Because age is a major risk factor for cancer, the majority of cancer patients are older adults. However, advancing age is also associated with many other factors detrimental to the older adult, which make a cancer diagnosis and associated treatment extremely stressful. Cytotoxic chemotherapy is still the most common form of cancer treatment, and research has shown that older cancer patients can benefit greatly from chemotherapy. Older adults are at greater risk than younger adults of certain complications from chemotherapy resulting in unpleasant and serious side effects, in particular, less toleration of the toxicity of the chemotherapy treatment. Therefore, the older adult cancer patient receiving chemotherapy is subject to problems associated with the treatment regimen that are exhibited as physical symptoms and comorbid conditions, and which are considered to be extremely stressful to the patient and may impair both physical and psychological functioning, thereby impacting quality of life (QOL). The process of coping with cancer involves the use of both internal and external resources by the patient to meet the demands of the disease and its treatments. Among external resources in cancer patients, and in the older population in general, social support and social networks are thought to be positively associated with better outcomes. As an internal resource, research has shown a strong sense of personal control is associated with better mental health and better physical health in older adults, and it is also thought to act as a buffer against stressful life events. Among the internal resources associated with cancer coping are two elements of personal control, i.e., self-efficacy and mastery. The proposed project is a two -year, longitudinal study to gather preliminary data on both direct and moderating effects of health status, the social environment, and perceived personal control on the cancer patient's symptom distress and QOL during a treatment regimen chemotherapy. The primary aim of the study is to determine the association of comorbid disease and physical functioning, social support and network, and perceived personal control (both cancer-specific and global) on symptom distress and QOL of older cancer patients undergoing adjuvant/therapeutic chemotherapy, both during treatment and upon completion of chemotherapy. ? ? ?
|Robb, Claire; Lee, Aaron; Jacobsen, Paul et al. (2013) Health and personal resources in older patients with cancer undergoing chemotherapy. J Geriatr Oncol 4:166-73|