Project 460502

The majority of cancer diagnoses in Canada occur in older adults. Aging is a risk factor for cancer and memory problems. Most patients with memory concerns or even those diagnosed with dementia can make their own health-related decisions when they receive a clear explanation and with family or caregiver support in place. At the same time, growing evidence suggests that cancer treatment can negatively impact memory, and those older adults with memory concerns may be more at risk for future memory decline, confusion or becoming acutely ill while receiving cancer treatment. Patients treated for cancer are routinely given complex instructions about treatment, assuming that they can recognize suddenly feeling unwell affecting their thinking and functioning, alert the oncology team promptly, and modify cancer treatment accordingly. Cognitively impaired older adults treated for cancer may have unique supportive care needs. Patients adjusting to multiple oncology visits and the complexities of the healthcare system in the challenging times of the Covid-19 pandemic often feel unprepared for navigating this system or unable to express their needs regarding the range of supports essential to sail through their cancer treatment as smoothly as possible. These vulnerable individuals may experience a myriad of symptoms, including worsening fatigue, "brain fog," increased falls, confusion, anxiety, or mood swings which can further impact their physical health and level of function. Therefore, the rationale for conducting this study is (1) to examine the impact of cancer treatment on cognition, disease burden and mortality in older adults with pre-existing memory problems and (2) to examine the supportive care needs of this group of patients. This study will incorporate a medical chart review of patients seen at an old age clinic in a cancer care centre in Toronto and in-depth interviews with older adults aged 65 or older, treated for cancer, their caregivers and oncologists.