[Drug treatment of cancer in elderly patients]

Cancer is a disease predominantly seen in the older age group. The most frequent forms are in males: lung, prostatic, stomach, colonic and bladder cancer. In females: breast, colonic, stomach cancer, lymphoma, leukaemia and rectal cancer. In view of the expected demographic figures a dramatic increase in the incidence of cancer is expected. The malignancies seen in the elderly respond generally poor to chemotherapy. Most cytotoxic drugs are excreted by the kidneys. Especially the renal clearance of anticancer drugs will therefore be compromised in the elderly, this should be considered when giving cytostatics. Mucositis, bone marrow toxicity, pulmonary and neurotoxicity are quite often enhanced in the older patient group. The indications for chemotherapy are limited. Chemotherapy should not be withheld from patients with advanced breast cancer and certain haematological malignancies. Further clinical research focussed on the elderly is warranted. Drugs with a mild spectrum of side effects deserve priority. Hormonal treatment is an important modality in breast, prostatic and endometrial carcinoma. The burden for the patients is limited and the advantages are well documented.