Older adults with advanced bladder cancer want honest communication, family involvement during care

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New research has examined the care planning priorities of older adults with advanced bladder cancer and found that these patients want more transparency when it comes to communication with their care providers and treatment.

The study, published in the Journal of Geriatric Oncology, was led by Elizabeth Kessler, MD, a University of Colorado Cancer Center member, and associate professor of medical oncology at the CU School of Medicine. She found that patients want to be engaged in their treatment very early on in the process. In addition to honest communication, these patients – who are typically in their 70s and 80s - want to know what to expect from treatment, how their quality of life might change, and how their families can be involved in their care planning.

For her investigation, Kessler and her co-researchers interviewed 10 older advanced bladder cancer patients through focus groups and individually. Many of those surveyed had previously received a diagnosis of localized bladder cancer that had either recurred or progressed. During the interviews, Kessler found that these patients continually recalled the experience of the initial cancer diagnosis, pointing to the profound impact of that moment, according to the study.

In addition, to having clear information about treatment, patients expressed a desire for clarity around what their care partner’s role would be, even if there was variation about how they wanted those care partners involved in discussions.

Results from the research are informing a pilot called ABC123: A Framework for Goal Concordant Care in Advanced Bladder Cancer, a project supported by a grant from the American Cancer Society that Kessler is leading. A goal for the pilot, which is nearing completion, is to test a framework that aligns care for advanced bladder cancer patients and takes into account their core priorities and values along with their health and physical function.

“What we’ve found is that patients really do want to talk about their prognosis and treatment right from the beginning,” Kessler said in a statement. “Instead of focusing on alignment at end-of-life, now we’re looking at ways to come up with a treatment plan that better aligns care for people right from the start.”