Basic assessment of the older cancer patient

Cancer is a disease of the elderly (median age 67 in the US), and this is a population with a variable health status. Therefore, treating the older half of the cancer population will present the challenge of not only addressing tumor diversity (the side often referred to in "personalized cancer care" discussions), but patient diversity as well as the interaction between these two heterogeneities. In that sense, geriatric oncology is the ultimate personalized cancer care. In this article, we will address the recent updates in the basic assessment of the patient's condition, and their implication for clinical and research use. The main progresses reported in the last couple of years pertain to geriatric screening tests, and to prediction of the tolerance to treatment. Some important data on the impact of comorbidities on cancer behavior have emerged, but the clinical implications of these data are still being sorted out. We recommend a two-step approach to the basic evaluation of the older cancer patient. First a short screening with a tested screening instrument. Then further work-up of the geriatric findings in parallel with the oncology work-up to define an integrated treatment plan.