Issues in the adjuvant treatment of common tumors (with a focus on breast cancer) in older adults (age >70)

Abstract

Establishing an indication for adjuvant chemotherapy in older cancer patients represents a major challenge. After surgery, older cancer patients can also have a significant risk of relapse and cancer death (even reported to be higher than in younger patients), but this is counterbalanced by the fact that the chance of dying from a noncancer cause is also much higher. A careful geriatric evaluation including assessment of comorbidity can provide some insight into the life expectancy and expected benefit from adjuvant chemotherapy for individual patients. Age-related physiological changes can decrease tolerance of classical chemotherapy regimens, indicating the need for close monitoring and preventive measures. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.