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Oncologist. 2017 Mar;22(3):335-342. doi: 10.1634/theoncologist.2016-0276. Epub 2017 Feb 20.

Management of Cancer in the Older Age Person: An Approach to Complex Medical Decisions.

Author information

1
Departamento de Química Inorgánica y Bioinorgánica, Facultad de Farmacia, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital, 12 de Octubre i+12, Madrid, Spain vallet@ucm.es.
2
Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
3
Departamento de Química Inorgánica y Bioinorgánica, Facultad de Farmacia, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital, 12 de Octubre i+12, Madrid, Spain.
4
Geriatrics Service.
5
Spanish Collaborative Research Network on Aging and Frailty (RETICEF).
6
Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Madrid, Spain.
7
Breast Center, IMO Clinique de Genolier, Genolier, Switzerland.
8
University of South Florida, College of Medicine, H. Lee Moffitt Cancer Center & Research Institute, Senior Adult Oncology Program, Tampa, Florida, USA.

Abstract

The management of cancer in older aged people is becoming a common problem due to the aging of the population. There are many variables determining the complex situation that are interconnected. Some of them can be assessed, such as risk of mortality and risk of treatment complications, but many others are still unknown, such as the course of disease, the host-related factors that influence cancer aggressiveness, and the phenotype heralding risk of permanent treatment-related damage.This article presents a dynamic and personalized approach to older people with cancer based on our experience on aging, cancer, and their biological interactions. Also, novel treatments and management approaches to older individuals, based on their functional age and their social and emotional needs, are thoughtfully explored here. The Oncologist 2017;22:335-342 IMPLICATIONS FOR PRACTICE: The goal of this article is to suggest a practical approach to complexity, a clinical situation becoming increasingly common with the aging of the population. Beginning with the analysis of two clinical cases, the authors offer an algorithm for approaching cancer in the older person that involves the assessment of life expectancy without cancer, the risk that cancer might compromise a patient's survival, function, or quality of life, and the potential benefits and risks of the treatments based on a clinical evaluation. The authors then review possible laboratory assessment of functional age and the importance of rapid-learning databases in the study of cancer and age.

KEYWORDS:

Aging and Cancer; Complexity of Cancer in the Elderly; Geriatric Oncology; Personalized Treatment

PMID:
28220025
PMCID:
PMC5344648
DOI:
10.1634/theoncologist.2016-0276
[Indexed for MEDLINE]
Free PMC Article

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