Treatment considerations for older patients with cancer.

It is apparent that cancer is primarily a burden for geriatric populations. This conclusion is based both upon the greater incidence of the disease with advancing age and the increasing distribution of elderly people in western cultures. Three questions have arisen that form the underpinnings of the evolving subspecialty of geriatric oncology. These are: Why are tumors more frequent in the elderly? Is there a difference in tumor aggressiveness with advancing age? And, should treatment be different for the older patient? Experimental data and clinical experience have indicated that tumors are not resistant to treatment by virtue of age alone. However, age is associated with slight reductions in certain organ functions, and these deficiencies might be magnified by comorbid conditions. Cancer treatments, especially chemotherapy may therefore be more toxic and therefore treatment should be tailored for the individual taking into consideration potential increased toxicities balanced by patients expectations. Quality of life considerations assume even greater importance in geriatric populations.