Incorporation of geriatric assessment domains into oncological assessment of older people with cancer may not be routine in oncology consultations
To explore the discussion of age and geriatric assessment domains during oncology consultations with older people.
Patients aged 70 or over were recruited from the institution's oncology clinics. Eligible patients were English speaking and attending an initial consultation or following re-staging procedure to assess treatment response. Consultations were audio-recorded and transcribed. Qualitative thematic analysis was conducted, and focused on discussion of age and geriatric assessment domains. Points of divergence were discussed by the research team and consensus reached.
11 consultations with patients aged 70 to 84 years were analysed. Age was discussed in direct relation to treatment decision making. Medical terminology was used by all consultation participants (doctors, patients and carers) when discussing medical conditions and medication, whilst physical function was described using non-specific lay terminology. Only limited enquiry about social supports was made. Inquiry about geriatric syndromes was rare. However, detailed and objective descriptions of physical function and social supports were revealed through social conversation with patients about interests and home life.
Age was a contributor to cancer treatment decision making in the consultations. Limited attention to geriatric assessment domains was seen, and geriatric terminology and concepts were not routinely used. Opened ended inquiry in a social manner provided most information about physical function and social supports.