Older adults with cancer often present with distinct complexities that complicate their care, yet the language used to discuss their management at multidisciplinary cancer conferences (MCCs) remains poorly understood. A mixed methods study was conducted at a tertiary cancer centre in Toronto, Canada, where MCCs spanning five tumour sites were attended over six months. For presentations pertaining to a patient aged 75 or older, a standardized data collection form was used to record their demographic, cancer-related, and non-cancer-related information, as well as the presenter’s specialty and training level. Descriptive statistics and thematic analysis were employed to explore MCC depictions of older patients (n= 75). Frailty status was explicitly mentioned in 20.0% of presentations, but discussions more frequently referenced comorbidity burden (50.7%), age (33.3%), and projected treatment tolerance (30.7%) as surrogate measures. None of the presentations included mentions of formal geriatric assessment (GA) or validated frailty tools; instead, presenters tended to feature select GA domains and subjective descriptions of appearance (“looks to be fit”) or overall health (“relatively healthy”). In general, MCCs appeared to rely on age-focused language that may perpetuate ageism. Further work is needed to investigate how frailty and geriatric considerations can be objectively incorporated into discussions in geriatric oncology.
患有癌症的老年患者通常表现出独特的复杂性，使其治疗更为困难，然而在多学科癌症会议（MCCs）中讨论其管理时使用的语言仍鲜为人知。本研究在加拿大多伦多的一家三级癌症中心进行了一项混合方法研究，在六个月内参与了涵盖五个肿瘤部位的MCCs。针对年龄在75岁及以上的患者报告，使用标准化数据收集表记录其人口统计学、癌症相关和非癌症相关信息，以及报告者的专业背景和培训水平。采用描述性统计和主题分析探讨MCCs对老年患者（n=75）的描述。在20.0%的报告中被明确提及衰弱状态，但讨论更频繁地以合并症负担（50.7%）、年龄（33.3%）和预期治疗耐受性（30.7%）作为替代指标。所有报告中均未提及正式的老年综合评估（GA）或经过验证的衰弱评估工具；相反，报告者倾向于选择性地提及GA的某些领域，并对患者的外貌（“看起来健康”）或整体健康状况（“相对健康”）进行主观描述。总体而言，MCCs似乎依赖于以年龄为中心的语言，这可能加剧年龄歧视。未来需要进一步研究如何在老年肿瘤学讨论中客观纳入衰弱和老年医学考量。
Exploring the Language Used to Describe Older Patients at Multidisciplinary Cancer Conferences
肿瘤(癌症)患者之家