L Balducci

Moffitt Cancer Center, Tampa, Florida, United States

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Publications (181)739.32 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Senescence-associated genes (SAGs) are responsible for the senescence-associated secretory phenotype, linked in turn to cellular aging, the aging brain, and the pathogenesis of cancer.
    Journal of Geriatric Oncology 09/2014; · 1.12 Impact Factor
  • Lodovico Balducci
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    ABSTRACT: Data relating to cancer treatment in the older patient population are limited because older individuals have been under-represented in clinical trials. The goal of this review was to establish which factors hinder the participation of older individuals to clinical trials and to examine possible solutions.
    Cancer control: journal of the Moffitt Cancer Center 07/2014; 21(3):215-20. · 3.59 Impact Factor
  • Lodovico Balducci
    Internal and Emergency Medicine 06/2014; · 2.35 Impact Factor
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    Lodovico Balducci
    Journal of Medicine and the Person. 06/2014;
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    Lodovico Balducci, Dawn Dolan
    Mediterranean Journal of Hematology and Infectious Diseases 01/2014; 6(1):e2014037.
  • Nicole Brighi, Lodovico Balducci, Guido Biasco
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    ABSTRACT: Persons aged 65 and over are the fastest growing segment of the population in most Western countries. Although cancer-related death occurs far more commonly in older people than in any age group, studies on palliative care in older adults are lacking. This paper aims at evaluating the needs in elderly patients affected by cancer and the state of the art of the research in palliative care in this setting. A literature search was performed (PubMed) to identify relevant studies. Papers were reviewed for relevance to palliative care in the elderly. Results Elderly who need palliative care are frequently disregarded as individuals and may experience discrimination because of their age. Palliative care for older patients relates particularly to multiple treatments for various conditions. This causes extra complexities for the researchers. Conclusions The aim of the study was not fully achieved due to the paucity of literature focusing upon these issues. The areas of investigation that need to be addressed comprise: establishing the prevailing symptoms in elderly patients, understanding patients' psychological/spiritual well-being and quality of life and elucidating the sources of caregiver burden, adapting research methodologies specifically for palliative care and comparing the needs and the outcomes of this age group to younger patients.
    Journal of Geriatric Oncology 01/2014; · 1.12 Impact Factor
  • Lodovico Balducci, Matti Aapro
    Journal of Geriatric Oncology 01/2014; 5(1):116-118. · 1.12 Impact Factor
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    ABSTRACT: The Middle Eastern population is aging rapidly, and as aging is the main risk factor for cancer, the incidence and prevalence of that disease are increasing among all the populations in the region. These developments represent huge challenges to national and community-based health services. At the current state of affairs, most Middle Eastern countries require the cooperation of international agencies in order to cope with such new challenges to their health systems. The focus and emphasis in facing these changing circumstances lie in the education and training of professionals, mainly physicians and nurses, at the primary, secondary and tertiary levels of health services. It is imperative that these training initiatives include clinical practice, with priority given to the creation of multidisciplinary teams both at the cancer centers and for home-based services.
    Annals of Oncology 10/2013; 24 Suppl 7:vii11-vii24. · 7.38 Impact Factor
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    ABSTRACT: Aging is associated with polymorbidity and polypharmacy. In the absence of a consensual definition, polypharmacy has been defined according to the number of drugs that an individual takes or to the presence of the risk of at least one severe drug interaction. In older cancer patients, polypharmacy is at least as common as it is in individuals of the same age without cancer. The management of cancer itself may result in the addition of more medications to counteract the adverse effects of antineoplastic treatment. Polypharmacy may be necessary to control the multiple health conditions of the older person, but it may represent a risk factor for more complications from antineoplastic therapy, and it may affect the outcome of cancer treatment. Polypharmacy is also associated with increased cost. The criteria proposed for the management of polypharmacy include the assessment that all medical conditions are properly treated, the avoidance of drug interactions, and of drugs that may compromise the outcome of antineoplastic treatment and the choice of drugs with the lowest risk of complications in older individuals.
    Annals of Oncology 10/2013; 24 Suppl 7:vii36-vii40. · 7.38 Impact Factor
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    ABSTRACT: Cancer is now the fastest growing killing disease in the Middle East. Accordingly, there is an urgent need to train local health professionals: Oncologists, Palliative Care experts, Oncology Nurses, Psychologists, along with social workers, physiotherapists and spiritual counselors on strategies for early detection, curative therapies and palliation. Professionals in the region, along with the public, need to convince medical administrators, regulators and policymakers about investing in education and training of YOUNG professionals, As well as those with already proven experience in cancer care. Training is the basis for any future cancer care program, which aims at the integration of palliative care practices into standard oncology care across the trajectory of the illness.
    Annals of Oncology 10/2013; 24 Suppl 7:vii5-vii10. · 7.38 Impact Factor
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    ABSTRACT: BACKGROUND: Screening tools for the identification of vulnerable older patients with cancer are needed. Aim of this study is to measure the prognostic value of multiple screening tools for the assessment of mortality risk in oncogeriatrics. METHODS: The prognostic value of the following assessment tools was tested in 200 older women with gynecological cancer (mean age = 73.5 years) for 1-year mortality: Short Physical Performance Battery, usual gait speed, handgrip strength, Eastern Cooperative Oncology Group Performance Status scale, Karnofsky Performance Status scale, Vulnerable Elders Scale-13, activities of daily living, and instrumental activities of daily living. Cox proportional hazard models were performed to estimate the associations of the performance measures with mortality. Areas under receiver operating characteristic curves were also estimated. RESULTS: Twenty-three participants (11.5%) died during the follow-up. The Short Physical Performance Battery, usual gait speed, and instrumental activities of daily living were the only parameters significantly associated with mortality, even after adjustment for confounders. No statistically significant results were reported for other functional measures. Similar results were obtained when testing the predictive values of the performance measures at the receiver operating characteristic analyses. CONCLUSIONS: The Short Physical Performance Battery and especially the usual gait speed may represent promising tools for measuring the mortality risk of older cancer patients, thus potentially supporting clinical decisions. Further studies are needed to confirm and extend the present findings.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 06/2013; · 4.31 Impact Factor
  • Lodovico Balducci
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    ABSTRACT: In a pluralistic society it is important that patients and health care operators be aware of each others’ beliefs and values. A value history allows the practitioners to identify the patients’ goals and desires and to provide a care congruent with these aims. In this respect the scope of a value history goes much beyond than its original intention to probe a practitioner’s standing on controversial issues such as abortion and euthanasia.. The case of Peggy Sue illustrates how the failure to take a value history may result in medically sound but humanly devastating medical treatment.
    Journal of Medicine and the Person. 04/2013; 11(1).
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    Lodovico Balducci
    Journal of Medicine and the Person. 04/2013; 11(1).
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    Lodovico Balducci, Sophia Dorothe Fossa
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    ABSTRACT: Abstract Cancer is a disease of aging. With the aging of the population and the improved survival of cancer patients, rehabilitation of older cancer survival is an increasingly common problem. Definition and assessment of aging. Age may be constructed as a progressive reduction in functional reserve of multiple organ systems leading to decreased life expectancy and reduced stress tolerance. Physiologic age may be different from chronologic age and is best assessed with a comprehensive geriatric assessment (CGA). The goals of cancer treatment in the older aged person include prolongation of active life expectancy that is prevention of functional dependence. Cancer condition in which rehabilitation of older individuals may be needed. Cancer and cancer treatment may accelerate physiologic aging. Rehabilitation is especially necessary in the case of curable malignancies or malignancies for which a prolonged survival is likely. Rehabilitation needs in older cancer survivors. Long-term complications of cancer treatment that may compromise life expectancy and functional independence include fatigue cognitive decline and peripheral neuropathy. This paper reviews the risk factors and the management of these complications. Conclusions. The number of older cancer survivors is expected to increase with the aging of the population. Prevention and management of fatigue, cognitive decline and peripheral neuropathy appear as the most important issue to prolong the active life expectancies of these individuals.
    Acta oncologica (Stockholm, Sweden) 02/2013; 52(2):233-8. · 2.27 Impact Factor
  • Lodovico Balducci, Matti Aapro
    Journal of Geriatric Oncology 01/2013; · 1.12 Impact Factor
  • L Balducci
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    ABSTRACT: A good death and a death with dignity may be achieved when death is congruent with the personal values of the patient. It behooves the practitioner to recognize these values and to cater to them. This paper describes effective communication with the dying person, and the partnership of treatment team, patient and family in face of the patient death. To identify and define the patient wishes it is necessary to learn how to interpret the patient's non verbal as often patients are unable to formulate the questions they wish to ask concerning their passing. These difficulties stem from several cultural factors including concern about disturbing the practitioner. It is the treatment team's responsibility to facilitate this discussion. A good death is achieved when symptoms are controlled and when patients and family recognize death as a unique living experience to be treasured as any other living experience. A death with dignity brings healing, that is always possible even when cure is out of reach. Patient's and practitioner's values may be at odd in face of controversial issues including euthanasia, assisted suicide and terminal sedation. Though he/she should not be compelled to execute these requests, the practitioner should be able to entertain an open discussion with the patient concerning these issues. Open communication and reflective listening even in presence of disagreements are the venue of healing. The study of death and dying requires novel approaches including personal narrative and qualitative research to complement traditional research instrument, such as questionnaire that cannot embrace the whole human dimension.
    Annals of Oncology 04/2012; 23 Suppl 3:56-61. · 7.38 Impact Factor
  • L. Balducci
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    ABSTRACT: The incidence and mortality rate of cancer increases with age. With a worldwide increase in life expectancy, the clinical problems associated with cancer and old age are becoming more and more widespread. The clinical questions relating to cancer and old age can be divided into three main areas: 1) Why does the incidence and prevalence of cancer increase with age? 2) Does age affect the biology of cancer? 3) Is the prevention and treatment of cancer beneficial to elderly patients? 4) What are the psychosocial consequences of treating elderly patients with cancer?
    Psycho-Oncologie 03/2012; 6(1). · 0.24 Impact Factor
  • Sarah Hoffe, Lodovico Balducci
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    ABSTRACT: Cancer in the older person is increasingly common. The biological interactions of cancer with age are only partly understood and may provide some clues to future forms of cancer prevention and treatment. Management-related decisions in a population with limited life expectancy and limited functional reserve should be based on the natural history of the cancer, the patient’s life expectancy, and the patient’s tolerance of treatment. In addition, financial and caregiver considerations are important in assessing the treatment’s benefits and risks. Cooperation between geriatricians and oncologists seems to be essential to generate predictive models, as well as outcome information to improve the decision making in older cancer patients. It may also be essential in caring for a host of older cancer survivors. In France, this cooperation is already a reality that finds its expression in a network of units of oncogeriatrics distributed throughout the country.
    Clinics in Geriatric Medicine 02/2012; 28(1):1-18. · 3.14 Impact Factor
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    ABSTRACT: The relationship between oncologists and their cancer patients is rapidly evolving. Oncologists and other cancer professionals master new anticancer and supportive treatment options, while working under increasing economic pressure and time constraints, and are often unprepared to deal with all the challenges of their new position in a therapeutic relationship with cancer patients and families. Good communication is as essential as are modern laboratory tests and sophisticated diagnostics to achieve the best clinical results. This book updates the evolution of truth-telling and communication patterns worldwide and offers insights into the recent trends and emerging challenges in communication with cancer patients and families. New Challenges in Communication with Cancer Patients is an invaluable resource to medical professionals, educators and patients in establishing a strong and effective partnership built on trust and mutual understanding.
    First edited by Surbone, A.; Zwitter, M.; Rajer, M.; Stiefel, R., 01/2012; Springer., ISBN: 978-1-4614-3369-9
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    Mark Basik, Lodovico Balducci, Marco Bregni
    Journal of Medicine and the Person. 12/2011; 9(3).

Publication Stats

4k Citations
739.32 Total Impact Points

Institutions

  • 1954–2014
    • Moffitt Cancer Center
      • Department of Cancer Epidemiology
      Tampa, Florida, United States
  • 1992–2013
    • University of South Florida
      • • Morsani College of Medicine
      • • Division of Gynecologic Oncology
      • • Department of Internal Medicine
      • • Florida Policy Exchange Center on Aging
      Tampa, FL, United States
  • 2009
    • Middle East Cancer Consortium
      H̱efa, Haifa District, Israel
    • Istituto Oncologico Veneto
      Padua, Veneto, Italy
  • 2008
    • National Institute on Aging
      • Clinical Research Branch (CRB)
      Baltimore, Maryland, United States
  • 2007
    • Georgetown University
      Washington, Washington, D.C., United States
  • 2000
    • University-Hospital of Padova
      Padua, Veneto, Italy
    • Wake Forest School of Medicine
      Winston-Salem, North Carolina, United States
  • 1997
    • Wake Forest University
      • Comprehensive Cancer Center
      Winston-Salem, North Carolina, United States
  • 1995
    • Brown University
      Providence, Rhode Island, United States
  • 1991–1993
    • James A. Haley Veterans Hospital
      Tampa, Florida, United States
  • 1981–1992
    • University of Mississippi Medical Center
      • • Department of Medicine
      • • Division of Oncology
      Jackson, Mississippi, United States