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Older cancer patients and COVID-19 outbreak: Practical considerations and recommendations.

Abstract
Since the COVID-19 outbreak started, it has been affecting mainly older individuals. Among the most vulnerable older individuals are those with cancer. Many published guidelines and consensus papers deal with prioritizing cancer care. Given the lack of high-quality evidence for management of cancer in older patients also in normal times, it is even more stringent to provide some resources on how to avoid both undertreatment and overtreatment in this population, who as of now is twice challenged to death, due to both a greater risk of getting infected with COVID-19 as well as from cancer not adequately addressed and treated. We hereby discuss some general recommendations (implement triage procedures; perform geriatric assessment; carefully assess comorbidity; promote early integration of palliative care in oncology; acknowledge the role of caregivers; maintain active take in charge to avoid feeling of abandonment; mandate seasonal flu vaccination) and discuss practical suggestions for specific disease settings (early-stage and advanced-stage disease for solid tumors, and hematological malignancies). The manuscript provides resources on how to avoid both undertreatment and overtreatment in older patients with cancer, who as of now is twice challenged to death, due to both a greater risk of getting infected with COVID-19 as well as from cancer not adequately addressed and treated.
AuthorsAntonella Brunello, Antonella Galiano, Silvia Finotto, Silvio Monfardini, Giuseppe Colloca, Lodovico Balducci, Vittorina Zagonel
JournalCancer medicine (Cancer Med) Vol. 9 Issue 24 Pg. 9193-9204 (12 2020) ISSN: 2045-7634 [Electronic] United States
PMID33219746 (Publication Type: Journal Article, Review)
Copyright© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Topics
  • Aged
  • COVID-19 (epidemiology, prevention & control, virology)
  • Caregivers (standards, statistics & numerical data)
  • Disease Outbreaks
  • Geriatric Assessment (methods, statistics & numerical data)
  • Humans
  • Medical Oncology (methods, standards, statistics & numerical data)
  • Neoplasms (diagnosis, therapy)
  • Palliative Care (methods, standards, statistics & numerical data)
  • SARS-CoV-2 (isolation & purification, physiology)

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