PATH Program for for Severely Frail or Cognitively Impaired Patients Scheduled for Cancer Surgery.

Summary

This is a single center, non-blinded randomized control trial taking place at the Queen Elizabeth II hospital (QEII) in Nova Scotia. Patients are eligible if aged 75 and older scheduled for elective cancer surgery (proven cancer or highly suspicious cancer) and screened to have mild or greater frailty (with cognitive impairments) or moderate to greater frailty (with medical/physical conditions). Eligible participants will then be randomized to preoperative standard of care or geriatric assessment through the PATH clinic. Primary outcome will assess time spend at home at 6 months after the surgery.

Eligibility

Inclusion Criteria:

1. Patients must have a clinically highly suspicious or pathologically confirmed diagnosis of bronchopulmonary, oropharyngeal (including head and neck surgery), orthopaedic, gynaecological, breast, genitourinary or gastrointestinal cancer surgery.
2. Patients must be scheduled and consented for curative or palliative intent surgery.
3. Patients must be aged 75 or older.
4. Patients must be screened by the CFS to have:

4a. Mild or greater frailty (CFS equal or greater than 5) due to cognitive impairment.

4b. Moderate or greater frailty (CFS equal or greater than 6) due to medical/physical conditions.

5\. Informed consent for participation must be received.

Exclusion Criteria:

1. Patients cannot be a resident in a long-term care facility prior to the cancer diagnosis.
2. Urgent/ emergent cases are excluded.

Conditions4

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