A defined pathway for patients with both dementia and cancer
People with dementia who develop cancer are often either overtreated or written off, and decisions are made without them. A clear pathway for assessment, consent and treatment planning would improve both.
Dementia is common among older cancer patients and complicates diagnosis, capacity assessment, consent, adherence, and toxicity recognition. There is little guidance. A pathway combining cognitive screening at diagnosis, structured capacity assessment, involvement of carers and, where appropriate, advance care planning, simplified regimens, and supported adherence would reduce both undertreatment of those who could benefit and harmful treatment of those who cannot.
- Older and multimorbid patients are excluded and undertreated · Most people with cancer are over 65 but most trial patients are younger and fitter. We guess how to treat the majority.
- Patients lack understanding, navigation and agency · Most patients cannot understand their options, find trials, or push back, so decisions are made for them.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
Pages like this
not linked directly; found by shared links- IdeaCaregiver training and respite as a covered service in cancer care for older patients
Shares Older and multimorbid patients are excluded and undertreated, Patients lack understanding, navigation and agency.
- IdeaFormal shared-care agreements between oncology and family doctors, with same-day e-consult
Shares Older and multimorbid patients are excluded and undertreated, Fragmented care and guideline gaps.
- IdeaPatient navigation as a legal entitlement from the day of diagnosis
Shares Patients lack understanding, navigation and agency, Fragmented care and guideline gaps.
- IdeaGeriatrician co-management for older patients having cancer surgery
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaParallel real-world cohorts for sicker patients alongside every pivotal trial
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaStop screening by life expectancy, not birthday, with a tool in the record
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaA standard handoff with medication reconciliation at every cancer care transition
Shares Older and multimorbid patients are excluded and undertreated, Fragmented care and guideline gaps.
- IdeaPragmatic trials in patients over 75 with function, not just survival, as the primary endpoint
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.