancer mortality rate, as well as high rates of type 2 diabetes, cardiovascular disease (CVD), and hypertension, which present more often in individuals who are poor, those living in rural areas, African Americans, and older adults. Women with comorbidities at the time of breast cancer diagnosis may have a worse prognosis, so researchers assessed survival disparities among these patient populations. According to the findings presented at the , comorbidities can negatively impact overall breast cancer survival.
Geriatric Assessment in Hematology Scale Classifies Frailty Phenotype
Researchers in Spain developed the Geriatric Assessment in Hematology (GAH) scale to classify patients as robust (those with strength or vigorous health) or frail (those with a poorer prognosis). The tool is validated for use in myelodysplastic syndromes, acute myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia. Researchers assessed its use and validity among patients with lymphoma. Raul Cordoba, MD, PhD, of Fundacion Jimenez Diaz University Hospital in Madrid, Spain, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Further Research Can Help Nurses Balance Cardiovascular Conditions With Cancer Treatments
As the leading cause of death for adult Americans, cardiovascular disease is a complication found in many patients with cancer. Many cancer treatments have the potential to impact existing cardiac comorbidities or develop new cardiovascular conditions in patients undergoing treatment. Understanding and recognizing this issue is paramount for oncology nurses and is the focus of current research efforts impacting clinical practice.
Address the Challenge of Polypharmacy in Older Adults Undergoing Cancer Treatment
Polypharmacy is the use of several medications simultaneously for different medical conditions. Data confirm that polypharmacy is prevalent in older adults with cancer, with one study reporting a minimum of four prescriptions to define polypharmacy. Many medications prescribed during cancer care are intended to treat other comorbid conditions that occur prior to a patient’s cancer diagnosis (e.g., heart disease, hypertension, hyperlipidemia, reflux disease). Reportedly, one third of individuals older than 65 years use more than one pharmacy to fill prescription medications. This can lead to further confusion for patients regarding medication management.
Heart Failure Affects Long-Term Survival Among Older Women With Breast Cancer
Research has shown that women aged 65 and older who have breast cancer experience higher rates of heart failure compared to their age-matched counterparts, ranging from 29% of women with breast cancer who received no chemotherapy to 38% of women who received treatment with anthracyclines. However, little is known about the association between heart failure and long-term survival in older women with breast cancer, and it is unclear how the relative contribution of heart failure to mortality risk varies by breast cancer stage.
Type 2 Diabetes May Increase Breast Cancer Mortality in Hispanic Women
The presence of type 2 diabetes mellitus at the time of breast cancer diagnosis has been suggested to adversely affect survival—independent of breast cancer stage, grade, and tumor phenotype—but few of those studies included people of Hispanic descent. Researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore and the University of Louisville in Kentucky examined the association between self-reported diabetes history, breast cancer-specific and all-cause mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer. They presented their results on Saturday, December 9, during a poster session at the San Antonio Breast Cancer Symposium.
Disease Factors Influence Treatment Decisions More Than Comorbidities in Patients With Follicular Lymphoma
Data from U.S. Lymphocare suggest that older patients with follicular lymphoma (FL) are more commonly treated with watchful waiting or single-agent rituximab and found no difference in outcomes by treatment groups, but comorbidity was not studied. Researchers aimed to describe patient features, comorbidity use of positron-emission tomography (PET) staging, management choices, and the impact of polypharmacy on outcomes of patients with FL aged 70 years or older. Prathima Reddy, MD, at CHI Franciscan Hospital in Federal Way, WA, discussed the findings at the ASH Annual Meeting.
Height and Weight May Be Linked to Aggressive Prostate Cancer
Taller men and those with a higher body mass index (BMI) may be at increased risk for high-grade prostate cancer and disease-related mortality, according to the results of a study published in BMC Medicine.
Researchers Identify Factors Associated With Readmission for Patients With Metastatic Cancer
Hospital readmission rates may be avoidable in some patients with metastatic disease. Researchers assessed patient factors more likely to be associated with increased readmissions, such as demographics, comorbidities, hospital type, payer, and discharge disposition, in a study presented at the ASCO Annual Meeting.
The Impact of Comorbidities on Patient Care
More than ever before, oncology nurses are required to provide multifaceted care when it comes to managing patients with cancer. As the population of patients with cancer continues to age and cancer becomes more of a chronic condition, oncology nurses are seeing more patients who exhibit comorbidities during their cancer journey.