gms | German Medical Science

In the years to come health care systems of western industrialized nations are going to be increasingly faced with the results of demographic changes. Especially the part of elderly citizens will grow steadily. Thus, also an increasing number of malignant diseases not only in the head & neck area is expected. Decision-making in cancer therapy for elderly patients is challenging for medical professional since this subject is accompanied by a high rate of uncertainness. For fear of aggressive therapy regimens with subsequent increase of morbidity, in many cases only incomplete diagnostic and therapeutic measures are taken. Reviewing the literature there is almost complete international consensus, that patients suffering from squamous cell cancer of the head & neck should be treated with curative intention, if thorough preoperative assessment of present comorbidities is performed. In this connection especially the so called "geriatric assessment" has to be mentioned. Furthermore, also aggressive surgical treatment options including reconstructive techniques like microvascular free flaps should not be excluded. An optimal medical adjustment of relevant concomitant diseases clearly improves the starting point. Compared to younger patients complications associated with surgical therapy options do not necessarily occur more frequent. For this reason surgical treatment options should not be witheld to elderly patients.