Management of elderly oncology patients presents some difficulties when deciding if a patient is suitable for curative treatment or not. Apart from the tumour characteristics, there might be some other factors that influence in this decision, as previous illnesses, disability or general life expectancy. Standardized geriatric assessment must be applied in these cases, evaluating frailty in the elderly as one important prognosis factor, as it has been related to higher mortality and worst treatment tolerance.
As symptoms, signs and exploratory findings can have common characteristics both for cancer and frailty, it is necessary to find other paths for approaching the frailty diagnosis that may influence the kind of treatment that a cancer patient receives. Biochemical markers are being developed, but in most cases they are not specific for cancer or frailty. Cardiovascular risk of patient, taking account on the analytic evolution of cardiovascular risks factors in the years previous to the neoplasia diagnosis, can help in the evaluation of the patient´s prognosis.
DNA methylation pattern changes with age, and is also altered in cancer patients. This fact relates the apparition of cancer with aging. Further research must investigate on this subject, in order to identify possible methylation patterns that can discriminate frail cancer patients and non frail ones.