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The Scientific World Journal
Volume 2012 (2012), Article ID 303852, 9 pages
http://dx.doi.org/10.1100/2012/303852
Review Article

Cancer Surgery in the Elderly

1Department of Surgery, Saint Agnes Hospital Center, 900 Caton Avenue, Baltimore, MD 21229, USA
2Department of Medicine, Saint Agnes Hospital Center, 900 Caton Avenue, Baltimore, MD 21229, USA
3Laboratory of Molecular Biology and Immunology, National Institute on Aging, NIH, 251 Bayview Boulevard, Baltimore, MD 21224, USA

Received 13 August 2011; Accepted 18 October 2011

Academic Editors: G. Onder, A. Roccaro, and C. M. Tsai

Copyright © 2012 Gopal C. Kowdley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The proportions both of elderly patients in the world and of elderly patients with cancer are both increasing. In the evaluation of these patients, physiologic age, and not chronologic age, should be carefully considered in the decision-making process prior to both cancer screening and cancer treatment in an effort to avoid ageism. Many tools exist to help the practitioner determine the physiologic age of the patient, which allows for more appropriate and more individualized risk stratification, both in the pre- and postoperative periods as patients are evaluated for surgical treatments and monitored for surgical complications, respectively. During and after operations in the oncogeriatric populations, physiologic changes occuring that accompany aging include impaired stress response, increased senescence, and decreased immunity, all three of which impact the risk/benefit ratio associated with cancer surgery in the elderly.