Improving Communication for Cancer Treatment: Addressing Concerns of Older Cancer Patients and Caregivers

Over 60% of cancers occur in older persons, and the number of older persons with cancer is
expected to grow as the population ages. Oncology clinical trials have traditionally excluded
older patients with advanced cancer and chronic health conditions. In this context, where
data is limited and risk from treatment is high, older patients with advanced cancer and
their caregivers must understand how cancer treatment can affect quality of life in light of
underlying health status. Better communication about age-related health conditions between
oncologists, older patients with advanced cancer, and their caregivers may improve
decision-making for cancer treatment and quality of life. A geriatric assessment (GA), a
validated set of patient-centered outcomes, has been shown to identify concerns (e.g.,
function, cognition) important to older persons with cancer and their caregivers. In this
cluster randomized clinical trial we examined whether providing a web-generated GA summary
with targeted recommendations to older patients with advanced cancer, their caregivers, and
their oncologists can improve communication about age-related concerns that could affect
efficacy and tolerance of cancer treatment. We also determined whether the intervention
improves patient-reported quality of life and patient and caregiver satisfaction.