Geriatric Oncology: A New Subspecialty?
TO THE EDITOR: The progressive aging of the population has been accompanied by an increase of cancer incidence. More than 60% of all tumors occur after age 65 years, and around 45%, after 70 years, with more than two thirds of tumor deaths in people older than 65 years.1 In the next 10 to 20 years, a longer life expectancy will lead to a heavier tumor care burden for elderly people. In the last 15 years, the number of studies conducted in elderly cancer patients has definitively increased, as well as lectures, conferences, courses, and books on tumors in the elderly. Nowadays, medical oncologists can rely on resources like the multidimensional geriatric assessment before therapy,2,3 or some drugs of the therapeutic armamentarium believed to be “elderly friendly”4
- medical oncologists can
prevent or treat hematologic toxicity with hematopoietic growth factors in elderly patients and, when necessary, interact with geriatricians. We are no longer in the situation Fentiman et al described more than 10 years ago: “Cancer in the elderly: why so badly treated?”5 However, an elderly-oriented approach is practiced by a minority of medical oncologists, and even a superficial observer could notice how therapy is still far from optimal for elderly cancer patients in our in and out patient services. Few elderly patients enter trials,6 not all receive treatment, and informed consent does not carry fully understandable information to elderly patients.4
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