Obsevanje starostnika z rakom

There is a growing number of evidence that elderly cancer patients can benefit oncology treatment. Despite this fact they are under treated, which leads to a worse outcome of the disease. Additionally, it is also concerning that a great deal of elderly people when diagnosed are in a relatively healthy and good condition and have presumably several years of life ahead of them. The chronological age, which is often the basis for deciding the type and intensity of treatments, has proven as an insufficient and misleading piece of information. Elderly people in good condition tolerate radiation just as well as younger patients and the disease has a comparable treatment response. Other contributing factors in treatment decision are false assessments of a patient’s life expectancy, doubts in therapeutic efficiency and fear because of treatment toxicity. An integral geriatric evaluation of older patients is recommended, which would help oncologists in deciding whether to refer patients for radical or palliative oncology treatment.Vse več je dokazov, da imajo stari bolniki z rakom dobrobit od specifičnega onkološkega zdravljenja. Kljub temu so pogosto premalo zdravljeni, kar ima za posledico slabši izid bolezni. Ob tem je zaskrbljujoče tudi to, da je veliko starostnikov ob diagnozi relativno dobrega zdravja in imajo po predvidevanjih pred sabo še več let življenja. Kronološka starost, ki je pogosto podlaga za odločitev o vrsti in intenzivnosti zdravljenja, se je izkazala kot nezadosten in zavajajoč podatek. Starostniki v dobrem stanju zmogljivosti prenašajo obsevanje enako dobro kot mlajši bolniki in imajo primerljiv odgovor bolezni na zdravljenje Vlogo pri odločitvi imajo tudi napačna presoja pričakovanega življenja bolnika, dvom v terapevtsko učinkovitost in strah zaradi toksičnosti zdravljenja. Priporoča se celovita geriatrična ocena starejših bolnikov, ki bi onkologom pomagala pri razmisleku o primernosti napotitve na radikalno ali paliativno onkološko zdravljenje