Page 185 - Risk quantification and modification in older patients with colorectal cancer

decreased functional decline after treatment.17 Another prospective randomised controlled trial which will determine the effect of these interventions to reduce hospitalisation and toxicity in older cancer patients receiving chemotherapy, is currently ongoing.18
This study has several limitations. First, we collected data from three different hospitals. Although all of the geriatricians who examined the patients are well-trained and experienced in geriatric oncology, consultations were not protocolised and therefore, there might be some differences in their execution and the interpretation of the results. While this may affect homogeneity, it is also a reflection of actual clinical practice. Second, the presented data represent a selected patient group, for which the primary cancer specialist or multidisciplinary team deemed a geriatric consultation as desirable or necessary. Therefore, these patients are not representative of all older colorectal cancer patients and the results of this study should be extrapolated with some caution.
Despite these limitations, this study demonstrates that geriatric assessment impacts oncologic treatment decision-making in older colorectal cancer patients. In the future, case managers (e.g. specialised geriatric oncology nurses) could aid the multidisciplinary decision-making process by collecting information about patient’s health status, wishes and priorities and treatment possibilities. Subsequently, older cancer patients with uncertainty regarding their ability to tolerate treatment or regarding the optimal oncologic treatment plan should be referred to specialists, who are experienced in geriatric oncology, for geriatric consultation to receive a thorough assessment which can help in formulating an individualised plan for the cancer treatment as well as optimising their overall health status.
Conclusion
Geriatric consultation can be useful in treatment decision making in elderly patients with colorectal cancer. It may lead to changes in the treatment plan for individual cases. Additionally, it may optimise patient’s health status prior to treatment.
CGA and treatment decisions
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