Age can no longer be the main factor in treatment decisions. There is ample evidence that older patients who are deemed fit can tolerate and will benefit from standard therapies in both the adjuvant and metastatic settings. Tools are being developed that can aid in predictions of life expectancy, help identify the vulnerable and frail older patients who may have some difficulty with treatment, and guide treatment modifications.
Oncologists need to be advocates for their older patients, encourage clinical trial participation, and evaluate their older patients in a personalized, systematic way to provide optimal cancer care. In the coming years, as older patients become the majority of the patients who we evaluate and treat, they will need to become the focus of our endeavors. They deserve nothing less (J Clin Oncol 2007;25:1821–1823).
Dr. Lichtman is an Attending Physician at Memorial Sloan-Kettering Cancer Center, a member of the 65+ Clinical Geriatric Program, and Professor of Medicine at Weill Cornell Medical College, New York, NY. He has no conflicts of interest to disclose.