Management of cancer in the elderly. Implications of the aging process

Cancer is one of the most serious illnesses of the elderly. Screening programs focusing on its early detection in this age-group are needed to allow maximum opportunity for cure. Also important is convincing the older patients who smoke that stopping is still worthwhile. Compared with younger patients, the elderly have more intercurrent medical illnesses and are more likely to suffer from financial difficulties and loss of family support. These factors must be considered when managing these patients. Although age-imposed compromises in treatment are often made, available data suggest that a priori dose reduction of chemotherapy on the basis of age alone is not indicated in patients with solid tumors. Prospective clinical trials are needed to further address the issue of responsiveness to chemotherapy as a function of age. Such trials should include assessment of physiologic age and quality of life.