Abstract
Population aging is associated with greater numbers of older people with cancer. Thanks to treatment advances, not only are more seniors diagnosed with cancer, but there are also more and more older cancer survivors. This upward trend will continue. Given the heterogeneity of aging, managing older patients with cancer poses a significant challenge for Medical Oncology. In Spain, a Geriatric Oncology Task Force has been set up within the framework of the Spanish Society for Medical Oncology (SEOM). With the aim of generating evidence and raising awareness, as well as helping medical oncologists in their training with respect to seniors with cancer, we have put together a series of basic management recommendations for this population. Many of the patients who are assessed in routine clinical practice in Oncology are older. CGA is the basic tool by means of which to evaluate older people with cancer and to understand their needs. Training and the correct use of recommendations regarding treatment for comorbidities and geriatric syndromes, support care, and drug–drug interactions and toxicities, including those of antineoplastic agents, as detailed in this article, will ensure that this population is properly managed.
Highlights
The gradual aging of the world’s population, the greater risk of developing neoplasms at older ages, and the lack of scientific evidence have made the management of older individuals with cancer a tremendous care challenge [1]
While comprehensive geriatric assessment (CGA) is a widely used tool in various medical specialties, there is no consensus as to the scales to be used; it calls for an investment of time and expertise that we are hard-pressed to assume within the reality of our
The transcendence of CGA in Geriatric Oncology links the advantages of CGA in older people with any disease with other specific advantages in seniors with cancer [18]: estimation of life expectancy [19,20,21], the risk of chemotherapyderived toxicity [19, 22, 23] and early treatment suspension, or the possibility of functional decline [24, 25]
Summary
The gradual aging of the world’s population, the greater risk of developing neoplasms at older ages, and the lack of scientific evidence have made the management of older individuals with cancer a tremendous care challenge [1]. The transcendence of CGA in Geriatric Oncology links the advantages of CGA in older people with any disease with other specific advantages in seniors with cancer [18]: estimation of life expectancy [19,20,21], the risk of chemotherapyderived toxicity [19, 22, 23] and early treatment suspension, or the possibility of functional decline [24, 25]. They established that the domains that should appear in any CGA model are functional status, comorbidity, cognitive status, emotional state, social situation, nutritional status, and the presence of fatigue and geriatric syndromes [16] Despite these recommendations, a recent publicationaddressing seniors undergoing chemotherapy reflected that certain components of CGA are only ascertained in a small percentage of older patients [26]. Despite all the difficulties incumbent in defining and quantifying social support, we believe that its necessity is evident and that it must be appraised and optimized for proper treatment planning for seniors with cancer
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