Head and neck oncological surgery and pearls in the elderly

Objective: To review special considerations of treating head and neck cancer in the elderly population.Finding: The number of adults aged 65 years and older projected to reach 90 million by 2050. The fastest growing age group, adults 85 years and older, is projected to triple by 2060. Determining the optimal treatment plan for elderly patients can be difficult for numerous reasons, including multiple medical co-morbidities, mental and physical disabilities, polypharmacy, cognitive state, social isolation, and lack of family support. Unfortunately, elderly patients frequently receive substandard care, while the literature suggests that age alone should not preclude an aggressive surgical approach or the avoidance of cytotoxic chemotherapy or radiation therapy.Conclusion: The elderly population undoubtedly represents a complex patient population due to numerous reasons. However, if there are no prohibitive medical co-morbidities, and the patient is not significantly frail, then elderly patients should receive the standard of care if able.