| Foreword |
xvii |
| |
|
| Chapter 1. Cancer and the Aging Population |
1 |
| Introduction |
1 |
| Aging Population |
1 |
| Cancer and Aging |
2 |
| Future Implications |
6 |
| Conclusion |
10 |
| |
|
| Chapter 2. Research Issues and Priorities |
13 |
| Introduction and Background |
13 |
| Scope of Problem |
14 |
| Historical Perspective |
15 |
| State of Geriatric Nursing Research |
16 |
| Nurse Competence in Aging |
16 |
| Assessment of the Older Adult Patient With Cancer |
28 |
| Research Focused on Treatment Modalities and Responses
|
29 |
| Issues in Palliative Care Research |
29 |
| Models of Evidence-Based Care and Existing Evidence-Based
Protocols |
31 |
| Research Challenges Encountered With Older Adult Populations |
33 |
| Recommendations for Future Directions |
35 |
| |
|
| Chapter 3. Physiology of Aging |
41 |
| Introduction |
41 |
| Organ Systems |
42 |
| Molecular Changes and Carcinogenesis |
45 |
| Growth Regulatory Genes |
47 |
| Conclusion |
52 |
| |
|
| Chapter 4. Comprehensive Geriatric Assessment |
57 |
| Introduction |
57 |
| Aspects of Health Assessment |
57 |
| Definition of the Comprehensive Geriatric Assessment |
59 |
| Components of the Comprehensive Geriatric Assessment |
59 |
| Benefits of the Comprehensive Geriatric Assessment |
64 |
| Role of the Nurse in Coordination of the Comprehensive
Geriatric Assessment and Follow-Up |
66 |
| Case Study |
68 |
| Conclusion |
70 |
| |
|
| Chapter 5. Cancer Screening in the Older Adult |
75 |
| Introduction |
75 |
| Screening Decisions |
75 |
| Breast Cancer |
80 |
| Ovarian Cancer |
81 |
| Prostate Cancer |
82 |
| Colorectal Cancer |
83 |
| Lung Cancer |
85 |
| Clinical Practice Implications |
86 |
| Research Implications |
86 |
| Conclusion |
87 |
| |
|
| Chapter 6. Pharmacologic Issues |
91 |
| Introduction |
91 |
| Pharmacokinetics |
91 |
| Adherence |
97 |
| Drug Interactions |
100 |
| Adverse Drug Reactions |
101 |
| Conclusion |
101 |
| |
|
| Chapter 7. The Older Adult With Breast Cancer |
103 |
| Introduction |
103 |
| Risk Factors |
105 |
| Pathophysiology |
108 |
| Screening |
108 |
| Clinical Presentation |
110 |
| Staging |
111 |
| Comprehensive Geriatric Assessment |
111 |
| Treatment |
111 |
| Nursing Care Issues |
118 |
| Areas for Future Research |
120 |
| Case Study |
127 |
| Conclusion |
128 |
| |
|
| Chapter 8. The Older Adult With Colorectal Cancer |
135 |
| Introduction |
135 |
| Risk Factors |
137 |
| Pathophysiology |
138 |
| Clinical Presentation |
139 |
| Diagnostic Evaluation |
140 |
| Staging |
140 |
| Treatment |
142 |
| Surgery |
145 |
| Radiation Therapy |
149 |
| Chemotherapy and Biologics: Adjuvant |
152 |
| New Agents |
154 |
| Individualized Treatment |
158 |
| Nursing Care and Considerations With the Older Adult |
158 |
| Areas for Future Research |
159 |
| Case Study |
161 |
| Conclusion |
162 |
| |
|
| Chapter 9. The Older Adult With Head and Neck Cancer
|
167 |
| Introduction |
167 |
| Head and Neck Cancer, Aging, and Older Adults |
167 |
| Incidence |
168 |
| Risk Factors |
170 |
| Early Detection |
172 |
| Staging |
172 |
| Treatment |
175 |
| Nursing Care Issues |
178 |
| Areas for Future Research |
178 |
| Case Study |
179 |
| Conclusion |
181 |
| |
|
| Chapter 10. The Older Adult With Lung Cancer |
185 |
| Introduction |
185 |
| Incidence |
185 |
| Mortality |
186 |
| Clinical Presentation |
186 |
| Lung Cancer in the Older Adult |
187 |
| Changes of Aging |
187 |
| Risk Factors |
188 |
| Screening |
189 |
| Chemoprevention in Lung Cance |
190 |
| Types of Lung Cancer in Older Adults |
191 |
| Diagnostic Evaluation |
192 |
| Tissue Diagnostic Procedures |
194 |
| Staging |
196 |
| Preoperative Evaluation in Patients With Operable Tumors |
197 |
| Treatment of Non-Small Cell and Small Cell Lung Cancer |
198 |
| Lung Cancer Biology |
205 |
| Biologic Prognostic Factors |
206 |
| New Therapies Under Investigation |
207 |
| Follow-Up and Usual Disease Progression |
213 |
| Palliative Care |
214 |
| Symptom Control |
215 |
| Clinical Practice Guidelines for Lung Cancer |
217 |
| Nursing Care Issues |
218 |
| Conclusion |
218 |
| |
|
| Chapter 11. The Older Adult With Prostate Cancer |
225 |
| Introduction |
225 |
| Incidence |
225 |
| Risk Factors |
226 |
| Pathophysiology |
227 |
| Screening |
227 |
| Clinical Presentation |
229 |
| Staging |
229 |
| Treatment |
230 |
| Nursing Care Issues |
241 |
| Areas for Future Research |
243 |
| Case Study |
244 |
| Conclusion |
245 |
| |
|
| Chapter 12. The Older Adult With Non-Hodgkin Lymphoma
|
251 |
| Introduction |
251 |
| Risk Factors |
252 |
| Pathophysiology |
252 |
| Clinical Presentation |
254 |
| Staging |
254 |
| Factors That Influence Treatment in the Older Person
With Non-Hodgkin Lymphoma |
256 |
| Treatment |
261 |
| Nursing Care Issues |
264 |
| Areas for Future Research |
268 |
| Case Study |
269 |
| Conclusion |
271 |
| |
|
Chapter 13. The Older Adult With Hematologic Malignancies
and Disorders |
277 |
| Introduction |
277 |
| Classifications |
278 |
The Challenge of Treating Acute or Chronic Leukemias
or Myelodysplastic
Syndromes in the Older Adult |
279 |
| Acute Leukemias |
279 |
| Acute Leukemias |
282 |
| Chronic Leukemias |
284 |
| Initial Evaluation of the Patient With Leukemia or
Myelodysplastic Syndrome |
289 |
| Treatment of Acute Leukemia |
291 |
| Treatment of Chronic Leukemia |
299 |
| Case Study |
303 |
| Conclusion |
304 |
| |
|
| Chapter 14. The Older Adult Receiving Radiation Therapy |
311 |
| Introduction |
311 |
| Treatment Definition |
312 |
| Principles of Radiation Therapy |
312 |
| Physical Consequences of Aging and Radiotherapy |
314 |
| Supportive Care |
320 |
| Case Study |
321 |
| Conclusion |
322 |
| |
|
| Chapter 15. The Older Adult With Myelosuppression and
Anemia |
325 |
| Introduction |
325 |
| Physiologic Effects of Aging |
326 |
| Evaluation of the Older Adult With Cancer |
329 |
| Geriatric Syndrome |
332 |
| Chemotherapy-Related Hematologic Toxicities |
334 |
| Minimizing Toxic Effects |
339 |
| Management of Febrile Neutropenia |
340 |
| Nursing Care Issues |
342 |
| Case Study |
343 |
| Conclusion |
344 |
| |
|
| Chapter 16. Symptom Management of Mucositis |
349 |
| Introduction |
349 |
| Incidence |
349 |
| Risk Factors |
350 |
| Pathophysiology |
351 |
| Clinical Presentation |
352 |
| Assessment |
353 |
| Complications Associated With Mucositis |
354 |
| Nursing Care Issues |
356 |
Evidence-Based Clinical Practice Guidelines for the
Prevention
and Management of Oral and Gastrointestinal Mucositis |
358 |
| New Investigational Treatments |
361 |
| Areas for Future Research |
362 |
| Conclusion |
362 |
| |
|
| Chapter 17. Symptom Management of Diarrhea and Constipation
|
367 |
| Introduction |
367 |
| Diarrhea |
368 |
| Cancer Therapy and Diarrhea |
371 |
| Constipation |
378 |
| Cancer Therapy and Constipation |
279 |
| Areas for Future Research |
386 |
| Conclusion |
387 |
| |
|
| Chapter 18. Nutritional Care of the Older Adult With
Cancer |
391 |
| Introduction |
391 |
| Diet as a Cancer Etiology |
391 |
| Effects of Cancer on Nutritional Status |
392 |
| Supporting Nutrition for Older Adult Patients With
Cancer |
394 |
| Conclusion |
395 |
| |
|
| Chapter 19. Symptom Management of Pain |
397 |
| Introduction |
397 |
| Prevalence of Pain in the Older Adult With Cancer |
398 |
| Pathophysiology of Pain in the Older Adult |
399 |
| Clinical Assessment of Pain |
401 |
Pain Treatment History and Responses to Previous and
Current
Analgesic Regimens |
408 |
| Principles of Opioid Administration in the Older Patient
With Cancer |
421 |
| Selecting a Route and Dosing Intervals |
423 |
Complementary and Alternative Therapies in the Management
of Pain in the Older Adult |
430 |
| Conclusion |
431 |
| |
|
| Chapter 20. Sexuality Care of the Older Adult With
Cancer |
439 |
| Introduction |
439 |
| Focus on Sexual Health |
440 |
| The Aging Population and Recent Research |
441 |
| Sociocultural Issues |
442 |
| Life Cycle Changes |
444 |
| Myths and Realities |
446 |
| Normal Psychosexual Development in Later Adulthood |
447 |
Sexual Problems Induced by Cancer: Sexual Desire, Arousal,
Orgasm Impairment |
450 |
| Maintaining Patient Confidence in Their Sexuality |
455 |
| Rehabilitation Interventions |
457 |
| Areas for Future Research |
459 |
| Case Study |
460 |
| Conclusion |
461 |
| |
|
| Chapter 21. Palliative Care of the Older Adult With
Cancer |
465 |
| Introduction |
465 |
| Information Sharing |
466 |
| Advanced Care Planning |
466 |
| End-of-Life Treatment Decisions |
467 |
| Caregiver Experiences |
476 |
| Physical Symptoms |
479 |
| Barriers to Palliative Care in the Older Adult |
479 |
| Role of the Advanced Practice Nurse in Palliative Care |
480 |
| Areas for Future Research |
481 |
| Conclusion |
481 |
| |
|
| Chapter 22. Complementary and Alternative Therapies |
485 |
| Introduction |
485 |
| Background |
486 |
| Defining Complementary andAlternative Medicine |
487 |
| Complementary and Alternative Medicine and Evidence-Based
Practice |
490 |
| Decision Making in the Older Adult With Cancer |
494 |
| Conclusion |
515 |
| |
|
| Chapter 23. Spiritual Care of the Older Adult With
Cancer |
529 |
| Introduction |
529 |
| Review of Literature |
530 |
| Spirituality Defined |
532 |
| Spiritual Assessment |
542 |
Promoting Spiritual Health Throughout the Cancer Trajectory:
A Case
Study Approach |
543 |
| Spiritual Self-Care for the Nurse |
551 |
| Conclusion |
556 |
| |
|
| Chapter 24. Legal and Ethical Issues |
561 |
| Introduction |
561 |
| Cancer and the Older Adult |
561 |
| Ethical and Legal Principles |
563 |
| Case Study and Discussion |
564 |
| Conclusion |
574 |
| |
|
| Chapter 25. Older Adults and Cancer Survivorship |
579 |
| Background Information on the Older Adult Population
and Cancer Incidence |
579 |
| Cancer Incidence and Survivors |
579 |
| What Is Survivorship and Who Are the Survivors? |
580 |
| Overview of the Current State of Research on Older
Adult Cancer Survivors |
583 |
| Review of Research on Older Adult Cancer Survivors |
584 |
| Future Directions in Age-Focused Research |
594 |
| |
|
| Conclusion |
596 |
| |
|
| Index |
601 |
