Cancer in older patients : the impact of global health assessments, measures and outcomes

• Main Author: Stokoe, Joanna
• Published: University of Brighton 2012
• Subjects: 610; A000 Medicine
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.619004

Worldwide the population is ageing. Colorectal cancer is the third commonest cancer in Great Britain. In this thesis, the epidemiology of colorectal cancer in patients aged sixty-five and over has been described. Between 1971 and 2006 the number of older people diagnosed with colorectal cancer has increased by nearly an extra ten thousand cases per year reflecting an increasing burden amongst the older patient population in Great Britain. The management of older colorectal cancer patients is challenging. A prospective cohort study, “The assessment and management of older patients with colorectal cancer”, was undertaken to investigate the use of a comprehensive geriatric assessment in patients aged sixtyfive and over. The ability of specific assessment tools to predict functional decline or death at one year, and if they could predict for severe chemotherapy toxicity in patients receiving adjuvant chemotherapy, was explored. Older patients receiving chemotherapy may be at increased risk of treatment-related toxicity for a variety of reasons. A study, “Global health measures and tolerance of cytotoxic chemotherapy”, was undertaken to investigate the predictive ability of three assessment tools in patients aged sixty-five and over receiving chemotherapy. Malnutrition may be an issue in older cancer patients that is not always addressed. The use of three nutritional screening tools in assessing patients with metastatic colorectal cancer has been investigated and the rates of malnutrition in older and younger patients compared. Social networks and support are important in helping cancer patients through treatment. Socially isolated patients may be at higher risk of death compared to those with strong social ties. An observational survey of patients attending an oncology outpatient department was performed and social ties of older and younger patients reported.