[How can the suitability of a geriatric patient for uro-oncological treatment be determined?]

backgroundGeriatric patients undergoing uro-oncological treatments are particularly susceptible to complications in many organ systems. Prior to starting treatment, a careful risk-benefit analysis must be performed, taking into consideration the patient's remaining life expectancy and existing functional deficits. These should be weighed against the side effect profile of the planned treatment.

objectiveAfter an introduction of the three-step geriatric assessment to identify geriatric patients, systematically identify functional deficits, and evaluate them in depth, the example of androgen deprivation therapy (ADT) for prostate cancer will be used to demonstrate the specific risks associated with geriatric patients and how these can be assessed to reach a well-founded decision regarding ADT. MATERIALS AND

methodsReview of the geriatric assessment, side effects of ADT, and uro-geriatric considerations.

conclusionThe classification of a patient as "geriatric" does not automatically mean treatment exclusion or the use of "best supportive care". On the other hand, treatment is often particularly risky given the limited compensatory abilities of geriatric patients and the possible loss of autonomy. The practitioner is faced with the task of estimating the risk knowing the individual functional deficits of the patient, but also knowing the special risks of the planned treatment, while being aware of the specific risks involved and modifying the treatment if necessary to ensure that the decision-making process is transparent across institutions and practitioners involved. Prophylactic treatment of treatable side effects is also advisable, such as the organization of reliable monitoring during treatment.