Assessment of health status in elderly patients with cancer

Rep Pract Oncol Radiother. 2012 Aug 9;18(1):44-8. doi: 10.1016/j.rpor.2012.07.007. eCollection 2012.

Abstract

Background: Health status assessment of senior adults is one of the most important aspects of a treatment decision making process. A group of elderly cancer patients is very heterogeneous according to the health status - some of them are fit enough for aggressive treatment, but others are frail and vulnerable. Treatment for the latter group has to be adapted and carefully monitored.

Aim: To review and analyze relevant literature on the usage and optimization of Comprehensive Geriatric Assessment (CGA).

Materials and methods: Medline search of studies published between 2000 and 2011, containing key words: Comprehensive Geriatric Assessment, aging, cancer in senior adults, frailty.

Results: To recognize and address individual needs of senior adults, a special holistic approach has been developed - comprehensive geriatric assessment (CGA). This tool is a gold standard in gerontooncology, recommended by International Society of Geriatric Oncology. CGA evaluates all important health domains, from physiology to social and economical problems, using sets of different tests. Assessment has to be performed by a trained team, including a physician, nurse and social worker. CGA has been clinically validated in many studies, but it is still not clear whether CGA improves the outcome of treatment of the elderly with cancer.

Conclusions: Complexity and multidimensionality of CGA pose a logistic challenge for everyday clinical practice. Special senior programs, which could be developed inside comprehensive cancer center, focusing attention on seniors' problems and needs seem to be a way forward for geriatric oncology.

Keywords: Aging; Comprehensive geriatric assessment; Elderly; Frailty.