Fighting diagnostic and therapeutic nihilism in the elderly with cancer

Palliative care in geriatric cancer patient is a severely under investigated and stigmatized topic. Presumptions and lack of clinical, validated data, lead to a poor or at least not optimal care for this specific and vulnerable population. The nihilism in the field of palliative geronto-oncology is a major contributor to a reduced quality of life among elderly with cancer and their families. Assumptions towards their compliance, accessibility to the treatment and their outcomes often lead to an undertreatment in terms of palliation, which is mostly falsely equalized with end-of-life and hospice care. However, an early palliative management of geriatric patients should always be aimed first-for symptomatic treatment, but also potentially including interventions and active anti-tumor therapies. Nevertheless, gerontopalliation should also assure comfort, closeness, hope and security for relatives. This review illustrates the stand of the knowledge, relevant problems, chances, necessary developments, perspectives and research directions on the area of geriatric palliative care, especially in terms of the outcomes and improved quality of life for this specific population, with applicability for not only oncologists, but any involved physicians, such as internists, palliative and geriatric care specialists. With the rapid progress in precision and personalized medicine, there are new perspectives opening for geriatric cancer patients.