Abstract
Radiation oncology has the potential to be an excellent option for the frail elderly cancer patients because of its limited systemic toxicities. It can be effective for curative, prophylactic, disease control or palliative purposes. Currently about 60% of all cancer patients undergoing active treatment at some point receive radiation treatment. However, though widely used, there are limited clinical trials strictly designed for the elderly. This paper will review the key points in the assessment and treatment of elderly cancer patient including quality of life, active life expectancy, cognitive performance, frailty, sarcopenia and how the new technologies can help to reach the key goal of maintaining autonomy and independence for the elderly cancer patient.
Highlights
The meaning of aging in the cancer patientsAging is defined as a progressive functional decline, or a gradual deterioration of physiological function or the intrinsic, inevitable, increase in vulnerability [3,4]
Radiation oncology has the potential to be an excellent option for the frail elderly cancer patients because of its limited systemic toxicities
Elderly patients aren’t frequently offered appropriate cancer therapies because of their age and because so often the physicians do not have the proper skills to assess the complexity of elderly patient or to recognize the functional limits that frail elderly individuals have
Summary
Aging is defined as a progressive functional decline, or a gradual deterioration of physiological function or the intrinsic, inevitable, increase in vulnerability [3,4] It is characterized by several individual changes including loss of muscle and bone mass, a lower metabolic rate, longer reaction times, declines in cognitive functions, sexual activity, changes in organ and immune functions (immunosenescences), pain threshold, and in exercise performance [2,5,6]. Try to imagine a therapeutic choice thinking not about the biological and chronological age of this patient, but in the years that could potentially face, could avoid both under-treatment and overtreatment [7] An approach of this type translates into a radical change of vision. While screening tests are insufficient alone, crucial is the first step to understand if cancer patients need a deeper geriatric evaluation as like a Geriatric Assessment (GA)[12]
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