Specificities of the treatment in elderly cancer patients

Abstract

The management of elderly cancer patients is a major health problem in Western countries due to theaging of the population and steady increase in cancer incidence with advancing age. Currently in WesternEurope and the United States, more than 60% of all cancers are diagnosed in patients older than65 years. Due to the minimal participation of this population in clinical trials, evidence based recommendationregarding optimal treatment of elderly is lacking. Observational studies are showing that elderlypatients are not included in screening programs, are suboptimally diagnosed and receive suboptimaltreatment. Physiological changes related to age, comorbidities, and concomitant medications influencepharmacology of antineoplastic agents and consequently efficacy and safety of therapy. Comprehensivegeriatric assessment including performance status, functional status, cognitive function, nutritional status,comorbidities, geriatric syndromes, and potential interaction among concomitant medications is essentialto plan optimal treatment. Choice of treatment in this population should be based on the chance toachieve benefits, such as improved survival or better quality of life, life expectancy and patients condition.