[Systemic cancer treatment in geriatric patients]

Functional health issues and the ability to autonomously participate in social life play a more pronounced role for geriatric patients than the mere prolongation of life. Quality-adjusted life years reflect the relation of health and life span. Comorbidities and functional or cognitive impairment represent independent predictors for the overall survival of geriatric patients. This must be kept in mind when planning systemic cancer treatment.

All forms of cancer-specific therapy should evaluate whether the patient can truly benefit taking into consideration geriatric aspects. This particularly demands a great deal of palliative chemotherapy. When curation is no longer possible, a cancer-specific treatment must not lead to therapy-related symptoms. Clear communication of the aims of therapy is indispensable. In addition to routine urooncologic data, other relevant information must be inquired in advance of cancer-specific treatment in order to identify those functionally or cognitively impaired patients who may not benefit from systemic cancer treatment.

A precise indication with respect of age-dependent physiological changes and a clear prioritization of symptoms outline the approach for systemic cancer-specific treatment.