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Comprehensive geriatric assessment for patients with cancer

Arti Hurria, MD
Harvey Jay Cohen, MD
Section Editors
Reed E Drews, MD
Kenneth E Schmader, MD
Deputy Editor
Sadhna R Vora, MD


Approximately 60 percent of new cases and 70 percent of mortality from cancer occur in patients ≥65 years of age [1]. As a result, the care of older patients constitutes an important part of the everyday practice for the adult oncologist.

Despite the high incidence of cancer in this group, older patients have been underrepresented in clinical trials that set the standards for care in oncology practice [2-4]. Less data exist regarding the risks and benefits of cancer treatment in this population, and there are few guidelines that specifically address the evaluation and treatment of the older patient.

Older patients are less likely to receive all types of standard cancer therapies compared with younger individuals [5-12]. Possible reasons include concerns regarding increased toxicity, competing causes of morbidity and mortality, lack of access to care, and clinician or patient preference.

Chronologic age alone provides relatively little information regarding an individual's tolerance to cancer treatment. Among patients of the same age, there is wide heterogeneity in the ability to undergo aggressive therapy.

Identifiable comorbid conditions and organ-specific physiologic changes due to aging can limit a patient's ability to tolerate cancer therapy. In addition, the aging process can be associated with decreased physiologic reserve affecting multiple systems. This can be manifested as frailty and can interfere with the functional status of the patient, even in the absence of specific comorbidities. The manifestations of frailty include various components of weight loss, exhaustion, weakness, relative immobility, and a general decrease in physical activity.

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Literature review current through: Nov 2017. | This topic last updated: Jun 22, 2017.
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