Assessment of elderly cancer patients and its clinical importance

Kim, Min Jeong; Kim, Jae Weon

Abstract

More than half of new cancers occur in the elderly and population is rapidly being aged. As a result, care of older patients constitutes an important part of the everyday practice for the adult oncologist. With few guidelines, the older patients are too much often under treated and have wide heterogeneity in the ability to undergo aggressive therapy. Comprehensive geriatric assessment (CGA) is helpful in evaluating the functional age of the elderly patients and guiding the adequate treatment in clinical practice, according to tolerance to cancer therapy and their life expectancy. For the healthy elderly patient with minimal comorbidity and near-normal functional reserve, aggressive treatment including full-dose chemotherapy is warranted and canyield results similar to those in young patients in gynecologic oncology part. The modified treatment plan, such as less aggressive or invasive operation and single-agent regimen of chemotherapy, can be considered to 'frail' patients with much impaired function. Many studies have shown promising results and more brief and practical tools of geriatric assessment are being developed. Prospective trials evaluating the utility of CGA to guide intervention to improve the quality of cancer care in the elderly cancer patients are justified. In addition, Korean version, cancer-specific or treatment-specific tools of geriatric assessment need to be constructed.