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Cancer care for people with dementia: literature overview and recommendations for practice and research

Ashley, Laura, Surr, Claire, Kelley, Rachael, Price, Mollie, Griffiths, Alys Wyn, Fowler, Nicole R., Giza, Dana E., Neal, Richard D., Martin, Charlene, Hopkinson, Jane B. ORCID:, O’Donovan, Anita, Dale, William, Koczwara, Bogda, Spencer, Katie and Wyld, Lynda 2023. Cancer care for people with dementia: literature overview and recommendations for practice and research. CA: A Cancer Journal for Clinicians 73 (3) , pp. 320-338. 10.3322/caac.21767

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As many countries experience population aging, patients with cancer are becoming older and have more preexisting comorbidities, which include prevalent, age‐related, chronic conditions such as dementia. People living with dementia (PLWD) are vulnerable to health disparities, and dementia has high potential to complicate and adversely affect care and outcomes across the cancer trajectory. This report offers an overview of dementia and its prevalence among patients with cancer and a summary of the research literature examining cancer care for PLWD. The reviewed research indicates that PLWD are more likely to have cancer diagnosed at an advanced stage, receive no or less extensive cancer treatment, and have poorer survival after a cancer diagnosis. These cancer disparities do not necessarily signify inappropriately later diagnosis or lower treatment of people with dementia as a group, and they are arguably less feasible and appropriate targets for care optimization. The reviewed research indicates that PLWD also have an increased risk of cancer‐related emergency presentations, lower quality processes of cancer‐related decision making, accessibility‐related barriers to cancer investigations and treatment, higher experienced treatment burden and higher caregiver burden for families, and undertreated cancer‐related pain. The authors propose that optimal cancer care for PLWD should focus on proactively minimizing these risk areas and thus must be highly person‐centered, with holistic decision making, individualized reasonable adjustments to practice, and strong inclusion and support of family carers. Comprehensive recommendations are made for clinical practice and future research to help clinicians and providers deliver best and equitable cancer care for PLWD and their families.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Additional Information: License information from Publisher: LICENSE 1: URL:
Publisher: Wiley
ISSN: 0007-9235
Date of First Compliant Deposit: 14 December 2022
Date of Acceptance: 1 November 2022
Last Modified: 02 Jun 2023 19:51

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