Mehr als die Hälfte der Menschen mit einer neu diagnostizierten onkologischen Erkrankung
ist über 70 Jahre alt. In dieser Altersgruppe ist die Tumorbehandlung mit anderen
Herausforderungen verbunden als bei Betroffenen im jüngeren Lebensalter. Dieser Beitrag
fasst dazu den gegenwärtigen Erkenntnisstand zusammen und beschreibt die Besonderheiten
von Diagnostik und Therapie onkologischer Erkrankungen im Alter.
Abstract
A majority of patients with newly diagnosed malignant disease are 70 years old or
older. Frailty – i. e. increased vulnerability towards stressors at older age – is
a major challenge during the oncological work-up and treatment in the elderly. Therefore,
older cancer patients should receive a systematic assessment of frailty by use of
standard tools. Assessment results should be carefully considered during oncological
treatment decisions, e. g. in interdisciplinary tumor conferences. Moreover, they
are prerequisite to initiate geriatric co-management for which there is emerging new
evidence. Advances in tumor surgery and irradiation as well as personalized precision
medicine with novel targeted drugs have facilitated the treatment of cancer even in
old age and frailty. However, patients with such characteristics are at increased
risk of complications compared to younger subjects. Physicians and medical staff involved
in treatment must therefore co-operate well. This article provides an overview of
the current evidence and highlights key aspects of diagnosis and treatment of malignant
diseases in the elderly.
Schlüsselwörter
Frailty - geriatrisches Assessment - Chemotherapie - Präzisionsmedizin
Key words
frailty - geriatric assessment - chemotherapy - precision medicine