Treating Head and Neck Cancer in the Older Adult

The management of head and neck squamous cell cancer in older adults requires an individualized approach that integrates oncologic efficacy with geriatric considerations. Chronological age alone should not preclude curative-intent therapy; rather, treatment selection should be guided by comorbidity burden, functional status, and frailty assessment. Comprehensive geriatric assessment provides prognostic insight beyond traditional staging, informing both tolerance and outcomes. Surgery and radiotherapy remain feasible options for appropriately selected patients, whereas systemic therapy is limited by increased toxicity, necessitating dose modifications or alternative regimens. Multidisciplinary evaluation is critical to balance disease control with quality-of-life priorities, including swallowing, speech, and independence. Shared decision-making, incorporating patient goals and life expectancy, is essential to optimize care. Critically, prospective clinical trials focused on older adults are urgently needed to refine prognostic tools, mitigate toxicity, and optimize patient selection and outcomes.