Spots Global Cancer Trial Database for PATH Program for for Severely Frail or Cognitively Impaired Patients Scheduled for Cancer Surgery.

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Trial Identification

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

Official Title: Application of the Palliative and Therapeutic Harmonization (PATH) Program for Shared-decision Making for Severely Frail or Cognitively Impaired Patients Scheduled for Cancer Surgery: a Randomized Control Trial.

Study ID: NCT06022666

Conditions

Frailty

Oncology Problem

Cognitive Impairment

Interventions

Geriatric assessment

Study Description

Brief 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 and screened as severely frail or cognitively impaired. 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.

Detailed Description: At Nova Scotia Health Authority (NSHA), geriatric medicine colleagues developed a preoperative palliative and therapeutic harmonization (PATH) clinic with the following objectives: 1. Assess medical conditions, health trajectory, and baseline frailty. 2. Conduct an in-depth discussion with the patient (or their substitute decision maker) to review medical conditions and how frailty stage impacts decision-making about surgery. 3. Co-develop a care plan, including ways to optimize health. The investigators have elaborated a single center randomized cohort trial for patients aged 75 and older, screened as severely frail or cognitively impaired scheduled for curative or palliative-intent surgery for bronchopulmonary, oropharyngeal, orthopaedic, gynaecological, breast or gastrointestinal cancers. Patients enrolled in the trial will be randomized to standard of care preoperative assessment versus PATH geriatric care arm.