Table 1.

A summary of the challenges and potential solutions facing clinicians treating older adults with cancer.

Challenge	Potential Solutions
Differing evidence base for surgery in older adults compared to younger	-Better recruitment of older adults to clinical trials -Consideration of the different treatment goals in older compared to younger adults (maintenance of quality of life and functional recovery compared to curative intent) -Moderation in trial design for older adults
Difficulty in selecting the most appropriate surgical procedure	-Individual assessment of fitness and frailty -Consideration of extent of surgical procedure and objective assessment of this -Evaluation of the impact of treatment on each patient as an individual
How to optimise the individual older adult for surgery	-Evolving evidence shows that prehabilitation may be able to minimise postoperative decline -Consider use of geriatric assessment as routine in surgical practice to identify which older adults may be at risk of postoperative deterioration -Use of enhanced recovery after surgery protocols for all oncological diagnoses
Collaboration between surgical oncologist and geriatrician	-Recognise there is a problem which requires collaboration -Novel methods for introduction of geriatrics into surgical practice -Utilise resources/personnel dependent on services available