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Main challenges in survivorship transitions: Perspectives of older adults with cancer.

Authors
  • Fitch, Margaret I1
  • Nicoll, Irene2
  • Lockwood, Gina3
  • Strohschein, Fay Judy4
  • Newton, Lorelei5
  • 1 Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave., Toronto, Ontario M4C 4V9, Canada. Electronic address: [email protected] , (Canada)
  • 2 Health Care Consultant, Toronto, Canada. , (Canada)
  • 3 Biostatistician Consultant, Toronto, Canada. , (Canada)
  • 4 Oncology and Aging Program, Jewish General Hospital, Montreal, Alberta, Canada. Electronic address: [email protected] , (Canada)
  • 5 School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria BC V8W 2Y2, Canada. Electronic address: [email protected] , (Canada)
Type
Published Article
Journal
Journal of geriatric oncology
Publication Date
May 01, 2021
Volume
12
Issue
4
Pages
632–640
Identifiers
DOI: 10.1016/j.jgo.2020.09.024
PMID: 33008768
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To describe main challenges experienced by older adults (75+ years) following primary cancer treatment as a basis for development of age-appropriate survivorship care. A national survey was conducted across ten Canadian provinces to identify experiences with follow-up for cancer survivors one to three years post-treatment. The survey included open-ended questions for respondents to add details that offered deeper insight into their experiences. This publication presents analysis of responses from older adults (75+ years) about the main challenge they faced in transitioning to survivorship. In total, 3274 older adults (75+ years) responded to the survey and 2057 responded to the main challenge question. Fifty-five percent were male, 72% had not experienced metastatic disease and 75% reported comorbid conditions. The 1571 (48.0%) respondents reporting at least one main challenge described 2426 challenges categorized as physical, emotional, practical, lifestyle adjustments, health care delivery, and relationships/support. Physical challenges were identified most frequently (68.2%, n = 1655) including physical capacity (35.8%), symptoms/side effects (32.7%), and changes in bodily function/appearance (31.3%). Thematic analysis revealed three themes: 'getting back on my feet', 'adjusting to the changes', and 'finding the support I needed'. This work highlights gaps in early cancer survivorship for older adults and raises concerns about unexamined ageism within the Canadian cancer care system. A need for comprehensive geriatric assessments is evident before and toward the end of primary treatment to individualize care plans. Proactive provision of information about managing changes from treatment, offered in meaningful multi-modal ways, is important. Copyright © 2020 Elsevier Inc. All rights reserved.

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