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Geriatric assessment for colorectal cancer surgery — SCE Geriatric Medicine MCQ

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ModerateSurgical liaisonGeriatric assessment for colorectal cancer surgerySCE Geriatric Medicine

An 84-year-old man with new rectal bleeding, weight loss and iron deficiency anaemia has CT showing a sigmoid cancer without metastases. He has moderate frailty, mild cognitive impairment and lives independently with carers twice daily. The surgical team requests geriatric input. What is the most appropriate management?

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Correct answer: D — Assess frailty, cognition, nutrition, function and goals to inform shared oncological and surgical planning

Older cancer care should integrate tumour stage with frailty, cognition, nutrition, function, comorbidity and patient goals. CGA can identify reversible risk factors and support shared decisions about surgery, stoma likelihood, rehabilitation and alternatives. CT stage alone is insufficient for treatment planning in frailty. The pearl is that geriatric oncology is about matching treatment intensity to resilience and priorities, not denying treatment by age.

Reference: BGS CGA guidance; SIOG geriatric oncology guidance