Comorbidity and clinical assessment in geriatric patients with cancer

Year 2007, Volume: 22 Issue: 4, 192 - 196, 01.05.2007

Savaş Tuna

Abstract

The developments in preventive and curative medicine, improvement of life conditions and nutrition have rapidly increased the number of elderly people in the general population. Approximately half of all cancer events occur in people 65 years and older. Cancer is the most second cause of all death in this patient population. Aging is a personal phenomenon and physiology may not necessarily be parallel to the chronological age. Elderly people are known to have a higher incidency of both cancer and comorbidity. Cancer patients age 70 and older have the least 3 comorbidities. Decision-making for cancer treatment in geriatric population must first evaluate personal functional capacity. Elderly people are not only older adults; they have unique physiologic features and pharmacological response patterns. Life expectancy and chemotherapy complication risks may be determined by comprehensive geriatric assessment and results of this assessment provide better judgment in the choice of standard or palliative treatment.

Keywords

Comorbidity, Aged, Geriatric Assessment, Neoplasms

Kanserli geriatrik hastalarda komorbidite ve klinik değerlendirme

Abstract

Koruyucu ve tedavi edici tıptaki gelişmeler ile beslenme ve hayat şartlarındaki iyileştirmeler sonucu genel nüfus içindeki yaşlı insan sayısı hızla artmaktadır. Tüm kanser vakalarının %50'si 65 yaş üzerinde görülür ve 65 yaş üzerinde ölüm nedenleri arasında kanser ikinci sıradadır. Yaşlanma kişisel bir fenomendir ve takvim yaşıyla paralellik göstermeyebilir. Yaşlılarda kanser ve komorbidite insidansının da yüksek olduğu bilinmektedir. Yetmiş yaş üzerindeki kanser hastalarının yarıdan fazlasında en az üç komorbidite vardır. Geriatrik nüfusta kanser tedavisi planlanırken öncelikle bireysel fonksiyonel kapasite iyi değerlendirilmelidir. Yaşlılar, erişkinlerin sadece yaşça büyükleri olmayıp, daha farklı fizyolojik özelliklere ve farmakolojik yanıt biçimine sahiptirler. Kapsamlı geriatrik değerlendirme ile elde edilen bilgiler sayesinde yaşam beklentisi öngörüleri ve kemoterapi komplikasyonları için yüksek riskli hastalar saptanabilir. Bu da standart ya da palyatif tedavi kararına olanak sağlar.

Keywords

Geriatrik onkoloji, kapsamlı geriatrik değerlendirme, komorbidite

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