針對老年人的癌癥護(hù)理方法可能會(huì)有更好的效果

針對老年人的癌癥護(hù)理方法可能會(huì)有更好的效果

When Lorraine Griggs' 86-year-old father was diagnosed with prostate cancer, he was treated with 35 rounds of radiation, though he had a long list of other serious medical issues, including diabetes, kidney disease and high blood pressure. The treatment left him frailer, Griggs recalls.

洛林·格里格斯86歲的父親被診斷出患有前列腺癌時(shí)，他接受了35輪放療，盡管他還有一長串其他嚴(yán)重的醫(yī)療問題，包括糖尿病、腎病和高血壓。格里格斯回憶說，治療使他更加虛弱。

A few years later, when his prostate cancer reoccurred, Griggs' father received a different kind of cancer care. Before his doctor devised a treatment plan, she ordered what's known as a geriatric assessment.

幾年后，當(dāng)他的前列腺癌復(fù)發(fā)時(shí)，格里格斯的父親接受了一種不同的癌癥治療方式。在他的醫(yī)生制定治療方案之前，她安排了一項(xiàng)所謂的老年評估。

It included a complete physical and medical history, an evaluation by a physical therapist, a psychological assessment and a cognitive exam. The doctor also asked her father about his social activities, which included driving to lunch with friends and grocery shopping with some assistance.

它包括完整的身體和病史，物理治療師的評估，心理評估和認(rèn)知檢查。醫(yī)生還詢問了她父親的社交活動(dòng)，包括與朋友一起開車去吃午飯，以及在一些幫助下去雜貨店購物。

"When the doctor saw how physically active and mentally sharp my father was at 89 years of age, but that he had several chronic, serious medical problems, including end stage kidney disease, she didn't advise him to have aggressive treatment like the first time around," says Griggs, who lives in Rochester, N.Y.

住在紐約州羅切斯特的格里格斯說：“當(dāng)醫(yī)生看到我父親89歲時(shí)身體活動(dòng)和精神敏銳，但他有幾個(gè)慢性、嚴(yán)重的醫(yī)療問題，包括腎病晚期，她沒有建議他像第一次那樣進(jìn)行積極的治療。”

Instead, his oncologist placed her dad on one pill a day that just slowed down his cancer. Griggs' father was able to enjoy his activities for another three years until he died at the age of 92.

相反，他的腫瘤醫(yī)生讓她的父親每天吃一片藥，這只是延緩了他的癌癥。格里格斯的父親又享受了三年他的活動(dòng)，直到他去世，享年92歲。

Geriatric assessment is an approach that clinicians use to evaluate their elderly patients' overall health status and to help them choose treatment appropriate to their age and condition. The assessment includes questionnaires and tests to gauge the patients' physical, mental and functional capacity, taking into account their social lives, daily activities and goals.

老年評估是臨床醫(yī)生用來評估老年患者整體健康狀況并幫助他們選擇適合其年齡和狀況的治療方法的一種方法。評估包括問卷和測試，考慮他們的社會(huì)生活、日常活動(dòng)和目標(biāo)，以衡量病人的身體、精神和功能水平。

The tool can play an important role in cancer care, according to clinicians who work with the elderly. It can be tricky to predict who will be cured, who will relapse and who will die from cancer treatment. Geriatric assessments can help physicians better estimate who will likely develop chemotherapy toxicities and other serious potential complications of cancer treatment, including death.

據(jù)專治老年人的臨床醫(yī)生說，這種工具可以在癌癥治療中發(fā)揮重要作用。很難預(yù)測誰會(huì)被治愈，誰會(huì)復(fù)發(fā)，誰會(huì)死于癌癥治療。老年評估可以幫助醫(yī)生更好地評估哪些人可能會(huì)出現(xiàn)化療毒性和癌癥治療的其他嚴(yán)重潛在并發(fā)癥，包括死亡。

Geriatric assessment includes an evaluation by a physical therapist, a psychological assessment, a cognitive exam and a complete physical and medical history. The doctor takes all these factors into account and tallies a score for their patient to help guide their decision-making about the patient's treatment.

老年評估包括物理治療師的評估、心理評估、認(rèn)知檢查和完整的有關(guān)身體和疾病的歷史。醫(yī)生把所有這些因素都考慮進(jìn)去，并為病人打分，以幫助指導(dǎo)他們對病人的治療做出決定。

Although the geriatric assessment is not 100% accurate, "it's better than the clinician eyeball test," says Supriya Gupta Mohile, a geriatric oncologist and professor of medicine at the University of Rochester. "If I didn't do a geriatric assessment and just looked at a patient I wouldn't have the same information," she says.

雖然老年評估不是100%準(zhǔn)確，但“它比臨床醫(yī)生用眼睛觀察好，”羅徹斯特大學(xué)老年腫瘤學(xué)家、醫(yī)學(xué)教授蘇普里亞·古普塔·莫海勒說。她說:“如果我不做一個(gè)老年評估，只（用眼睛）看一個(gè)病人，我就不會(huì)得到同樣的信息。”

More than 60% of cancers in the U.S. occur in people older than 65. As the population grows older, so will the rate of cancer among seniors. The cancer incidence in the elderly is expected to rise 67% from 2010 to 2030, according to a 2017 study in the Journal of Clinical Oncology. Yet many oncologists don't have geriatric training.

美國60%以上的癌癥發(fā)生在65歲以上的人身上。隨著人口老齡化，老年人患癌癥的比率也會(huì)增加。《臨床腫瘤學(xué)雜志》2017年的一項(xiàng)研究顯示，從2010年到2030年，老年人的癌癥發(fā)病率預(yù)計(jì)將上升67%。然而，許多腫瘤學(xué)家沒有接受過老年醫(yī)學(xué)培訓(xùn)。