Helping cancer patients by better detecting frailty
As people grow older, their risk of developing cancer increases. So does their risk of becoming frail — a medical condition involving reduced function and health. It’s a dangerous combination, given that frailty affects up to 40 per cent of patients living with cancer, increasing their risk of both short and long-term side effects, and even death, following treatment.
When a person is frail, their body has less resilience to tolerate treatments and recover, says Dr. Julie Nguyen, a gynecologic oncologist at Hamilton Health Sciences’ Juravinski Hospital and Cancer Centre (JHCC). Nguyen is also a clinician-researcher who studies frailty in patients with gynecological cancers, such as cancers of the uterus, cervix and ovaries.
“Research shows that frail patients have shorter survival rates after being diagnosed with cancer and going through treatment,” says Nguyen. “This is why it’s so important for cancer researchers to better understand frailty, and how to best measure it, so that we can tailor treatments to a patients’ individual needs, and develop interventions to help them grow stronger and live longer with the best possible quality of life.”
Finding the most effective way to measure risk of complications
The FARGO (Frailty Assessment for Risk prediction in Gynecologic Oncology) study, co-led by Nguyen and senior researcher Dr. Maura Marcucci at the Population Health Research Institute (PHRI) — a joint institute of HHS and McMaster University — aims to find better, more practical ways to assess frailty in patients with cancer as they go through treatment and recovery.
“FARGO is one of the first studies to measure frailty at several time points in a patient’s treatment journey, and perhaps the first that seeks to find new blood tests for frailty in patients with gynecologic cancers.”
Nguyen and Marcucci are both researchers with PHRI and the McMaster Institute for Research on Aging. They are working on the study in collaboration with leading experts from PHRI; the HHS Clinical Research Laboratory and Biobank – Genetic and Molecular Epidemiology Laboratory (CRLB-GMEL); and the gynecologic oncology and internal medicine teams at JHCC, Sunnybrook Health Sciences Centre, University Health Network and Credit Valley Hospital. The FARGO study is supported with funding from the HHS Foundation, among other funding sources.
Stock photo
It will follow 280 patients having surgery and treatment for gynecologic cancers to discover the most effective methods for measuring frailty and risk of complications. To date, more than 50 per cent of participants have been enrolled. All are 55 years of age or older whose treatment will include a laparotomy — a major surgery to help diagnose and treat gynecological cancers – and chemotherapy.
“FARGO is one of the first studies to measure frailty at several time points in a patient’s treatment journey, and perhaps the first that seeks to find new blood tests for frailty in patients with gynecologic cancers,” says Nguyen.
“In the future, we hope to develop interventions to help frail patients become stronger before, during and after their treatments. Studies show that patients value their quality of life just as much as length of life after cancer. The goal would be to preserve or even improve quality of life and functional status throughout treatment.”
Treating gynecological cancers
Gynecologic cancers are often treated with surgery and chemotherapy which can be intensive and lead to short and long-term complications.
Study participants will take a frailty assessment before and after surgery, as well as six months and one year after surgery, when treatments are completed. “Frail patients are known to have greater complication rates after surgery, and are also less likely to tolerate regular doses of chemotherapy,” says Nguyen.
Early detection could help patients
Testing for frailty isn’t part of daily medical care, and as a result this condition is often overlooked. Obstacles to frailty screening include time and resource limitations of the health-care system.
Meanwhile, the burden of frailty on the health-care system is increasing as our population ages and cancer rates among older adults rise. “Unfortunately, frailty remains greatly under-diagnosed,” says Nguyen.
Developing blood tests to measure frailty through blood biomarkers could help increase screening rates, because it could be faster, more efficient, and potentially more reliable. The FARGO study will innovate to find new blood tests in partnership with the CRLB-GMEL lab.
“Early detection of frailty through new blood tests could lead to proactive interventions, allowing us to strengthen patients before, during, and after their treatment, ultimately enhancing their outcomes and decreasing complications,” says Nguyen. “Developing more convenient and accurate methods for measuring frailty is crucial to improve patient care.”
Award-winning research
For this study, Nguyen has been recognized with several awards including the Early Career Research Award and the New Investigator Fund from HHS, the Transforming Tomorrow Today grant from the PHRI, as well as the Most Promising Research Award from the Department of Obstetrics and Gynecology at McMaster University. Nguyen and Marcucci, with their research team, were also awarded the Hamilton Academic Health Sciences Organization Innovation Fund in 2020 as well as the HHS Foundation Research Thematic Grant.
Patients interested in joining are encouraged to speak with their health-care provider.
Related Posts
HHS study aims to help breast cancer survivors manage chronic pain
Studying how Canadian kids were affected by the pandemic
Combatting high blood pressure in kids globally through big-data research
Frailty scores could be at docs’ fingertips
Hamilton’s best kept secret? HHS research includes world-class PHRI
The many hats of a sepsis expert