title: Decision-making in geriatric oncology: systemic treatment considerations for older adults with colon cancer.
abstract: Colon cancer is common and can be considered a disease of older adults with more than half of cases diagnosed in patients aged over 70 years. Decision-making about treatment with chemotherapy for older adults may be complicated by age-related physiological changes, impaired functional status, limited social supports, concerns regarding the occurrence of and ability to tolerate treatment toxicity, and the presence of comorbidities. This is compounded by a lack of high quality evidence guiding cancer treatment decisions for older adults. Areas covered: This narrative review evaluates the evidence for adjuvant and palliative systemic therapy in older adults with colon cancer. The value of an adequate assessment prior to making a treatment decision is addressed, with emphasis on the geriatric assessment. Guidance in making a treatment decision is provided. Expert commentary: Treatment decisions should consider goals of care, a patient's treatment preferences, and weigh up relative benefits and harms.
authors.affiliation: a Concord Cancer Centre , Concord Repatriation General Hospital , Sydney , Australia.|b Sydney Medical School , University of Sydney , Sydney , Australia.
authors.forename: Erin B
authors.initials: EB
authors.lastname: Moth
authors.affiliation: a Concord Cancer Centre , Concord Repatriation General Hospital , Sydney , Australia.|b Sydney Medical School , University of Sydney , Sydney , Australia.
authors.forename: Janette
authors.initials: J
authors.lastname: Vardy
authors.affiliation: a Concord Cancer Centre , Concord Repatriation General Hospital , Sydney , Australia.|b Sydney Medical School , University of Sydney , Sydney , Australia.
authors.forename: Prunella
authors.initials: P
authors.lastname: Blinman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015897:Comorbidity; D003661:Decision Support Techniques; D005260:Female; D005853:Geriatrics / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D010166:Palliative Care; D057240:Patient Preference; D018579:Patient Selection; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Colon cancer; chemotherapy; decision-making; older adult