Health care economics of cancer in the elderly.

Changing economic circumstances have brought increased pressure to bear on the traditional revenue sources of oncologists. Practice standards and settings are being challenged to generate cost savings both for third-party payers and for oncology practices. Add to this the growing number of patients older than 65 years, and particularly older than 85 years, and the profession is facing a forced reconsideration of its approach to patient treatment. The current and future training of oncologists needs to incorporate both a multidisciplinary approach of cancer subspecialties and an enhanced ability to evaluate the use and cost-effectiveness of new therapies, second-line and third-line therapies, and palliative treatments.