Symptom frequency and change of oldest old cancer patients

Linda Pang, Maxine de la Cruz, Jimin Wu, Diane Liu, Mujtaba Naqvi, Eduardo Bruera

    Research output: Contribution to journalArticle

    Abstract

    Purpose: The oldest old, described as those aged 85 and older, is a growing cancer population. There are limited studies evaluating the symptoms of the oldest old cancer patient population. Our study aimed to evaluate symptom frequency and clinical symptom change as assessed by the Edmonton Symptom Assessment System (ESAS) of the oldest old (≥ 85) compared to older adult (65–84) and general adult (18–64) outpatient cancer patients on initial consult and follow-up visit. Methods: Retrospective review of a total of 441 patients, 200 randomly sampled patients in the general and older adult group and 41 consecutive patients in the oldest old group. Chart review was performed for demographic and clinical information including ESAS. Results: The oldest old group had less advanced tumors and worse performance status and was receiving less cancer therapy. Eighty percent or more of these patients reported fatigue, sleep disturbance, appetite, and drowsiness. They experienced lower frequencies of pain (p < 0.0001), fatigue (p = 0.0338), nausea (p = 0.0151), feeling of well-being (p = 0.0245), sleep disturbance (p = 0.0484), financial distress (p = 0.0002), and spiritual distress (p = 0.0010) compared to the younger groups. Twenty-six to fifty-one percent of the oldest old patients’ symptoms improved on the first follow-up visit. Conclusions: Oldest old cancer patients have high frequencies of multiple symptoms on initial referral. However, these symptom frequencies are lower when compared to younger age groups. Additionally, many of their symptoms improved on first follow-up visit in the palliative care clinic. More research is needed to address the needs of this growing cancer population and focus symptoms that can improve with palliative care intervention.

    Original languageEnglish (US)
    Pages (from-to)4165-4170
    Number of pages6
    JournalSupportive Care in Cancer
    Volume27
    Issue number11
    DOIs
    StatePublished - Nov 1 2019

    Fingerprint

    Neoplasms
    Symptom Assessment
    Palliative Care
    Fatigue
    Sleep
    Population
    Sleep Stages
    Appetite
    Nausea
    Emotions
    Outpatients
    Referral and Consultation
    Age Groups
    Demography
    Pain
    Research
    Therapeutics

    Keywords

    • Aged
    • Geriatric oncology
    • Oldest old
    • Palliative care
    • Symptoms

    ASJC Scopus subject areas

    • Oncology

    Cite this

    Symptom frequency and change of oldest old cancer patients. / Pang, Linda; de la Cruz, Maxine; Wu, Jimin; Liu, Diane; Naqvi, Mujtaba; Bruera, Eduardo.

    In: Supportive Care in Cancer, Vol. 27, No. 11, 01.11.2019, p. 4165-4170.

    Research output: Contribution to journalArticle

    Pang, Linda ; de la Cruz, Maxine ; Wu, Jimin ; Liu, Diane ; Naqvi, Mujtaba ; Bruera, Eduardo. / Symptom frequency and change of oldest old cancer patients. In: Supportive Care in Cancer. 2019 ; Vol. 27, No. 11. pp. 4165-4170.
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    abstract = "Purpose: The oldest old, described as those aged 85 and older, is a growing cancer population. There are limited studies evaluating the symptoms of the oldest old cancer patient population. Our study aimed to evaluate symptom frequency and clinical symptom change as assessed by the Edmonton Symptom Assessment System (ESAS) of the oldest old (≥ 85) compared to older adult (65–84) and general adult (18–64) outpatient cancer patients on initial consult and follow-up visit. Methods: Retrospective review of a total of 441 patients, 200 randomly sampled patients in the general and older adult group and 41 consecutive patients in the oldest old group. Chart review was performed for demographic and clinical information including ESAS. Results: The oldest old group had less advanced tumors and worse performance status and was receiving less cancer therapy. Eighty percent or more of these patients reported fatigue, sleep disturbance, appetite, and drowsiness. They experienced lower frequencies of pain (p < 0.0001), fatigue (p = 0.0338), nausea (p = 0.0151), feeling of well-being (p = 0.0245), sleep disturbance (p = 0.0484), financial distress (p = 0.0002), and spiritual distress (p = 0.0010) compared to the younger groups. Twenty-six to fifty-one percent of the oldest old patients’ symptoms improved on the first follow-up visit. Conclusions: Oldest old cancer patients have high frequencies of multiple symptoms on initial referral. However, these symptom frequencies are lower when compared to younger age groups. Additionally, many of their symptoms improved on first follow-up visit in the palliative care clinic. More research is needed to address the needs of this growing cancer population and focus symptoms that can improve with palliative care intervention.",
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    T1 - Symptom frequency and change of oldest old cancer patients

    AU - Pang, Linda

    AU - de la Cruz, Maxine

    AU - Wu, Jimin

    AU - Liu, Diane

    AU - Naqvi, Mujtaba

    AU - Bruera, Eduardo

    PY - 2019/11/1

    Y1 - 2019/11/1

    N2 - Purpose: The oldest old, described as those aged 85 and older, is a growing cancer population. There are limited studies evaluating the symptoms of the oldest old cancer patient population. Our study aimed to evaluate symptom frequency and clinical symptom change as assessed by the Edmonton Symptom Assessment System (ESAS) of the oldest old (≥ 85) compared to older adult (65–84) and general adult (18–64) outpatient cancer patients on initial consult and follow-up visit. Methods: Retrospective review of a total of 441 patients, 200 randomly sampled patients in the general and older adult group and 41 consecutive patients in the oldest old group. Chart review was performed for demographic and clinical information including ESAS. Results: The oldest old group had less advanced tumors and worse performance status and was receiving less cancer therapy. Eighty percent or more of these patients reported fatigue, sleep disturbance, appetite, and drowsiness. They experienced lower frequencies of pain (p < 0.0001), fatigue (p = 0.0338), nausea (p = 0.0151), feeling of well-being (p = 0.0245), sleep disturbance (p = 0.0484), financial distress (p = 0.0002), and spiritual distress (p = 0.0010) compared to the younger groups. Twenty-six to fifty-one percent of the oldest old patients’ symptoms improved on the first follow-up visit. Conclusions: Oldest old cancer patients have high frequencies of multiple symptoms on initial referral. However, these symptom frequencies are lower when compared to younger age groups. Additionally, many of their symptoms improved on first follow-up visit in the palliative care clinic. More research is needed to address the needs of this growing cancer population and focus symptoms that can improve with palliative care intervention.

    AB - Purpose: The oldest old, described as those aged 85 and older, is a growing cancer population. There are limited studies evaluating the symptoms of the oldest old cancer patient population. Our study aimed to evaluate symptom frequency and clinical symptom change as assessed by the Edmonton Symptom Assessment System (ESAS) of the oldest old (≥ 85) compared to older adult (65–84) and general adult (18–64) outpatient cancer patients on initial consult and follow-up visit. Methods: Retrospective review of a total of 441 patients, 200 randomly sampled patients in the general and older adult group and 41 consecutive patients in the oldest old group. Chart review was performed for demographic and clinical information including ESAS. Results: The oldest old group had less advanced tumors and worse performance status and was receiving less cancer therapy. Eighty percent or more of these patients reported fatigue, sleep disturbance, appetite, and drowsiness. They experienced lower frequencies of pain (p < 0.0001), fatigue (p = 0.0338), nausea (p = 0.0151), feeling of well-being (p = 0.0245), sleep disturbance (p = 0.0484), financial distress (p = 0.0002), and spiritual distress (p = 0.0010) compared to the younger groups. Twenty-six to fifty-one percent of the oldest old patients’ symptoms improved on the first follow-up visit. Conclusions: Oldest old cancer patients have high frequencies of multiple symptoms on initial referral. However, these symptom frequencies are lower when compared to younger age groups. Additionally, many of their symptoms improved on first follow-up visit in the palliative care clinic. More research is needed to address the needs of this growing cancer population and focus symptoms that can improve with palliative care intervention.

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    KW - Geriatric oncology

    KW - Oldest old

    KW - Palliative care

    KW - Symptoms

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    U2 - 10.1007/s00520-019-04702-7

    DO - 10.1007/s00520-019-04702-7

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