2021 Volume 74 Issue 5 Pages 269-275
In the field of oncology in Japan, an important issue is to manage older cancer patients suffering from progressive physical and cognitive impairment. It is known that healthy ‘fit' senior cancer patients can tolerate standard therapy with anticipated results similar to non-elderly patients, whereas it is hard for ‘frail' patients to receive cancer treatment because their general condition is too poor to tolerate any anticancer therapy and only the best supportive care may be the preferred method of management. For a medical team, one of the most difficult issues is to manage ‘prefrail' patients whose condition lies between fit and frail, since they can only tolerate less intense cancer therapy because of potentially too much treatment toxicity. There is also no guideline for the treatment of such patients because of insufficient evidence. Thus, this project aimed to state provisional clinical opinions (PCO) recommended by experts of geriatrics, geriatric oncology and other stakeholders in order to establish future guidelines for managing these patients. We established five treatment working groups to state PCO for vulnerable elderly patients in colorectal cancer as a model case; this paper presents a definition of prefrail and the process of producing PCO discussed by the Overview and Geriatric Assessment Working Group.
