Supportive Care and Geriatric Assessment in Older Cancer Patients

Abstract

In the management of elderly people with cancer under diagnosis, under treatment, or overtreatment, are often recurring problems that can be minimized through the application of Geriatric Assessment. Research studies show that older patients experience more incomplete investigations, toxicity complications, dose reductions and delays and decreased utilization of standard therapy compared to younger patients. The increased incidence of comorbidities in older adults can raise the risk of treatment related toxicities; however the assumption of sarcopenia and/or frailty based on a patient’s age alone may lead to inadequate and inappropriate treatment. The use of Geriatric Assessment, the best practices physicians currently have, can direct supportive care interventions. The Geriatric Assessment assists physicians in determining a patient’s medical decision making capacity, emphasizes the preservation of independent function and minimizes the risk of toxicity, regardless of treatment or treatment intent. The goal of this review is to explain the most relevant aspects of the comprehensive geriatric assessment in elderly cancer patients and provide the basis for supportive care therapies such as pain management, dyspnoea, cachexia and geriatric syndromes like sarcopenia.