Cancer Management in Extremely Elderly Patients: Applying Comprehensive Geriatric Assessment in High Burden Settings

Abstract

The demographic shift toward an aging population has resulted in an increasing number of extremely elderly patients (aged 80 years and above) presenting with cancer diagnoses. This population presents unique challenges in oncological care, characterized by physiological vulnerability, multiple comorbidities, polypharmacy, and diminished functional reserves. Comprehensive Geriatric Assessment (CGA) has emerged as an essential tool for optimizing treatment decisions and improving outcomes in this vulnerable population. This review examines the current evidence on cancer treatment approaches in extremely elderly patients, the role of CGA in treatment planning, specific considerations for different treatment modalities, and practical implementation strategies. Evidence demonstrates that chronological age alone should not dictate treatment decisions; instead, a holistic assessment of functional status, comorbidities, and patient preferences should guide individualized care plans. When appropriately selected and managed with CGA integration, extremely elderly patients can benefit from cancer-directed therapies while maintaining quality of life.

Keywords: Extremely Elderly; Cancer Treatment; Geriatric Assessment; Octogenarians; Nonagenarians; Frailty; Chemotherapy Tolerance

Citation

Rahul Garg. Cancer Management in Extremely Elderly Patients: Applying Comprehensive Geriatric Assessment in High-Burden Settings. WebLog J Cancer Clin Res. wjcacr.2026.f1704. https://doi.org/10.5281/zenodo.21312395