Older patients' experiences of treatment for colorectal cancer: an analysis of functional status and service use
- 6 December 2004
- journal article
- Published by Hindawi Limited in European Journal of Cancer Care
- Vol. 13 (5), 483-493
- https://doi.org/10.1111/j.1365-2354.2004.00555.x
Abstract
Age and ageing are an important part of the context within which the care and treatment of people with cancer is provided. More information is needed about the effects of cancer treatment on the lives of older people following inpatient care. We conducted a 3‐year study in which older people with colorectal cancer completed a detailed questionnaire on multidimensional function and service use before and after elective treatment. Here we present an analysis of changes in functional status and service use over the pre‐ to post‐treatment period, and set out a detailed picture of older people's experiences before and after treatment. In total, 337 patients with colorectal adenocarcinoma aged 58–95 years were interviewed before treatment using the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), Rotterdam Symptom Checklist (RSCL) and a severity of morbidity score. Study end points were defined as post‐treatment functional status, symptom distress, severity of morbidity and frequency of service use. Pre‐ and post‐treatment data were compared using matched analyses. Logistic regression was used to assess associations between age and the main outcome measures, and frequency of service use after treatment was compared between age groups using the χ2 test. Overall, patients experienced both positive and negative outcomes following treatment. It was notable that patients aged ≥ 75 years showed improvement in only one of the principal outcome measures. Patterns of service use following treatment suggest that support at home is a key issue for patients. With the exception of nursing care, however, help at home is provided on a majority of occasions by families themselves. This raises important questions about how much preparation patients and families receive or would like before they leave hospital after treatment for cancer. A collaborative, family‐centred approach to meeting people's needs is called for in the months following inpatient care.Keywords
This publication has 14 references indexed in Scilit:
- Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional functionEuropean Journal of Cancer Care, 2003
- Physical Functioning of Elderly Cancer Patients Prior to Diagnosis and Following Initial TreatmentNursing Research, 2001
- Older patients' experiences of pre-treatment discussions: An analysis of qualitative data from a study of colorectal cancerNT Research, 2001
- Age and Adjuvant Chemotherapy Use After Surgery for Stage III Colon CancerJNCI Journal of the National Cancer Institute, 2001
- Chemotherapy in elderly patients with colorectal cancerAnnals of Oncology, 2001
- Quality of life in survivors of colorectal carcinomaCancer, 2000
- Longitudinal study on quality of life and social support in cancer patientsCancer Nursing, 1996
- Intergroup study of fluorouracil plus levamisole as adjuvant therapy for stage II/Dukes' B2 colon cancer.Journal of Clinical Oncology, 1995
- Commission of the European Communities “Europe Against Cancer” Programme European school of oncology advisory report cancer treatment in the elderlyEuropean Journal of Cancer, 1993
- Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom ChecklistBritish Journal of Cancer, 1990