{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:12:37Z","timestamp":1789996357620,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Geriatric assessment (GA)\u2010guided supportive care (GAIN\u2010S) may improve decision\u2010making in older adults with cancer, but its effects on prognostic awareness remain unclear. The authors evaluated whether GAIN\u2010S enhances prognostic awareness among older adults with metastatic cancer in Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This randomized controlled trial was conducted in Brazil (June 2022\u2013July 2023). Adults \u226565 years old with metastatic cancer were randomized 1:1 to GAIN\u2010S (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a039) or usual care (UC;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a038). GAIN\u2010S included multidisciplinary GA review, individualized care planning, and targeted referrals. UC consisted of standard care without GA\u2010guided interventions. Prognostic awareness was assessed using the Prognostic Awareness Impact Questionnaire, covering emotional (10 items; range, 0\u201330), adaptive (12 items; range, 0\u201336), and cognitive (2 categorical items) domains. Group differences were analyzed using\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests; item\u2010level analyses used Mann\u2010Whitney\n                      <jats:italic>U<\/jats:italic>\n                      , McNemar\u2019s, or \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010seven participants were enrolled (mean age, 74.5; 56% female). Common cancers included genitourinary (29.9%), breast (24.7%), and gastrointestinal (22.1%). GAIN\u2010S led to greater improvements in emotional (mean difference\u00a0=\u00a01.14, standard error [SE]\u00a0=\u00a00.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.002) and adaptive (mean difference\u00a0=\u00a00.82, SE\u00a0=\u00a00.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.008) domains compared to UC. No differences were observed in the cognitive domain. Most participants reported their oncologist had not clearly stated whether their cancer was curable (74% GAIN\u2010S vs. 57% UC). GAIN\u2010S participants more often reported improved coping with prognostic uncertainty, better emotional acceptance, and reduced distress (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GAIN\u2010S improved emotional and adaptive domains of prognostic awareness. These novel findings underscore the value of the GAIN\u2010S intervention for older adults. Studies are needed to explore longer\u2010term effects on decision\u2010making, communication, and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70054","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:10:19Z","timestamp":1755785419000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The impact of a geriatric assessment\u2010guided management intervention (GAIN\u2010S) on prognostic awareness: A randomized controlled trial"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0037-0303","authenticated-orcid":false,"given":"Cristiane Decat","family":"Bergerot","sequence":"first","affiliation":[{"name":"Oncoclinicas &amp; Co, Medica Scientia Innovation Research (MEDSIR)  Sao Paulo 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