Challenges and determinants in the management of the older patients with cancer – Report from a low- and middle-income country

Introduction: Cancer is a malady of old age. Older people lose autonomy and independence due to age-associated functional decline and adverse consequences of comorbidity. The impact of these variables has an effect on treatment decisions in older cancer patients. Methods: In an observational study, 290 cancer patients aged 60 years or more were evaluated before the initiation of the treatment. They were subjected to a geriatric assessment by various validated assessment tools. Management decisions were as per the prevailing hospital practice. Results: The median age at the diagnosis was 65 years and two-third were males. Lung cancer was the most common (49.3%) diagnosis. The major comorbidities seen were hypertension (34.14%), diabetes (20.34%), and COPD (15%). Depression (57%), cognitive impairment (37%), malnourishment (34%), and vision problem (20%) were common age-related issues observed. Seventy-one percent were dependent in one or more domains of activities of daily living. Eighty-one percent had Eastern Cooperative Oncology Group status score between 0 and 2 (thereby eligible for treatment). In multivariable analysis, good functional status (P