The Role of Comprehensive Geriatric Assessment in the Treatment of Cancer Patients of Elderly and Senile Age
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Role of Comprehensive Geriatric Assessment in the Treatment of Cancer Patients of Elderly and Senile Age Yu. V. Alekseevaa, *, T. Yu. Semiglazovaa, b, B. S. Kasparova, E. V. Tkachenkoa, K. I. Proshchayeuc, N. A. Brisha, L. V. Filatovaa, b, V. V. Semiglazova, d, E. A. Voroninae, R. H. Kasymovf, and A. M. Belyaeva, b aPetrov
National Medical Research Center of Oncology, St. Petersburg, 197758 Russia Mechnikov Northwestern State Medical University, St. Petersburg, 195067 Russia c Institute of Advanced Training of the Federal Medical and Biological Agency, Moscow, 125371 Russia dPavlov First St. Petersburg State Medical University, St. Petersburg, 197022 Russia e Department of Labor and Social Protection of the Kemerovo region, Kemerovo, 650991 Russia fGerontology Research Medical Center, Moscow, 125371 Russia *e-mail: [email protected] b
Received September 13, 2019; revised November 19, 2019; accepted November 25, 2019
Abstract—Modern approaches to the organization of the diagnosis and treatment of elderly and senile patients with malignant tumors make it possible to improve the quality of life and increase life expectancy. Assessment of the geriatric status in oncology allows the prediction of complications during complex treatment, including drug treatment; the modification of treatment to reduce risk factors for adverse outcomes; and the selection of patients for specialized treatment with standard schemes. Thus, the timely assessment of geriatric syndromes and their correction can expand the indications for specialized treatment of elderly and senile patients. Keywords: malignant tumors, assessment of geriatric status DOI: 10.1134/S2079057020040025
INTRODUCTION Cancer is primarily a disease of the elderly. According to the classification of the World Health Organization (WHO), the elderly age is 60–74 years old, and senile age is 75–89 years old [3]. It is expected that life expectancy will increase to 80 years by 2030; hence the number of elderly patients with cancer will increase. In Russia in 2017, 70.8% of cases of cancer were detected in the age group of 60 years or older in the male population, and 65.3% were detected in the female population (Fig. 1) [4]. Aging is an increasing, multiorgan decline in the body’s functional resources, which, in turn, leads to a decrease in stress tolerance, including specialized anticancer treatment. However, it should not be forgotten that patients over the age of 60 differ significantly in their physical, mental, and cognitive status. The choice of treatment tactics must be largely based not on chronological age but on biological age, which more accurately reflects the individual characteristics of the patient. In the process of the aging of elderly and senile patients with cancer, chronological age is not the only indicator of heterogeneity. There are three main factors that affect a sick elderly person—a concomitant
pathology, the oncological disease itself, and the geriatric status. Therefore, a systematic and scientifically substantiated method of comprehensiv
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