The amount of time older patients with advanced cancer spend on treatment and care has risen, according to study results published in JAMA Network Open. Lead author Arjun Gupta, MD, of City of Hope Cancer Center in Phoenix, coined the term “time toxicity” to describe the time commitments associated with cancer care, arguing that it should be considered along with physical side effects and financial burdens.

 

This analysis included nearly 59,000 Medicare beneficiaries ages 66 and older who were diagnosed with four types of metastatic cancer between 2008 and 2019. The researchers calculated the number of days spent receiving ambulatory care (for example, clinician visits, tests, scans and treatment) and institutional care (including hospital stays and time in a nursing facility).

 

During the first year after diagnosis, people with colorectal cancer had the highest average number of health care contact days (62.9), followed by those with lung cancer (60.2), breast cancer (48.7) and prostate cancer (40.1). While the number of days of institutional care remained stable, outpatient care increased substantially from 2016 onward. Stated another way, patients spent 11% to 17% of their first year after diagnosis receiving care outside the home; those who survived less than a year spent up to 30% of their remaining days interacting with the health care system.

 

The increasing time burden reflects new, more intensive treatments as well as fragmented and uncoordinated health care delivery.

 

“This study’s results suggest that oncology teams should discuss expected contact days and related burdens when developing care goals and treatment plans with older adult patients,” Gupta and colleagues concluded.