Treating cancer in elderly patients is difficult, acknowledged Andrew E. Chapman, DO, FACP, in an Internal Medicine session this morning on geriatric oncology. But that doesn't mean you shouldn't do it.
Many elderly patients, especially those who are very fit for their age, are undertreated by oncologists, he said. "Age should not drive the decision making." Of course, you also don't want to put sickly, frail patients through cancer treatment that won't extend or improve their lives.
Therefore, one of the first steps in cancer treatment decision making for elderly patients should be a geriatric assessment. Use comorbidities and functional status (such as activities of daily living) to categorize patients as fit, vulnerable or frail, and then guide treatment decisions using that categorization.
Sound like a task for the oncologist, rather than you, the general internist? Maybe, but don't count yourself out of the process just because you've referred a patient to an oncologist.
"The days of the patient being diagnosed with cancer and being cared for solely by the oncologist should end. We need your help," said Dr. Chapman.