28/01/2026
โDoc, dili na magchemo si tatay kay tigulang naman cya.โ
This was the initial remarks of my 72 year old patientโs daughter during our first consult. There was a 4x3cm mass bulging in his left eye that impaired his vision. After a careful discussion with the patient and the family, we have come to a conclusion that the patient wanted to be treated and I have deemed his a good candidate for treatment after a thorough evaluation.
4 months later, he can now see better, and his latest scan show no evidence of cancer. Thank You Lord! ๐๐ผ
โฆ
People should understand that when planning chemotherapy in elderly patients, physiologic age is more important than chronological age.
Functional status, frailty, comorbid illnesses, and baseline organ functionโespecially renal, hepatic, and bone marrow reserveโstrongly influence treatment tolerance. Polypharmacy, nutritional status, and cognitive function must also be assessed, as these factors increase the risk of toxicity, poor adherence, and complications.
Cancer-related factors such as tumor biology, stage, and treatment intent (curative vs palliative) play a key role in regimen selection. Estimating toxicity risk using geriatric assessment tools helps guide dose adjustments, supportive care, and the choice of simpler or less intensive regimens.
Most importantly, chemotherapy decisions should be guided by patient goals and preferences, with emphasis on quality of life and available social support. The overall aim is to tailor treatment to maximize benefit while minimizing toxicity and preserving independence.
Bottomline: Chronologic age should never be the sole reason to deny chemotherapy. A comprehensive geriatric assessment helps tailor treatment, minimize toxicity, and align therapy with what matters most to the patient. ๐ซถ๐ผ๐๐ผ๐๏ธ
