Introduction: Personalization of Cancer Care for Older Adults

To explore perspectives on music therapy as a nursing intervention in adult cancer care and to expand and integrate knowledge and understanding about music therapy as an adjunctive intervention in adult cancer nursing care. Published nursing articles. Medical and nursing journals have reported on research related to music and its effect as a nursing intervention. However, this research often lacks a musical context (i.e., knowledge and understanding from a musical perspective). Music therapy is not a consistent concept. Perspectives on the meanings of music therapy vary according to knowledge and scientific orientation. The perspective may influence the character and methodology of the music therapy intervention as well as the understanding of its results. To fully develop music therapy as an adjunct intervention in adult cancer care, interdisciplinary cooperation between nurses and music therapists should be supported on clinical and educational levels.

Older adults with cancer face unique challenges, including complex needs and systemic barriers to care. These factors affect their medical treatment decisions and overall quality of life, while caregivers face concurrent burdens. Building on a multi-phase, patient- and community-engaged project, this survey study aimed to validate and rank research and care priorities for older adults with cancer in British Columbia, Canada generated from our earlier work. A cross-sectional survey was conducted with healthcare professionals, older adults with cancer, caregivers, and community members recruited from health and community organizations. Respondents completed a 19-item online survey with five open-ended questions. Respondents rated and ranked six care and six research priorities identified from our previous work. Quantitative analysis utilized descriptive statistics to assess the significance of priorities, while thematic analysis examined factors influencing respondents' prioritization and decision-making. Data from106 respondents were analyzed. Financial barriers (e.g., medication costs, transportation, housing) was identified as the top care priority, followed by continuity of care. The highest-ranked research priority was implementing geriatric assessment and co-management by interdisciplinary teams. Open-ended responses emphasized financial strain, the need for holistic and culturally competent care, and challenges older adults face navigating fragmented healthcare systems. This study highlights the need for integrated geriatric oncology services that address financial, cultural, and systemic barriers. These priorities provide a foundation for developing tailored interventions and policies to improve cancer care for older adults in Canada. Differences in rankings across groups have methodological implications for inclusive, patient and community-engaged research.

Guiding Principles for the Care of Older Adults with Multimorbidity: An Approach for Clinicians

The world's population is aging rapidly and older adults carry a disproportionate cancer burden. Despite this, older patients remain underrepresented in clinical research. As a result, the evidence base informing guideline development remains limited. Existing guidelines vary in methodological quality and applicability. We aimed to evaluate the quality and clinical applicability of established geriatric oncology guidelines using the Appraisal of Guidelines Research and Evaluation, version II (AGREE II) instrument. A systematic search was conducted across PubMed, Embase, and the Cochrane Library, in addition to official oncology society websites (ASCO, NCCN, SoFOG, Japanese Geriatric Oncology Group). The search covered publications from January 2000 to May 2025 and was limited to English and to guidelines that specifically address cancer care in older adults and provide documented methodologies. Two reviewers independently appraised each guideline using the AGREE II tool across six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence. A total of 807 records were identified,out of which only 6 guidelines met the eligibility criteria. The AGREE II assessment revealed significant variability in guideline quality. Most guidelines scored high in clarity of presentation and scope and purpose, but showed moderate to low scores in stakeholder involvement and applicability. The recent ASCO guidelines demonstrated higher overall methodological rigor, whereas others lacked comprehensive documentation of evidence synthesis and user applicability. While several geriatric oncology guidelines demonstrate acceptable quality, inconsistencies remain, particularly in stakeholder engagement and practical implementation. Enhanced methodological rigor and inclusive development processes are essential for future guideline improvement and effective translation into geriatric oncology practice.

By 2030, the United States' population will increase to approximately 365 million, including 72 million older adults (age > or = 65 years) and 157 million minority individuals. Although cancer incidence varies by age and race, the impact of demographic changes on cancer incidence has not been fully characterized. We sought to estimate the number of cancer patients diagnosed in the United States through 2030 by age and race. Current demographic-specific cancer incidence rates were calculated using the Surveillance Epidemiology and End Results database. Population projections from the Census Bureau were used to project future cancer incidence through 2030. From 2010 to 2030, the total projected cancer incidence will increase by approximately 45%, from 1.6 million in 2010 to 2.3 million in 2030. This increase is driven by cancer diagnosed in older adults and minorities. A 67% increase in cancer incidence is anticipated for older adults, compared with an 11% increase for younger adults. A 99% increase is anticipated for minorities, compared with a 31% increase for whites. From 2010 to 2030, the percentage of all cancers diagnosed in older adults will increase from 61% to 70%, and the percentage of all cancers diagnosed in minorities will increase from 21% to 28%. Demographic changes in the United States will result in a marked increase in the number of cancer diagnoses over the next 20 years. Continued efforts are needed to improve cancer care for older adults and minorities.

The number of older adults with Alzheimer's disease and related disorders is expected to triple over the next 50 years. While we may be on the cusp of important therapeutic advances, such advances will not alter the disease course for millions of persons already affected. Hoping for technology to spare the health care system from the need to care for older adults with dementia is no longer tenable. Most older adults with dementia will receive their medical care in the primary care setting and this setting is not prepared to provide for the complex care needs of these vulnerable elders. With an increasing emphasis on earlier diagnosis of dementia, primary care in particular will come under increasing strain from this new care responsibility. While primary care may remain the hub of care for older adults, it cannot and should not be the whole of care. We need to design and test new models of care that integrate the larger health care system including medical care as well as community and family resources. The purpose of this paper to describe the current health care infrastructure with an emphasis on the role of primary care in providing care for older adults with dementia. We summarize recent innovative models of care seeking to provide an integrated and coordinated system of care for older adults with dementia. We present the case for a more aggressive agenda to improving our system of care for older adults with dementia through greater training, integration, and collaboration of care providers. This requires investments in the design and testing of an improved infrastructure for care that matches our national investment in the search for cure.

Socioeconomic Considerations and Shared-Care Models of Cancer Care for Older Adults

In recent decades, global crises like the COVID-19 pandemic and natural disasters have significantly challenged the ability to provide care for older adults, highlighting a critical research priority. Israel, with its advanced system of care for older adults and strong community support, performed well during COVID-19. This report describes efforts to maintain care during the June 2025 Israel-Iran war, a period of physical threat, disrupted medical services, psychological distress, and weakened social supports due to displacement and infrastructure damage. We highlight innovative strategies ensuring continuity of medical, mental health, and essential social services for older adults. Israel’s approach to emergency care for older adults rested on three pillars: (i) Leveraging past experience: Protocols from previous emergencies, including COVID-19, were quickly activated. This ensured continuity of care for older adults, especially those evacuated or in unsafe apartments, balancing safety with independence. (ii) Coordinated communication: Ongoing national and municipal collaboration and communication about at-risk older adults, enabled effective and timely, targeted interventions. (iii) Volunteerism and Civil Initiatives: A massive surge of community-led volunteer efforts provided transport, medications, and evacuee assistance, critically addressing urgent needs beyond government capacity. In conclusion, these three pillars – rapid response based on prior experience, a strong national and municipal system of communication and collaboration, and robust volunteerism – enabled continuous, high-quality care for older adults during this major crisis., These lessons can inform other systems aiming to enhance their resilience and capacity to provide care to older adults during emergency situations.

Adolescents are a distinct group in paediatric and adult cancer and palliative care specialities. The process that is experienced by the patient and his/her family of the transition from health to living with a life-threatening illness and from a life-threatening to a life-limited illness raises specific issues for service provision. The adolescent population presents with a wide variety of physical and emotional maturity that highlights the need for health professionals to be equipped with skills in adolescent care, cancer care and specialist palliative care. Due to the small number of patients who will require such a service in any one health district in the UK this is not usually realistic. This article discusses a model of care that promotes collaborative professional practice in a cancer centre between the paediatric department and adult specialist palliative care team that in turn extends a philosophy of care into cancer units and the community setting.

Artificial Intelligence (AI) applications in healthcare have significant potential to address the unmet needs of older adults. To successfully adopt and implement AI in the care of older adults, it is critical to understand stakeholders' perspectives. We sought to explore the perceived benefits and concerns among stakeholders about AI applications in caring for older adults. We conducted individual semi-structured interviews with five groups of stakeholders: older adults and caregivers, clinicians, health system and health insurance plan leaders (payers), investors, and technology developers. Interviews asked about the perceived role of AI in the care of older adults, the perceived benefits and concerns regarding AI, and suggestions for mitigating the concerns. Interviews were audio recorded and transcribed verbatim. We used thematic content analysis to code the transcripts. Overall, 49 participants completed interviews: older adults/caregivers (n = 15), clinicians (n = 15), payers (n = 8), investors (n = 5), and technology developers (n = 6). We identified three themes. (1). Stakeholders reported multiple benefits of AI and identified several roles for its use in the care of older adults. (2). Stakeholders expressed concerns about AI, including worsening social isolation, high cost, propagating ageism, goal misalignment, and scams/misuse of AI; views on privacy concerns were mixed. (3). Stakeholders suggested potential solutions, such as setting appropriate guardrails, to mitigate concerns about AI. Given the complexity and significant unmet needs among older adults, AI's potential benefits and harms are both heightened in this population. Appropriate guardrails are needed to leverage the benefits of AI while mitigating potential harms. Our findings have implications for technology developers to design innovations that align with the stakeholders' perceived roles for AI, for regulatory bodies to incorporate stakeholders' concerns when developing AI regulations, and for health systems and end-users of technology to critically evaluate a product regarding its affordability and impact on social isolation and ageism.

The U.S. health care system is not prepared to meet the needs of the increasing population of older adults. Few physicians become geriatricians, but most will care for older adults. The authors assessed the quality of care for older adults in residency clinics and physician practices. Using the American Board of Internal Medicine's Care of the Vulnerable Elderly practice improvement module, researchers studied the quality of care provided to older adults in 52 internal and family medicine residency clinic sites and by a motivated group of 144 practicing physicians from 2006 to 2008. They also studied the characteristics of the practice systems in the clinics and offices and the relationship between specific elements of practice systems and the quality of care. Patients seen by residents were younger, had fewer chronic conditions, and were less likely to receive recommended care. Residency clinic systems were less likely to have elements designed to support care for older adults. Even when present, there was little correlation with care provided. Practicing physicians were more likely to provide recommended processes of care, and system elements in their practices were more likely to function well and correlate with delivery of key processes of care, but much room for improvement remains. Practice system elements designed to support care for older adults perform differently in residency clinics than in practicing physicians' offices. Significant gaps in the quality of care for older adults exist and are much more pronounced in the residency clinic setting.

ObjectiveTo characterise clinical questions raised by providers in the care of complex older adults in order to guide the design of interventions that can help providers answer these questions.Materials and...

In surveys and in research, proxies such as family members may be used to assess patient health-related quality of life. The aim of this research is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data. Systematic review and methodological appraisal of studies examining the concordance of paired adult cancer patient and proxy responses for multidimensional, validated HRQOL tools. We searched PubMed, CINAHL, PsycINFO and perused bibliographies of reviewed papers. We reviewed concordance assessment methods, results, and associated factors for each validated tool. A total of 32 papers reporting on 29 study populations were included. Most papers were cross-sectional (N = 20) and used disease-specific tools (N = 19), primarily the FACT and EORTC. Patient and proxy mean scores were similar on average for tools and scales, with most mean differences <10 points but large standard deviations. Average ICCs for the FACT and EORTC ranged from 0.35 to 0.62, depending on the scale. Few papers (N = 15) evaluated factors associated with concordance, and results and measurement approaches were inconsistent. The EORTC was the most commonly evaluated disease-specific tool (N = 5 papers). For generic tools, both concordance and associated factor information was most commonly available for the COOP/WONCA (N = 3 papers). The MQOL was the most frequently evaluated end-of-life tool (N = 3 papers). Proxy and patient scores are similar on average, but there is large, clinically important residual variability. The evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).

Introduction Psychosocial care improves the quality of life (QoL) for cancer patients and their families. A growing body of randomized controlled trials (RCTs) and quasi experimental studies have been published and systematic reviews have been done on psychosocial interventions in cancer care in the recent past, in the low-and-middle income countries (LMICs). However, a quantitative assessment of the effectiveness of psychosocial interventions in cancer care for adults living with cancer in LMICs is missing. This study aimed at synthesizing the available evidence on the effectiveness of psychosocial care interventions towards the improvement of the quality of life of adult patients with cancer in LMICs. Methods We registered the protocol of this study with PROSPERO (ID: CRD4202342156) before conducting this systematic review and meta-analysis of original studies on psychosocial care interventions in cancer care for adults with cancer in LMICs. Studies published between 1st January 2002 and 31st December 2023 in any LMIC, were searched from various electronic databases which included Ovid MEDLINE (PubMed), Web of Science, EmBASE, APA PsycINFO, and Google Scholar. We followed the standard guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) standards. Results Twenty-six RCTs and quasi experimental studies (with 3,878 participants, 1,955 in study arm and 1,923 in control arm) were included in this systematic review and meta-analysis. Sixty-nine percent (n=18) of the included studies were RCTs. The study sizes ranged between 24 and 2140 participants. Most of the included studies (46%) were published between 2016 and 2019. Of the five WHO regions, the Eastern Mediterranean region had the highest number (62%, 18) of the included studies and Africa region has only three studies (1 from Ethiopia and 2 from Nigeria) in this meta-analysis. The biggest number of psychosocial care interventions utilised by the included studies belonged to the Cognitive Behavioural therapy (CBT) (38%, n=10 studies) followed by Mindfulness-based therapy (MBT) with 31% (n=8) with Family systems therapy trailing with 4% (n=1). From the subgroup analyses of the means and standard deviations of domains of quality of life in the pooled primary studies, the respective standardized mean differences (SMD) indicated that the psychosocial care intervention had a significant positive effect on the physical (0.972: p= 0.002), social (0.884: p=0.005) and psychological (0.590: p= 0.03) domains of quality of life of adult patients with cancer. However, the negative SMD for depression (-1.612: p=0.007) and anxiety (-3.313: p= &lt;0.001) domains indicates that the psychosocial care interventions in the primary studies for these domains did not improve the quality of life of study participants. The CBT-related psychosocial care interventions significantly improved in the QoL of adult patients with cancer compared to the interventions that belonged to other models. Conclusion On the overall, psychosocial care interventions effectively improved most domains of the QoL of adult patients with cancer. Future research is needed for those interventions whose findings had negative effect on some domains of the QoL of patients with cancer.

People with intellectual disability have unmet health needs and experience health inequalities. There is limited literature regarding cancer care for children, adolescents, and young adults (AYA) with intellectual disability despite rising cancer incidence rates in this population. This systematic review aimed to identify the psycho-social and information support needs of AYA cancer care consumers with intellectual disability to generate recommendations for future research and cancer care service delivery enhancement. We searched eight databases yielding 798 articles. Following abstract and full-text review, we identified 12 articles meeting our inclusion criteria. Our three themes related to communication and accessible information; supports and system navigation, cancer service provider training, and reasonable adjustments. There was a lack of user-friendly, accessible information about cancer and screening programs available. Both paid and family carers are critical in accessing cancer supports, services, and screening programs for AYA with intellectual disability. Ongoing training should be provided to healthcare professionals regarding the importance of care screening for AYAs with intellectual disability. This review recommends that AYA with intellectual disability and their family carers be involved in developing tailored cancer services. This should focus on enabling inclusive screening programs, accessible consent, and challenging the enduring paternalism of support services via training and appropriate communication tools.