Comprehensive Geriatric Assessment in Cancer Patients

Abstract

Approximately 60% of cancers are diagnosed in patients 65 years and older. Older patients with cancer represent therapeutic challenges because they are a heterogenous population with various combinations of comorbidities, organ-specific physiologic changes, disabilities, and geriatric syndromes. Scientific societies recommend a comprehensive geriatric assessment (CGA) to detect multidomain health problems potentially associated with adverse outcomes, to guide decision-making about cancer treatments, and to introduce interventions effective for health issues that may be reversible. Based on validated tools, CGA is used to systematically assess functional, nutritional, cognitive, emotional, and social status as well as comorbidities in patients. It allows for (1) detecting numerous unrecognized health problems existing in parallel with the cancer, (2) implementing tailored and individualized geriatric interventions effective for health problems that may be reversible, (3) identifying geriatric factors and comorbidities competing with the cancer in terms of mortality risk, and (4) identifying geriatric prognostic factors in terms of treatment feasibility and toxicity risk. Thus, CGA can help oncologists identify older patients with cancer who could benefit from optimal anticancer treatment and those who could benefit from adapted treatment.