Reducing frailty in older cancer patients

18 Mar 2024
Dr Louise Cooney (centre) with her fellow project team members Associate Professor Rahul Ladwa (far left) Robyn Berry (left), Professor Ruth Hubbard, (right) and Associate Professor Ingrid Hickman (far right).

When older Australians are diagnosed with cancer, how frail they are can affect their outcomes and ability to bounce back after treatment.

Thanks to PA Research Foundation donors, a new research project based at the PA Hospital (PAH) campus will explore several ways to reduce frailty in older cancer patients, so they can have better outcomes from their treatment and live fuller lives.

Led by a multidisciplinary team that includes PAH dietitian Louise Cooney, the World Cancer Research Fund co-funded project, will serve a demographic that is often overlooked when it comes to cancer research.

“There's really good data that was generated here at the PAH, to show that the frailer you are the poorer your outcomes are during cancer treatment,” Louise said.

“There's lots of work being undertaken here at the PAH, led by Prof Ruth Hubbard, which looks at screening for frailty in older people when they first attend PAH for cancer treatment.”

“What we don't know, is if we do find that someone is frail, pre-frail or at risk of developing frailty during the cancer treatment, what can we do about it?”

“We know that frailty is reduced in older people without cancer who have their medications optimised, have good social connection, eat a great diet, and are physically active..”

“We want to know if these important lifestyle aspects will work in this cancer population.”

“Why it matters and why we’re so grateful to the PA Research Foundation is because this research will allow us to test if a lifestyle program for older people with cancer will improve their outcomes both in terms of extending their life, but also quality of life”.

Part of the study will be engaging with patients and their families and carers to learn the best ways to work with them to help them to reduce their frailty.

“This is a very challenging group to work with because of their age and because cancer treatment is burdensome,” Louise said.

“It takes up a lot of their time, it takes up a lot of their carers’ time, and it has a psychological as well as a physical burden. So how do we engage older people with cancer in an intervention that will either reduce the severity of their frailty or prevent them from getting frailty during cancer treatment.”

“We figured instead of just trying to tell them what they should be doing, what if we asked them what will work for them.”

“We've got expertise in all of these different areas, such as behavior change, exercise and nutrition and we've got experts in social connectedness and cancer treatment.”.

 “We have all these experts that understand how frailty can be reduced, what we don’t understand is how can we do that in a population that are undergoing cancer treatment. It’s a marriage between the experts and the people that are actually experiencing it.”

The study which will extend into regional Queensland and Northern NSW through telehealth and liaison with GPs will primarily focus on patients with cancers that are most prevalent in the older population including lung cancer, head and neck cancer, upper and lower gastrointestinal cancer and blood cancers.

“There's a much higher incidence of cancer now because the population is getting older. With older age comes increased risk of frailty, and that risk can be increased during cancer treatment.  So, knowing how to identify, prevent or treat frailty in older cancer patients is super important.”

“I think the really big thing for older patients is that they want to maintain a good quality of life, they want to maintain independence and social connection especially when they are going through cancer treatment.”

“It's one thing for cancer treatment to preserve or extend someone's life but it also should provide a life worth living. As health care providers we can treat their cancer and extend their life, but we also need to do everything we can to ensure they attain their best quality of life; preventing and treating frailty ensures that happens.”

Funding for this research was obtained from the PA Foundation Project grant and grant # 2023 -005 from Wereld Kanker Onderzoek Fonds (WKOF) as part of the World Cancer Research Fund International grant programme