Cancer is a disease that can affect older adults and in Canada alone, 70 per cent of patients diagnosed with cancer are 65 and older. However, evidence-based information on how older adults decide if they will accept or refuse cancer treatment is scarce. The Canadian Cancer Society has awarded Dr. Martine Puts an Innovation Grant to examine the treatment decision-making process amongst older patients, their caregivers and physicians so that interventions can be developed to improve this process in the future.
“Evidence suggests that older adults get overtreated and undertreated because there is limited information to assist with making cancer treatment decisions,” says Puts, an assistant professor at Bloomberg Nursing. “The Innovation Grant from the Canadian Cancer Society will ensure we can gather insight into how older adults decide on cancer treatment options, and allow us to address the specific needs of this growing population.”
This grant program, introduced to support unique and creative research ideas, looks to impact the understanding of cancer by generating new approaches to combat this pervasive disease. The study by Puts will explore the reasons why older adults might refuse cancer treatment and how they weigh the pros and cons of their decision.
“If you are already 75, managing a chronic condition, and then receive a cancer diagnosis the idea of living another 20 years is different than if you’re 45 and you want to be cured of your cancer,” says Puts. “The treatment risks and benefits differ at every age, but currently the only data older adults can access to inform their treatment decisions are based mostly on clinical trials with younger adults or very healthy older adults and this really limits the evidence available for older patients and their physicians.”
The grant will allow Puts to conduct a mixed methods study including older adults, family caregivers, family physicians and cancer specialists to discover what motivates treatment decisions. Gaining insight into how participants take into account frailty, vulnerability or other co-morbidities and then decide to accept or refuse cancer treatment, will inform the development of interventions to support the treatment decision-making process. Following the participants for six months after the diagnoses allows Puts and her team to examine whether the patient changed their mind on the treatment decision, changed their treatment, or if they’re satisfied with the treatment and the support they received.
Based on the results, Puts will refine and augment decision-support interventions for frail, older adults with cancer and complex health needs.