Are Older Adults Getting the Most Effective Cancer Treatments?

Journal of the American Geriatrics Society Research Summary

As people age, cancer becomes an increasing health concern. Solid cancer tumors are cancers that don’t affect the blood and instead form tumors, or growths of abnormal cells in certain parts of the body. These solid cancer tumors mainly impact people who are 65 and older.

If you or an older loved one is diagnosed with cancer, many different factors come into play to guide treatment choices. However, leading geriatric oncologists (specialists who treat cancer in older adults) say that, perhaps surprisingly, age is not necessarily one of them. Recently, leaders in the field emphasized that being older, on its own, does not necessarily mean that surgical treatment is not an option for you.

Older patients with cancer may not receive the same treatment as younger adults. The reasons for this are unclear and may include the fact that surgical oncologists fear a higher risk of poor outcomes for older cancer patients following surgery. They may be uncertain about how surgery will affect an older patient’s survival and quality of life. But since long-term outcomes after surgery for older adults with cancer have not been well-studied, we don’t know whether such concerns are justified.

Fortunately, a screening tool exists that may help surgical oncologists and other physicians decide which patients might face complications after surgery. The “Preoperative Risk Estimation for Onco-Geriatric Patients” (or PREOP) risk score uses several easy-to-administer tests and can be given to people before surgery. The risk score includes a nutritional risk score to make sure you aren’t malnourished and a test called Timed Get Up and Go (TUG). In this simple test, you are timed getting out of a chair, walking 10 feet, and sitting back down again.

In addition to these two tests, the PREOP risk score also takes into consideration your gender, how significant your surgery will be, and an anesthesiologist’s assessment of your physical condition. In a previous study, a high PREOP risk score was found to be associated with an increased risk of major postoperative complications within 30 days after surgery.

A team of researchers recently examined how the PREOP score might predict how older adults fared following surgery for cancer. The researchers said they hoped their study would help both physicians and patients make decisions regarding cancer surgery. They published their study in the Journal of the American Geriatrics Society. Continue reading

After a Hospitalization, Older Adults Prescribed Potentially Inappropriate Medications May Face Health Risks

Journal of the American Geriatrics Society Research Summary

Potentially inappropriate medications (PIMs)” are treatments that sometimes pose risks that outweigh their benefits, particularly for people who are 65 or older. About 20 to 60 percent of older adults take medicines that may be potentially inappropriate. That can increase the risk for being hospitalized, needing to visit the emergency department, having poor quality of life, and/or experiencing a harmful reaction.

When older adults are hospitalized for medical reasons or for surgery, they often go home with prescriptions for treatments that may be different from those they were taking beforehand. These treatments may include PIMs. Until now, however, few studies have examined how PIMs affect older adults when prescribed at the time of their hospital discharge.

A team of researchers recently designed a study to learn more about this important issue. They examined information from medical and surgical patients to evaluate the association of PIMs (both the ones the patients had been taking earlier as well as those newly prescribed at their hospital discharge) with the risk of four outcomes. The outcomes were harmful drug problems, emergency department visits, readmission to the hospital, and death after hospital discharge. The study was published in the Journal of the American Geriatrics Society. Continue reading

During the Coronavirus Crisis: Things to Consider if Someone You Care for is in Long-Term Care

If you are caring for someone who lives in a long-term care facility, you may have questions about their care and well-being during the coronavirus crisis. You’ve probably wondered whether it would be safer to take them out of the nursing home and move them into your home.

We put some of the questions you may be asking to Sharon K. Inouye, MD, MPH, Director, Aging Brain Center, Milton and Shirley F. Levy Family Chair Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center.

“These are very difficult and individual decisions for each family. There is no right or wrong situation, just a balance of the specific considerations,” says Dr. Inouye. “I had to consider this for my own mother. Ultimately, we were unable to move her out of her facility because our home was not set up for her safety (too many stairs, lack of adapted bathrooms, narrow hallways that would not permit her walker).”

Dr. Inouye noted other hazards at her sister’s home (who lives closest to her mother). Her children who are home from school might pose an exposure risk. Her family also has pets who could create fall risks.

“The facility where my mother lives has outstanding infection control processes and procedures in place, with a highly trained staff. So, with difficulty, we made the decision to keep her in the facility. Five weeks later, after one documented case of COVID-19, my mother remains safe without any additional cases. This turned out to be the right decision for our family, but it was a very difficult one—and obviously, had more cases emerged, it might have shifted the equation for us,” Dr. Inouye said.

Questions to Consider Continue reading

Avoiding COVID-19 Scams

Unfortunately, some people—including criminals—often look for opportunities to take advantage of others during times of national crisis. The current COVID-19 pandemic creates a perfect environment for lawbreakers who may be targeting vulnerable victims. Very often, their targets may be older adults.

Here are some effective defenses to help stop criminals in their tracks. Arm yourself with these smart strategies to protect yourself and your family against scammers.

First Step

Make sure to fact-check all the COVID-19 information you receive. Don’t share any messages about the virus on social media or email—or even in conversation with friends and loved ones—unless you verify the information is from a trusted source. Look to government agencies such as the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), or the Federal Trade Commission (FTC). If you’re unsure about a news item or piece of information, use a fact-checking website such as www.snopes.com. Continue reading

Advice for Caregivers: Older Adults and COVID-19

The coronavirus (COVID-19) has caused a worldwide pandemic that has changed how we live, as governments worldwide seek to limit the spread of this disease. We are being asked to stay at home, businesses are closed, and there have been shortages of the basic necessities of daily life.

These are stressful times for all of us, and even more so for adults age 65 and older or individuals with multiple chronic conditions, since they are at higher risk for severe complications if they contract COVID-19.

One way to help your older family members, neighbors, or friends to navigate these challenging times is to be sure they are aware of basic advice from the Centers for Disease Control and Prevention (CDC)  that you can share with older adults:

  • The safest thing to do is to stay home. If you must go out for essential errands, stay six feet away from other people. (Six feet equals about two arm lengths.). If you are sick, you must stay home.
  • Also avoid close contact with people who are sick. Keep six feet away from them at all times.
  • Wash your hands often. Wash for at least 20 seconds (sing the Happy Birthday song twice).
  • Clean and disinfect surfaces that you frequently touch.
  • Avoid all cruise travel and non-essential air travel.
  • If you are sick, or have concerns about COVID-19 and an underlying health condition, call your healthcare professional.

Continue reading