Geriatric Evaluation of Oncological Elderly Patients

Cancer has a high prevalence in older age. The management of cancer in the older aged person is an increasingly common problem. Age may be construed as aprogressive loss of stress tolerance, due to decline in functional reserve ofmultiple organ systems, high prevalence of comorbid conditions, limitedsocioeconomic support, reduced cognition, and higher prevalence of depression. Inthe elderly, the comorbidities and physiological changes in the pharmacokinetics reduce the prospective for therapy and suggest the importance of amultidimensional assessment of cancer patients as well as the formulation ofpredictive models of risk, in order to estimate the life expectancy and toleranceto treatment. The pharmacological changes of age include decreased renalexcretion of drugs and increased susceptibility to myelosuppression, mucositis,cardio toxicity and neurotoxicity. The chemotherapy in patients older than 75years is very limited. The geriatric assessment is considered a valid tool ingeriatric medical. It is important for two main reasons: first of all, for theneed to distinguish the features linked to the geriatric syndromes from thoseones which are strictly connected to the cancer pathology; secondly, for itspotential prognostic value.