Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional function.

Chris Bailey, Jessica Corner, Julia Addington-Hall, D Kumar, Marion Nelson, Jo Haviland

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of the study was to investigate the role of age and multidimensional functional status in treatment decisions in older patients with colorectal cancer. Three hundred and thirty-seven patients aged 58–95 yearswith adenocarcinoma of the colon or rectum were interviewed before and after treatment using the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), a self-reported severity of morbidity scale, and the Rotterdam Symptom Checklist (RSCL). The OMFAQ rates five dimensions of function: social
resources, economic resources, mental and physical health and self-care capacity. The likelihood of patients with Duke’s C colorectal cancer receiving adjuvant chemotherapy decreased significantly with age (P=0.001, trend). Differences in treatment received were not explained by differences in morbidity, economic, mental or physical function, self-care capacity, or any of the RSCL measures. After controlling for age, Duke’s C patients who received adjuvant chemotherapy were less impaired in social resources than Duke’s C patients who did not (P=0.06). No other significant pre-treatment differences in functional status were found. Differences in age and social resources exist between patients who do and do not receive adjuvant chemotherapy.
Care should be taken to ensure that patients are not excluded from treatment with known survival benefits because of their age, and the question of providing appropriate social support during adjuvant chemotherapy should be re-examined.
Original languageEnglish
Pages (from-to)257
Number of pages262
JournalEuropean Journal of Cancer Care
Volume12
Issue number3
Publication statusPublished - 2003

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