Patients with mobility disabilities likely received substandard care for their cancer. These findings, from a retrospective analysis of electronic medical records (EMR), were published in JCO Oncology Practice.
Records were sourced from the Research Patient Data Repository, which included patients from Massachusetts. Data from 27 patients aged 21 to 75 years with a primary diagnosis of colorectal cancer (n=12), prostate cancer (n=11), or non-Hodgkin lymphoma (n=4) between 2005 and 2017 who had been using a wheelchair for 12 months or longer were included. Major themes from EMRs were discussed.
Patients were aged mean 60.0 years (standard deviation [SD], 10.4), 17 were men, and 21 were White.
Clinicians often stated concerns about performing screening tests or that diagnostic equipment could not accommodate the patient. The EMR from a patient diagnosed with stage III colorectal cancer stated a colonoscopy was infeasible due to polio-related breathing difficulties.
Some evidence in the EMRs indicated symptoms of cancer were attributed to the disability instead. A patient with multiple sclerosis (MS) presented with constipation and rectal bleeding, which was attributed to her MS rather than her stage III colorectal cancer.
Patients with disability often were given differing treatments than their able-bodied counterparts. A clinician stated that chemotherapy was ‘generally reserved for patients with good performance status’ in the EMR of a patient who was quadriplegic diagnosed with stage IV colorectal cancer.
These findings may not be generalizable across all patients, as the EMRs were from a single network of care facilities. However, these data indicated patients with pre-existing mobility difficulties experienced significant barriers to diagnostic procedures and access to equitable care.
Agaronnik N D, El-Jawahri A, Lindvall C, et al. Exploring the Process of Cancer Care for Patients With Pre-Existing Mobility Disability. Published online December 10, 2020. J Oncol Pract. doi:10.1200/OP.20.00378