Management of the frail person with advanced cancer.

The frail population is increasing: currently, approximately 400,000 frail persons have cancer in the USA. Although the frail person is not a candidate for aggressive life-prolonging antineoplastic treatment, he/she is a candidate for aggressive symptom palliation. Most common symptoms include pain, especially bone pain, anemia, and fatigue. Destruction of cancer with antineoplastic treatment is pivotal to symptom palliation. A number of cytotoxic agents including gemcitabine, taxanes in low doses, vinorelbine, oral fluorinated pyrimidine, appear suitable for the management of metastatic cancer in the frail patient and should be tested in clinical trials.