resilience and equity in aging, cancer, and health (reach)

Conditions: Gastric Cancer; Colon Cancer; Esophageal Cancer; Rectal Cancer; Pancreatic Cancer; Gastrointestinal Cancer

Summary: the purpose of this multi-phase research study is to understand how consultation of cancer care with a geriatrician can best improve outcomes for older adults with gastrointestinal malignancies.

this research study will be conducted in three phases: * phase 1 - needs assessment and implementation plan * phase 2 - pilot intervention * phase 3 - expanded clinical trial * please note phase 2 - pilot intervention and phase 3 - expanded clinical trial will be added to the clinicaltrials.gov record once institutional review board (irb) approved. phase 1 is composed of three aims and will inform the subsequent two phases:. * aim 1: to evaluate the perceived needs of older adults diagnosed with gastrointestinal malignancies, caregivers, staff, and faculty to characterize the implementation setting for a geriatric consultation. * aim 2: to refine the proposed reach program implementation plan based on qualitative feedback provided by older adult (oa) patients, their identified caregivers, staff, and faculty. * aim 3: determine the patient, demographic, social determinants, clinical and disease characteristics of older adults (oa) associated with ed visits/hospitalization following initial oncology consultation at df/bwcc in year 2019. * phase 2 intervention has started as of january 2022 following irb approval. study team has begun recruiting participants into phase 2 intervention of reach study starting in january 2022. participants approached by reach coordinator for consenting and enrollment after their initial consult visit at dana-farber/brigham and women's cancer center (df/bwcc). participants are then asked to complete an electronic fitness assessment (efa) that is sent to them via patient gateway. participants complete this questionnaire and receive a score of "robust", "pre-frail", or "frail" - those who score "pre-frail" or "frail" will be randomized to meet with a study geriatrician for geriatric co-management intervention alongside their standard oncology care. all enrolled participants will be followed for a duration of 1 year as they are continuing care at df/bwcc.

Eligibility criteria:
inclusion criteria: * patients who are age 70+ at time of initial consult at df/bwcc * diagnosed with a gastrointestinal cancer, including: cancers of the esophagus, stomach, pancreas, liver, bile duct, ampulla, colon, rectum, or anus, as well as neuroendocrine tumors. * continuing care at df/bwcc beyond initial consult visit * english and spanish-speaking exclusion criteria: * patients less than age 70 at time of initial consultation appointment with df/bwcc. * patients who are not continuing care at df/bwcc beyond first consult visit. * not proficient in english or spanish * patient who are not considered appropriate for enrollment due to complex medical, social, or other situation as determined by their primary oncology team. * participants with psychiatric illness/social situations that would limit compliance with study requirements.

Keywords: gastrointestinal cancer