Gero-Oncology Nursing Research

ONF 2004, 31(2), 293-299. DOI: 10.1188/04.ONF.293-299

Purpose/Objectives: To analyze the development of gero-oncology research through a critical review of nursing and other relevant research as well as the present state of practice.

Data Sources: Journal articles, book chapters, and personal experience.

Data Synthesis: Cancer in older adults is viewed through two investigative perspectives. The assumptions, questions, theoretical frames, and research design that follow from these investigative perspectives do not adequately meet the need to examine the interplay of responses to aging, cancer, and nursing practice. The mismatch of need, knowledge, and resources marks older adults with cancer as a special population in need of far more sophisticated research. With the synthesis of a new perspective, gero-oncology nursing research becomes age focused, more precisely shaping theoretical, methodologic, and analytic approaches.

Conclusions: Uniform attachment of chronologic age or other simple age-related variables to investigations, which is the primary consideration of age-related research, is irrelevant for older adults who are diagnosed with, treated for, live with, survive, and die from cancer. Shaping the next phase of gero-oncology research with a focus on age precisely integrates theoretical, methodologic, and analytic approaches through language specific to older adults and cancer.

Implications for Nursing: Shifting perspectives in gero-oncology nursing research will better inform future practice.

Jump to a section

    References

    American Nurses Association. (2003). Nursing's social policy statement (2nd ed.). Washington, DC: American Nurses Publishing.

    Aubertin, M.A. (1997). Home care of the elderly oral cancer patient. Home Healthcare Nurse, 15, 381-390.

    Balducci, L. (2000a). Evidence-based management of cancer in the elderly. Cancer Control, 7, 368-376.

    Balducci, L. (2000b). Geriatric oncology: Challenges for the new century. European Journal of Cancer, 36, 1741-1754.

    Balducci, L. (2001). The geriatric cancer patient: Equal benefit from equal treatment. Cancer Control, 8(Suppl. 2), 1-25.

    Balducci, L., & Extermann, M. (2000a). Cancer and aging: An evolving panorama. Hematology/Oncology Clinics of North America, 14, 1-16.

    Balducci, L., & Extermann, M. (2000b). Management of cancer in the older person: A practical approach. Oncologist, 5, 224-237.

    Balducci, L., & Stanta, G. (2000). Cancer in the frail patient. A coming epidemic. Hematology/Oncology Clinics of North America, 14, 235-250.

    Balducci, L., & Yates, J. (2000). General guidelines for the management of older patients with cancer. Oncology (Huntington), 14(11A), 221-227.

    Biley, A., Robbe, I., & Laugharne, C. (2001). Adult/elderly care nursing: Sources of health information for people with cancer. British Journal of Nursing, 10, 102-106.

    Bixby, M.B., Konick-McMahon, J., & McKenna, C.G. (2000). Applying the transitional care model to elderly patients with heart failure. Journal of Cardiovascular Nursing, 14(3), 53-63.

    Blesch, K.S. (1988). The normal physiological changes of aging and their impact on the response to cancer treatment. Seminars in Oncology Nursing, 4, 178-188.

    Blesch, K.S., & Prohaska, T.R. (1991). Cervical cancer screening in older women: Issues and interventions. Cancer Nursing, 14, 141-147.

    Boyd, M.D., Weinrich, S.P., Weinrich, M., & Norton, A. (2001). Obstacles to prostate cancer screening in African-American men. Journal of the National Black Nurses Association, 12(2), 1-5.

    Boyle, D.A., & Angert, V.J. (1998). Lymphoma at the extremes of age. Seminars in Oncology Nursing, 14, 302-311.

    Boyle, D.M. (1994). Realities to guide novel and necessary nursing care in geriatric oncology. Cancer Nursing, 17, 125-136.

    Boyle, D.M., Abernathy, G., Baker, L., & Wall, A.C. (1995). End-of-life confusion in patients with cancer. Oncology Nursing Forum, 25, 1335-1343.

    Boyle, D.M., & Engelking, C. (1993). Cancer in the elderly: The forgotten priority. European Journal of Cancer Care, 2, 101-107.

    Boyle, D.M., Engelking, C., Blesch, K.S., Dodge, J., Sarna, L., & Weinrich, S. (1992). Oncology Nursing Society position paper on cancer and aging: The mandate for oncology nursing. Oncology Nursing Forum, 19, 913-933.

    Burnett, C.B. (1997). Cancer in the older adults In M.M. Burke & M.B. Walsh (Eds.), Gerontologic nursing: Wholistic care of the older adult (2nd ed., pp. 526-549). St. Louis, MO: Mosby.

    Campisi, J. (2000). Cancer, aging, and cellular senescence. In Vivo, 14, 183-188.

    Clotfelter, C.E. (1999). The effect of an educational intervention on decreasing pain intensity in elderly people with cancer. Oncology Nursing Forum, 26, 27-33.

    Corner, J. (1999). Interface between research and practice in psycho-oncology. Acta Oncologica, 38, 703-707.

    Dellefield, M.E. (1986). Caring for the elderly patient with cancer. Oncology Nursing Forum, 13(3), 19-27.

    Dellefield, M.E. (1988). Informational needs and approaches for early cancer detection in the elderly. Seminars in Oncology Nursing, 4, 156-168.

    DePinho, R.A. (2000). The age of cancer. Nature, 408, 248-254.

    de Rijke, J.M., Schouten, L.J., Hillen, H.F., Kiemeney, L.A., Coebergh, J.W., & van den Brandt, P.A. (2000). Cancer in the very elderly Dutch population. Cancer, 89, 1121-1133.

    Dickson, G.W. (1990). The relationship between health beliefs, knowledge, intrinsic motivation, and breast cancer screening of older women. Unpublished dissertation, University of South Carolina.

    Duggleby, W. (2000). Enduring suffering: A grounded theory analysis of the pain experience of elderly hospice patients with cancer. Oncology Nursing Forum, 27, 825-831.

    Extermann, M., & Aapro, M. (2000). Assessment of the older cancer patient. Hematology/Oncology Clinics of North America, 14, 63-77.

    Fehring, R.J., Miller, J.F., & Shaw, C. (1997). Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer. Oncology Nursing Forum, 24, 663-671.

    Ferrell, B.A., Ferrell, B.R., & Rivera, L. (1995). Pain in cognitively impaired nursing home patients. Journal of Pain and Symptom Management, 10, 591-598.

    Ferrell, B.R. (1995). Controlling pain in the elderly. Nursing, 25(7), 73.

    Ferrell, B.R. (1999). The marriage: Geriatrics and oncology. Geriatric Nursing, 20, 238-240.

    Ferrell, B.R., & Borneman, T. (1999). Pain and suffering at the end of life for older patients and their families. Generations, 23(1), 12-17.

    Ferrell, B.R., Cohen, M.Z., Rhiner, M., & Rozek, A. (1992). Pain as a metaphor for illness. Part II: Family caregivers' management of pain. Oncology Nursing Forum, 18, 1315-1321.

    Ferrell, B.R., & Ferrell, B. (1992). Pain in the elderly. In J. Watt-Watson & M. Donovan (Eds.), Pain management: Nursing perspective (pp. 349-369). St. Louis, MO: Mosby.

    Ferrell, B.R., & Ferrell, B.A. (1990). More research needed on geriatric pain management. Provider, 16(7), 31-32.

    Ferrell, B.R., Grant, M., Chan, J., Ahn, C., & Ferrell, B.A. (1995). The impact of cancer pain education on family caregivers of elderly patients. Oncology Nursing Forum, 22, 1211-1218.

    Ferrell, B.R., Rhiner, M., Cohen, M.Z., & Grant, M. (1992). Pain as a metaphor for illness. Part I: Impact of cancer pain on family caregivers. Oncology Nursing Forum, 18, 1303-1309.

    Fitch, M.I., Gray, R.E., & Franssen, E. (2000). Perspectives on living with ovarian cancer: Older women's views. Oncology Nursing Forum, 28, 1433-1442.

    Frank-Stromborg, M. (1985). Sexuality and the elderly cancer patient. Seminars in Oncology Nursing, 1, 49-55.

    Frank-Stromborg, M. (1986). The role of the nurse in early detection of cancer: Population sixty-six years of age and older. Oncology Nursing Forum, 13(3), 66-74.

    Frank-Stromborg, M. (1988). Future projected trends in the care of the elderly individual with cancer and implications for nursing. Seminars in Oncology Nursing, 4, 224-231.

    Gelfand, D.E., Parzuchowski, J., Cort, M., & Powell, I. (1991). Digital rectal examinations and prostate cancer screening: Attitudes of African American men. Oncology Nursing Forum, 22, 1253-1255.

    Given, B., Given, C., Azzouz, F., & Stommel, M. (2001). Physical functioning of elderly cancer patients prior to diagnosis and following initial treatment. Nursing Research, 50, 222-232.

    Given, B., & Given, C.W. (1989). Cancer nursing for the elderly: A target for research. Cancer Nursing, 12, 71-77.

    Given, B.A., & Keilman, L. (1990). Cancer in the elderly population: Research issues. Oncology Nursing Forum, 17, 121-123.

    Given, C.W., Given, B., Azzouz, F., Kozachik, S., & Stommel, M. (2001). Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. Journal of Pain and Symptom Management, 21, 456-466.

    Given, C.W., Given, B., Azzouz, F., Stommel, M., & Kozachik, S. (2000). Comparison of changes in physical functioning of elderly patients with new diagnoses of cancer. Medical Care, 38, 482-493.

    Given, C.W., Given, B.A., & Stommel, M. (1994). The impact of age, treatment, and symptoms on the physical and mental health of cancer patients. A longitudinal perspective. Cancer, 74(Suppl. 7), 2128-2138.

    Hodgson, N.A. (2002). Epidemiological trends of cancer in older adults: Implications for gerontological nursing practice and research. Journal of Gerontological Nursing, 28(4), 34-43.

    Hughes, L.C., Hodgson, N.A., Muller, P., Robinson, L.A., & McCorkle, R. (2000). Information needs of elderly postsurgical cancer patients during the transition from hospital to home. Journal of Nursing Scholarship, 32, 25-30.

    Hughes, L.C., Robinson, L.A., Cooley, M.E., Nuamah, I., Grobe, S.J., & McCorkle, R. (2002). Describing an episode of home nursing care for elderly postsurgical cancer patients. Nursing Research, 51, 110-118.

    Kagan, S.H. (1994). Integrating cancer into a life mostly lived (elderly). Unpublished dissertation, University of California, San Francisco.

    Kagan, S.H. (1997). Older adults coping with cancer. New York: Garland Publishing.

    Kennedy, B.J. (2000). Aging and cancer. Oncology (Huntington), 14, 1731-1733.

    Khayat, D., & Auclerc, G. (2000). Cancer in the elderly: Are we ready? Current Oncology Reports, 20, 279-280.

    Koren, M.E. (1991). The practice of self-breast exam among elderly women. Unpublished dissertation, Rush University.

    Kurtz, M.E., Kurtz, J.C., Stommel, M., Given, C.W., & Given, B. (1999). The influence of symptoms, age, comorbidity, and cancer site on physical functioning and mental health of geriatric women patients. Women and Health, 29(3), 1-12.

    Kurtz, M.E., Kurtz, J.C., Stommel, M., Given, C.W., & Given, B. (2000). Symptomatology and loss of physical functioning among geriatric patients with lung cancer. Journal of Pain and Symptom Management, 19, 249-256.

    Ludwick, R. (1988). Breast examination in the older adult. Cancer Nursing, 11, 99-102.

    Ludwick, R. (1992). Registered nurses' knowledge and practices of teaching and performing breast exams among elderly women. Cancer Nursing, 15, 61-67.

    Ludwick, R., Rushing, B., & Biordi, D.L. (1994). Breast cancer and the older woman: Information and images. Health Care for Women International, 15, 235-242.

    McCaffery, M., & Ferrell, B.R. (1991). Patient age: Does it affect your paincontrol decisions? Nursing, 21(9), 44-48.

    McCorkle, R., Hughes, L., Robinson, L., Levine, B., & Nuamah, I. (1998). Nursing interventions for newly diagnosed older cancer patients facing terminal illness. Journal of Palliative Care, 14(3), 39-45.

    McCorkle, R., Strumpf, N.E., Nuamah, I.F., Adler, D.C., Cooley, M.E., Jepson, C., et al. (1997). A specialized home care intervention improves survival among older post-surgical cancer patients. Journal of the American Geriatrics Society, 48, 1707-1713.

    McDonald, M. (1999). Assessment and management of cancer pain in the cognitively impaired elderly. Geriatric Nursing, 20, 249-254.

    McGill, J.S., & Paul, P.B. (1993). Functional status and hope in elderly people with and without cancer. Oncology Nursing Forum, 20, 1207-1213.

    McMillan, S.C., & Small, B. J. (2002). Symptom distress and quality of life in patients with cancer newly admitted to hospice home care. Oncology Nursing Forum, 29, 1421-1428.

    McMillan, S.C., Tittle, M., Hagan, S., & Laughlin, J. (2000). Management of pain and pain-related symptoms in hospitalized veterans with cancer. Cancer Nursing, 23, 327-336.

    Meares, C.J. (1997). Primary caregiver perceptions of intake cessation in patients who are terminally ill. Oncology Nursing Forum, 24, 1751-1757.

    Miller, M. (1999). Ageism within cancer care: A priority for nursing. European Journal of Oncology Nursing, 3, 25-30.

    Miyaishi, O., Ando, F., Matsuzawa, K., Kanawa, R., & Isobe, K. (2000) Cancer incidence in old age. Mechanisms of Ageing and Development, 117(1-3), 47-55.

    Morrison, C. (1996). Determining crucial correlates of breast self-examination in older women with low incomes. Oncology Nursing Forum, 23, 83-93.

    Muss, H.B., Cohen, H. J., & Lichtman, S.M. (2000). Clinical research in the older cancer patient. Hematology/Oncology Clinics of North America, 14, 283-291.

    National Cancer Institute. (2002a). SEER incidence crude rates breast cancer, 11 registries, 1992-1999. Retrieved January 19, 2003, from http://canques.seer.cancer.gov/cgi-bin/cq_submit?dir=seer1999&db=4&rpt=LINE&sel=1^0^51^0^^2^&x=Age%20at%20diagnosis^1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18&y=Race/ethnicity^1,2,3,4,5&dec=4

    National Cancer Institute. (2002b). SEER incidence crude rates prostate cancer, 11 registries, 1992-1999. Retrieved January 19, 2003, from http://canques.seer.cancer.gov/cgi-bin/cq_submit?dir=seer1999&db=4&rpt=LINE&sel=1^0^62^0^^1^&x=Age%20at%20diagnosis^1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18&y=Race/ethnicity^1,2,3,4,5&dec=4

    Naylor, M.D. (2000). A decade of transitional care research with vulnerable elders. Journal of Cardiovascular Nursing, 14(3), 1-14.

    Naylor, M.D., Bowles, K.H., & Brooten, D. (2000). Patient problems and advanced practice: Nurse interventions during transitional care. Public Health Nursing, 17, 94-102.

    Neumark, D.E., Stommel, M., Given, C.W., & Given, B.A. (2001). Brief report. Research design and subject characteristics predicting nonparticipation in a panel survey of older families with cancer. Nursing Research, 50, 363-368.

    Nivens, A.S., Herman, J., Weinrich, S.P., & Weinrich, M.C. (1999). Cues to participation in prostate cancer screening: A theory for practice. Oncology Nursing Forum, 28, 1449-1456.

    O'Connor, L., & Blesch, K.S. (1992). Life cycle issues affecting cancer rehabilitation. Seminars in Oncology Nursing, 8, 174-185.

    Paterson, B.L. (2001). The shifting perspectives model of chronic illness. Journal of Nursing Scholarship, 33, 21-26.

    Powe, B.D., & Weinrich, S. (1999). An intervention to decrease cancer fatalism among rural elders. Oncology Nursing Forum, 26, 583-588.

    Rich, M.L. (1999). The PACE model: Description and impressions of a capitated model of long-term care for the elderly. Care Management Journals, 1(1), 62-70.

    Robinson, L., Nuamah, I.F., Cooley, M.E., & McCorkle, R. (1997). A test of the fit between the Corbin and Strauss trajectory model and care provided to older patients after cancer surgery. Holistic Nursing Practice, 12(1), 36-47.

    Sharp, L., Lewin, F., Hellborg, H., Lundgren, J., Hemmingsson, E., & Rutqvist, L.E. (2002). When does my treatment start? The continuum of care for patients with head and neck cancer. Radiotherapy and Oncology, 63, 293-297.

    Taylor, E.J., Ferrell, B.R., Grant, M., & Cheyney, L. (1993). Managing cancer pain at home: The decisions and ethical conflicts of patients, family caregivers, and homecare nurses. Oncology Nursing Forum, 20, 919-927.

    Temkin-Greener, H., Meiners, M.R., & Gruenberg, L. (2001). PACE and the Medicare+Choice risk-adjusted payment model. Inquiry, 38(1), 60-72.

    Tishelman, C. (1993). Who cares? Patients' descriptions of age-related aspects of cancer and care in Stockholm. Cancer Nursing, 16, 270-282.

    Wallace, M. (2001). The quality of life of older men who are receiving the watchful waiting treatment for prostate cancer. Unpublished dissertation, New York University.

    Weinrich, S.P., Blesch, K.S., Dickson, G.W., Nussbaum, J.S., & Watson, E.J. (1989). Timely detection of colorectal cancer in the elderly: Implications of the aging process. Cancer Nursing, 12, 170-176.

    Weinrich, S.P., Ellison, G.L., Boyd, M., Hudson, J., Bradford, B., & Weinrich, M. (2000). Participation in prostate cancer screening among low-income men. Psychology Health and Medicine, 5, 439-450.

    Weinrich, S.P., Haddock, S., & Robinson, K. (1999). Adult/elderly care nursing. Therapeutic massage in older persons: Research issues. British Journal of Nursing, 8, 159-164.

    Weinrich, S.P., & Nussbaum, J. (1984). Cancer in the elderly: Early detection. Cancer Nursing, 7, 475-482.

    Weinrich, S.P., & Weinrich, M.C. (1986). Cancer knowledge among elderly individuals. Cancer Nursing, 9, 301-307.

    Weinrich, S.P., Weinrich, M.C., Boyd, M.D., Atwood, J., & Cervenka, B. (1994). Teaching older adults by adapting for aging changes. Cancer Nursing, 17, 494-500.

    Weinrich, S.P., Weinrich, M.C., Boyd, M.D., Johnson, E., & Frank-Stromborg, M. (1992). Knowledge of colorectal cancer among older persons. Cancer Nursing, 15, 322-330.

    Weinrich, S.P., Weinrich, M.C., Priest, J., Fodi, C., & Talley, C.B. (2001). Perceived health status in African American and Caucasian men 40 to 70 years old. Holistic Nursing Practice, 16(1), 65-72.

    Weinrich, S.P., Weinrich, M.C., Stromborg, M.F., Boyd, M.D., & Weiss, H.L. (1993). Using elderly educators to increase colorectal cancer screening. Gerontologist, 33, 491-496.

    Wood, R.Y., Duffy, M.E., Morris, S.J., & Carnes, J.E. (2002). The effect of an educational intervention on promoting breast self-examination in older African American and Caucasian women. Oncology Nursing Forum, 29, 1081-1090.

    Wyatt, G.K., & Friedman, L.L. (1998). Physical and psychosocial outcomes of midlife and older women following surgery and adjuvant therapy for breast cancer. Oncology Nursing Forum, 25, 761-768.

    Wyatt, G.K., Friedman, L.L., Given, C.W., Given, B.A., & Beckrow, K.C. (1999). Complementary therapy use among older cancer patients. Cancer Practice, 7, 136-144.

    Yancik, R., & Ries, L.A. (2000). Aging and cancer in America: Demographic and epidemiologic perspectives. Hematology/Oncology Clinics of North America, 14, 17-23.

    Zabalegui, A. (1999). Coping strategies and psychological distress in patients with advanced cancer. Oncology Nursing Forum, 26, 1511-1518.