Geriatric Assessment and Management in Cancer

As the majority of patients with cancer are older than 65 years, most medical, surgical, and radiation oncologists treat a large number of older adults in their clinical practice. Older adults are a heterogeneous group of patients, in terms of physiologic reserves, comorbidity, and geriatric conditions such as cognitive impairment and disability. Comorbidities become increasingly common as people age, as does frailty (limited physiologic reserves that increase the risk of negative outcomes).1 Neither chronological age alone nor performance status does justice to characterizing this heterogeneity. Furthermore, since older patients are under-represented in clinical cancer trials, especially if they are frail with comorbidity or functional dependency, traditional treatment algorithms may not be applicable.2,3 As a result, treatment decisions in older adults with cancer are not straightforward.