Gastrointestinal tract cancer in the elderly

Gastrointestinal cancers are common in the elderly. In the 1990s, modest advances in the early diagnosis, staging, and treatment of gastrointestinal cancers were made. Emphasis has been placed on screening for colorectal cancer; development of new diagnostic and staging modalities, particularly endoscopic ultrasound; and introduction of new treatment regimens, such as chemoradiation programs for esophageal, pancreatic, and colorectal cancers as well as endoscopic mucosal resection of early gastrointestinal cancers. New palliative techniques, such as laser and photodynamic therapy and placement of enteral stents, are being used increasingly in patients who have advanced cancer and are not surgical candidates. In the past, attitudes toward the elderly affected the management of cancer. Age should not be the only parameter considered when addressing the treatment of a gastrointestinal malignancy. Management decisions in the elderly should follow the same principles as those in younger patients. A thorough medical evaluation in the elderly is necessary to evaluate the patient's risk and to optimize surgical, chemotherapeutic, and palliative outcomes.