2021 Volume 74 Issue 5 Pages 276-286
Following the general statement for the management of prefrail elderly in colorectal cancer, the following six important clinical questions concerning the management of such patients were raised, discussed and recommended by the working group: 1) The purpose of cancer treatment is extension of both the overall and disability-free survival (healthy life expectancy); 2) The healthcare workers' team should respect patients' will and values, and should try to build a consensus on the treatment purpose with patients; 3) Patients who potentially have cognitive impairment need to be evaluated by appropriate tools and supported by the medical team to make a decision on selecting the treatment plan depending on their cognitive function; 4) Life expectancy will support shared decision-making on the treatment plan; 5) Quality of life measured before and after treatment is an important factor to evaluate healthy life expectancy; and 6) Geriatric assessment before starting the treatment is useful to predict the risk of developing adverse events, prolonged length of hospital stay and death. The prefrail elderly will eventually deteriorate to require nursing care despite cancer treatment. Close collaboration between medical and nursing care is recommended as soon as a diagnosis of cancer is made in those presenting with significant frailty.
