Cancer in the elderly: assessing patients for fitness

As aging is highly heterogeneous, the clinical evaluation of the older person with cancer is influenced by several factors including comorbid conditions, disabilities, tumour type and stage. Assessment of comorbidity and disability represent on evolving area of research. Results from geriatrics are now translating in clinical oncology. Instruments for measurement of comorbidity and disability have been evaluated in the older cancer patients with promising results. The use of comprehensive geriatric assessment (CGA) in the older cancer patient represents a major improvement in the oncological practice. CGA is based on standardised interviews and covers areas of physical and psychical dysfunction. Moreover, CGA allows the collections of homogeneous information among different centres and recognition of the frail elderly. A diffuse ageistic prejudice may prevent adequate evaluation and treatment of older individuals. A wide based educational effort may allow a more appropriate management of the older cancer patient.