The elderly patient with cancer: a holistic view.

The elderly cancer patient (ECP) population is a heterogeneous group, ranging from competent, active, and fit individuals to those who are frail and cognitively impaired. A continuum exists from an increased vulnerability to stressors that results from the usual decreases in physiologic reserves (=aging) to the deregulation of multiple physiologic systems (=frailty). The ability or inability of carrying out activities of daily living is both a cause and an effect of frailty and may exacerbate the clinical manifestations of comorbidities. Cachexia is one of the most important comorbid conditions in ECPs, which can directly impair their quality of life, their ability to tolerate tumor-directed treatments, and their ability to respond to rehabilitation. Gait speed, handgrip strength, and cognitive tests along with simple laboratory tests to rule out the presence of increased inflammatory state and/or a particular hormonal deficiency may guide interventions and allow for monitoring of clinical outcomes over time. An organized social network, collaborative support from the team of caregivers and sufficient home care services comprise a comprehensive care approach that guarantees successful treatment outcomes for the ECP population.