Ovarian Cancer Treatment In The Elderly

This practical book provides up-to-date information on the particular features of ovarian cancer in older women and the best management approach. The full range of relevant topics is covered. Guidance is provided on geriatric assessment, screening, pathology, diagnosis, and follow-up. The various treatment options are carefully explained, covering surgical approaches, chemotherapy as a first-line strategy, the use of anti-angiogenic agents, and treatment of relapse. The cognitive problems that may arise in elderly women during and after treatment of ovarian cancer are documented, with advice on response. Guidance is also provided on the design of clinical trials, and current directions in biological research are reviewed. This book will be of value to both practitioners and researchers with an interest in ovarian cancer and the elderly.​

Background. Treatment of elderly patients with neoplasia is challenging due to the frailty of the patients, existing comorbidities and increased number of concomitant medications1. In addition, elderly patients are usually underrepresented in clinical trials2. Age is a known prognostic factor in ovarian cancer but optimal treatment of elderly patients has not been determined3. We undertook a retrospective analysis to determine clinical practice in advanced stage ovarian cancer patients older than 75 years of age.Methodology. Medical records of women with high grade serous and endometrial ovarian cancer, stage III and IV, treated at Alexandra Hospital from 2011 to 2016 were retrospectively identified. Clinicopathological data, treatment and survival data were analyzed. Kaplan-Meier Survival curves were generated using IBM SPSS version 20; survival differences were estimated using the long-rank test. Results. In total, 158 patients were identified with a median age of 61.1 years. Among them 20 (12.7%) were older than 75 years of age at diagnosis (range 75.03- 92.72 years). First line Progression Free Survival (PFS) and Overall Survival (OS) were statistically significant worse in elderly patients in comparison to the younger ones (mPFS 13.4 months vs 21.9 months, P

This book presents comprehensive assessment and up-to-date discussion of the epidemiology, prevention, and treatment of cancer in the elderly, highlighting the growing demands of the disease, its biology, individual susceptibility, the impact of state-of-the-art and emerging therapies on reducing morbidity, and decision making processes. Describ

In an era of promising advances in cancer research, there are considerable and even alarming gaps in the fundamental knowledge and understanding of ovarian cancer. Researchers now know that ovarian cancer is not a single disease-several distinct subtypes exist with different origins, risk factors, genetic mutations, biological behaviors, and prognoses. However, persistent questions have impeded progress toward improving the prevention, early detection, treatment, and management of ovarian cancers. Failure to significantly improve morbidity and mortality during the past several decades is likely due to several factors, including the lack of research being performed by specific disease subtype, lack of definitive knowledge of the cell of origin and disease progression, and incomplete understanding of genetic and non-genetic risk factors. Ovarian Cancers examines the state of the science in ovarian cancer research, identifies key gaps in the evidence base and the challenges to addressing those gaps, considers opportunities for advancing ovarian cancer research, and examines avenues for translation and dissemination of new findings and communication of new information to patients and others. This study makes recommendations for public- and private-sector efforts that could facilitate progress in reducing the incidence of morbidity and mortality from ovarian cancers.

This book aims to provide an up-to-date review of the literature in each of the major areas relating to the management of older gynecological cancer patients, and makes recommendations for best practice and future research. The authors come from a broad geographic spread including the UK, mainland Europe and North America to ensure a worldwide relevance.

Women aged u226565 represent nearly 50% of ovarian cancer (OC) patients (pts). However, elderly OC pts are less likely to receive the optimal treatment and multidimensional geriatric assessment is still underused. Furthermore, they are significantly under-represented in clinical trials. The present study aimed to provide an overview of real-life treatment strategies for elderly advanced-OC pts and to investigate clinico-pathological features that potentially drive clinical decision-making in first-line treatment.A retrospective analysis was conducted on a consecutive series of 45 OC pts u226569 years old treated with first-line chemotherapy (CT) from 2011 to 2018 at National Cancer Institute, IRCCS CRO Aviano (Italy). Factors associated with treatment choice and rate of adverse events were investigated through Fisher-exact test and Pearson's Chi-squared test; differences in progression free survival (PFS) and overall survival (OS) were tested by log-rank test.In the total series, 67% of pts received standard carboplatin-paclitaxel combination (CPC) first-line CT . Conversely, 33% received a monotherapy (MT) (31% with carboplatin, 2% with paclitaxel). PS ECOG u22651 was the only factor significantly associated with MT (P=0.021). No differences were observed between CPC and CPC with dose reductions (CPCdr), either in terms of PFS (HR=1,29 P=0,59) or OS (HR=1,40 P=0,56). On the other hand, MT was associated with shorter PFS (HR=4,35 P=0,001) and OS (HR=4,48 P=0,005). No differences in treatment discontinuation rate, neutropenia, thrombocytopenia, neuropathy, constipation, diarrhea and asthenia in CPC, CPCdr and MT were detected (P>0.05).CPC represents the first-line standard therapy in advanced OC, the present study suggests that, in elderly patients, a dose reduction could be considered rather than a single agent regimen. Clinical decision-making was, moreover, mainly driven by PS ECOG, emphasizing the value of multidimensional geriatric assessment. Notwithstanding the limitations due to the small sample size, the evaluated regimens showed a comparable toxicity profile. Further prospective studies are needed to investigate biomarkers, aiming to tailor treatment strategies and to improve clinical outcomes.

The Johns Hopkins Patients’ Guide to Ovarian Cancer is a concise, easy-to-follow “how to” guide that puts you on a path to wellness by explaining ovarian cancer treatments from start to finish. It guides you through the overwhelming maze of treatment decisions, simplifies the complicated schedule that lies ahead, and provides valuable tools to help you to put together your plan of care. Empower yourself with accurate, understandable information that will give you the ability to confidently participate in the decision making about your care and treatment.

Handbook of Geriatric Oncology is a practical resource for oncologists and related clinicians who want to provide comprehensive, patient-centered care to the elderly cancer patient. Divided into nine succinct sections, it includes topics spanning an Overview of Geriatric Oncology and Aging, Geriatric Syndromes, Geriatric Assessment, Select Cancers Commonly Diagnosed in the Elderly, Communication with the Older Cancer Patient, the Nursing Home Patient with Cancer, Models of Care and Survivorship, Palliative Care, and Integrative Medicine. Complex issues such as the physiologic changes of aging and their effect on cancer, corresponding social and psychological aspects that accompany aging and a cancer diagnosis, assessment of frailty, managing comorbid conditions and diseases, effective communication among healthcare providers, the patient and caregivers, as well as the risks and benefits of cancer screening, are made simpler with helpful clinical guidance and clinical pearls. Spearheaded by world experts in geriatric oncology from Memorial Sloan Kettering Cancer Center in New York, this book is the definitive resource for oncologists and related clinicians to meet the demands of clinical management along the continuum of geriatric cancer care. Key Features: Provides best practices for evaluating geriatric syndromes such as functional dependency, falls, cognitive impairment and dementia, delirium, depression and anxiety, social isolation as well as syndromes related to nutrition, comorbid conditions, and polypharmacy. Includes practical guidance on when to treat and when not to treat cancer in older patients Discusses unique factors associated with breast cancer, prostate cancer, colorectal cancer, lung cancer, ovarian cancer, bladder cancer, pancreatic cancer, head and neck cancers, and myelodysplastic syndromes in the elderly that impact care plans and treatment.

A state-of-the-art, multidisciplinary approach to cancer and aging With the majority of cancers occurring in individuals over the age of 65 against a backdrop of an expanding aging population, there is an urgent need to integrate the areas of clinical oncology and geriatric care. This timely work tackles these issues head-on, presenting a truly multidisciplinary and international perspective on cancer and aging from world-renowned experts in geriatrics, oncology, behavioral science, psychology, gerontology, and public health. Unlike other books on geriatric oncology that focus mainly on treatment, Cancer and Aging Handbook: Research and Practice examines all phases of the cancer care continuum, from prevention through evidence-based diagnosis and treatment to end-of-life care. Detailed clinical and research information helps guide readers on effective patient care as well as caregiver training, research, and intervention. Coverage includes: Epidemiology of cancer in older adults, plus the unique physical, mental, and social issues involved Strategies and guidelines for prevention, screening, and treatment of older individuals with cancer The most common cancers in the elderly, including breast, colorectal, lung, prostate, and ovarian cancer Cancer survivorship in older adults as well as the all-critical issues of palliative care and pain management Emerging topics such as caregiver and family issues, different models of care, and cost considerations An essential resource for clinicians and caregivers as well as researchers interested in this evolving field, Cancer and Aging Handbook is also useful for public health professionals and policymakers who need to formulate services and allocate resources for the growing population of older cancer patients.