Resumen de Head and Neck Cancer in the Elderly: Frailty, Shared Decisions, and Avoidance of Low Value Care

Leila J. Mady, Marci Lee Nilsen, Jonas T. Johnson

• Head and neck cancer is a disease of older adults, with an estimated 61% of patients ages 65 and older by the year 2030.

  Even with treatment advancements, recurrent/metastatic head and neck squamous cell carcinoma remains a lethal disease with median overall survival of less than 12 months.

  It is imperative to distinguish fit individuals, who may tolerate multimodality therapy, from frail patients, who may benefit from prehabilitation or palliative and supportive services.

  Chemotherapy, radiation, and targeted molecular agents have limited efficacy when used for the palliation of symptoms in advanced disease.

  Shared decision making considers evidence-based best practices in the context of a patient’s goals and values and forms the foundation of end-of-life considerations in geriatric oncology.