What may influence aged cancer patient survivorship in post-COVID-19 time?

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Geriatric cancer patients are vulnerable to any disturbance in careful healthcare provision. For example, in Poland, still reforming its oncological care, mortality due to breast cancer raised abruptly in eldest female +85 from 2014 despite the incidence had risen in closely preceding years mainly in younger females, most rapidly in 65-69 age groups (1). Also, we have observed that not only under treatment of elder breast cancer patients may influence survival (2). We postulate that geriatric cancer patients need not mainly standardized protocols for different modalities of concomitant treatment but also tailored and coordinated social and medical support. COVID-19 pandemic apparently interfered with healthcare performance. In early series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy (3). Mainly patients ≥60 with hematologic malignancy and COVID-19 had a high risk of dying, while pediatric patients were relatively spared and It was concluded that recent cancer treatment does not appear to significantly increased the risk of death (4). Moreover, prospective registry analysis suggested that the COVID-19 mortality rate in breast cancer patients depends more on comorbidities than prior radiation therapy or current anti-cancer treatment (5). Nevertheless, de-escalation of cancer treatments, especially monotherapy administration with greater use of oral anticancer drugs was arranged and especially the elderly have been undertreated during the COVID- 19 pandemic as it is recorded in oncological real world practice (5). The nearest consequence of fading COVID19 pandemic is an new epidemic wave of advanced cancer diagnoses with no perspective of treatment with clinical benefit in elderly due to neglecting screening, as recently noted (6). The author speculates how to keep and increase elderly cancer patient’s survival in post-Covid-19 era.

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