Main challenges in survivorship transitions: Perspectives of older adults with cancer

摘要

Objectives: To describe main challenges experienced by older adults (75+ years) following primary cancer treat-ment as a basis for development of age-appropriate survivorship care. Material and Methods: A national survey was conducted across ten Canadian provinces to identify experiences with follow-up for cancer survivors one to three years post-treatment. The survey included open-ended ques-tions for respondents to add details that offered deeper insight into their experiences. This publication presents analysis of responses from older adults (75+ years) about the main challenge they faced in transitioning to sur-vivorship. Results: In total, 3274 older adults (75+ years) responded to the survey and 2057 responded to the main chal-lenge question. Fifty-five percent were male, 72% had not experienced metastatic disease and 75% reported co-morbid conditions. The 1571 (48.0%) respondents reporting at least one main challenge described 2426 challenges categorized as physical, emotional, practical, lifestyle adjustments, health care delivery, and relation-ships/support. Physical challenges were identified most frequently (68.2%, n = 1655) including physical capacity (35.8%), symptoms/side effects (32.7%), and changes in bodily function/appearance (31.3%). Thematic analysis revealed three themes: 'getting back on my feet', 'adjusting to the changes', and 'finding the support I needed'. Conclusion: This work highlights gaps in early cancer survivorship for older adults and raises concerns about un-examined ageism within the Canadian cancer care system. A need for comprehensive geriatric assessments is ev-ident before and toward the end of primary treatment to individualize care plans. Proactive provision of information about managing changes from treatment, offered in meaningful multi-modal ways, is important. (c) 2020 Elsevier Ltd. All rights reserved.