Geriatric oncology. Medical and psychosocial perspectives.

PURPOSE

The authors aim to promote cancer control in the older person through an understanding of medical and psychosocial issues related to early detection, evaluation, and management of care.

OVERVIEW

The management of cancer in the older adult is an increasingly common aspect of oncologic practice. Over the next decades, special concerns will be generated by the rapid rise in the number and proportion of older persons in our society. This article addresses the following: the identification of those patients who would benefit from interventions; the need for individualized treatment plans and a multidisciplinary approach; factors affecting incidence, clinical course, and treatment of cancer, barriers to cancer screening and treatment; psychological adjustment to cancer; and the medical and psychosocial management of the older person with cancer.

CLINICAL IMPLICATIONS

Cancer control in the older person may be improved by removal of the barriers to appropriate screening and by individual treatment plans focused on the special needs of individual patients. The Comprehensive Geriatric Assessment allows adequate appraisal of functional status, comorbidity, life expectancy, quality of life, and economic and emotional needs of individual patients. Treatment strategies based on a global evaluation of the older person are more likely to be successful in terms of compliance and effectiveness.