TY - CHAP M1 - Book, Section TI - A Frail Patient with Colorectal Cancer Considered for Chemotherapy Who Struggles to Complete Activities of Daily Living A1 - Ghosh, Sharmistha A1 - Hardwick, Joanna A1 - Diem, Peter A1 - Sarker, Debashis A2 - Ring, Alistair A2 - Harari, Danielle A2 - Kalsi, Tania A2 - Mansi, Janine A2 - Selby, Peter PY - 2018 T2 - Problem Solving in Older Cancer Patients AB - An 82-year-old man presented to his GP with rectal bleeding and weight loss of 2 st over 6 months. He admitted to having increased fatigue and had become housebound. He lived alone and struggled to complete activities of daily living (ADL) such as cooking and cleaning. He had a past medical history of hypertension for which he took ramipril 5 mg and bendroflumethiazide 2.5 mg daily. On examination, he appeared thin, dishevelled and had palpable hepatomegaly. From the history and examination, it was clear that his performance status (PS) had deteriorated from a baseline of 1 to 2 over a period of just 3 months.He agreed to a referral for a Comprehensive Geriatric Assessment (CGA) along with initial investigations. Flexible sigmoidoscopy and biopsy revealed a proximal rectal adenocarcinoma. A CT scan of the chest, abdomen and pelvis, and an MRI scan of the pelvis, confirmed this diagnosis and demonstrated liver metastases.His case was discussed at the colorectal cancer multidisciplinary team (MDT) meeting, and his disease was staged T3N1M1. The patient was provided with a clinical nurse specialist to act as a key worker across the whole care pathway. A clinical nurse specialist is the first point of contact for cancer patients and acts as a coordinator between the patient and different medical specialties.1 An appointment was given to see an oncologist to discuss palliative systemic treatment options and suitability for palliative radiotherapy to the rectal primary. It was felt that initial surgery and local therapy for the metastases would not be appropriate due to his PS and the distribution of the metastatic disease. In addition, a referral was made to the community palliative care team.BackgroundRole of the CGAWhat systemic treatments are available for this patient?What are the potential toxicities of treatment?Local treatment for liver metastasesWhy is it important to identify and manage functional impairment? SN - PB - Clinical Publishing CY - New York, NY Y2 - 2021/03/09 UR - hemonc.mhmedical.com/content.aspx?aid=1152358479 ER -