Een geriatrisch assessment voor oudere kankerpatiënten: wie, wat en waarom?

Abstract

A comprehensive geriatric assessment for elderly cancer patients: who, what and why? Advanced age is often accompanied by the development of a certain level of frailty. This can pose important challenges to the treatment of older patients with cancer. In this regard, a comprehensive geriatric assessment (CGA) allows physicians to sketch a clear picture of the functional, cognitive and social situation of an individual patient. This article provides an overview of the essential elements of a CGA and discusses the screening tools that facilitate the selection of patients for whom a CGA truly has added value. An overview of clinical trials evaluating the impact of a CGA-based treatment strategy in the management of elderly cancer patients is also provided. A CGA allows physicians to assess whether a patient has sufficient functional reserve to undergo a specific anticancer therapy. Based on a CGA, the anticancer treatment can be tailored to the individual needs and capabilities of a given patient. Furthermore, targeted, non-oncological interventions can be deployed to optimize one’s functional, cognitive and social status. Clinical studies evaluating such a CGA-based treatment strategy in older cancer patients indicate a lower incidence of high-grade toxicity and a better quality of life, without a detrimental impact on the survival rate. There is a broad consensus on the added value of a CGA-based treatment strategy in older cancer patients. However, the implementation of such a dedicated oncogeriatric management into the daily clinical practice of busy clinics can be challenging. In this regard, a close collaboration between oncologists and geriatric specialists proves to be essential.