Abstract
The number of elderly patients with incurable head and neck cancer will increase. They are in need of geriatric palliative care, that takes into account oncology, palliative care and geriatric medicine. In this review of the most recent and relevant literature and includes the expert opinion of the authors, several physical problems (e.g. pain, fatigue, malnutrition, and loco-regional problems) encountered by the elderly head and neck cancer patients are addressed. In addition end-of life issues in this patient population are discussed.
Highlights
The number of head and neck cancers is high in elderly patients and the peak incidence of head and neck cancer is around 70-74 years [1]
In some elderly patients multi-modal treatment may be used, but a German retrospective single-center analysis which enrolled all patients older than 65 years treated with radiotherapy or chemoradiation for histologically confirmed head and neck squamous cell carcinoma between 2010 and 2018, combined modality treatment seems to translate in a lower overall survival rate than in younger patients, so that single agent treatment may be considered in this patient group [2]
In the United Kingdom (UK), five-year survival rates again depend on the head and neck region involved and varies from around 20% for men and women aged 70-89 years diagnosed with hypopharyngeal cancer to 58% in 80-99 year-old patients diagnosed with laryngeal cancer [1]
Summary
The number of head and neck cancers is high in elderly patients and the peak incidence of head and neck cancer is around 70-74 years [1]. In the United Kingdom (UK), five-year survival rates again depend on the head and neck region involved and varies from around 20% for men and women aged 70-89 years diagnosed with hypopharyngeal cancer to 58% in 80-99 year-old patients diagnosed with laryngeal cancer [1]. Palliative care is defined as an approach that improves the quality of life (Qol) of patients and their families who are facing problems associated with a progressive life-threatening illness It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual [3]. Since head and neck cancer in the elderly is an under-researched area, extrapolations of some issues are made from head and neck cancer and geriatric oncology
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