The numbers of elderly patients with oral cavity cancer is expected to increase in the future. Nowadays, surgery is the therapeutic mainstay for oral cancer. However, many elderly patients may not be considered as candidates for aggressive treatment. How old is the patient that is not recommended for oral cancer surgery?
Dr. Obehi O Osadolor,
Do you know the relevant references? Looking forward to your response and discussion.
very interesting question. i believe there are several questions to be answered first before classifying the patient is old enough no have surgery for their life threatening condition like oral cancer. The first is surgery is the right treatment for the condition (the extent and stage of the disease)? then is the surgery is the right treatment for that patient? To answer the second question; 1)the informed consent and the patient view on the treatment options offered;2) The medical condition and fitness to undergo the long invasive procedure under GA and 3) what is possible serious outcome like strike, MI...etc
Dr. Kamis Gaballah,
Thank you for your very useful and professional comments.
I completely agree with Kamis Gaballah that the answer depends on many factors, mainly the patient's biological age, co-morbidities and overall general health. In our department as a general rule, there is no upper limit, as long as the patient is able to undergo the surgery, and as long as it is with intent to cure. In a non-curable/non-operable disease we usually do not perform palliative surgery. It should also be noted that nowadays with TORS and endoscopic approaches, the recovery period and morbidity associated with oral surgery significantly improved, allowing elderly patients to benefit from these innovative techniques.
Thanks to Dr. Ofir Zavdy and Dr. Kamis Gaballah for your thorough clinical perspective and excellent insights.
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