To the Editor The research letter by Chauhan et al1 highlights an important dilemma in managing nonmelanoma skin cancer (NMSC) in the elderly population. This study looked at the Veterans Affairs population presenting with a facial NMSC treated with excision and the effect of age.
Determining an age at which treatment may not be warranted is challenging. In the very elderly population, we have shown that age alone is inadequate for making NMSC treatment decisions, and consideration of comorbidities, functional status, and anticipated life expectancy is warranted.2 Furthermore, a shared decision-making approach that informs the patient of the tumor biology (eg, histology) and treatment options while establishing the goals of care and addressing patient expectations is vital.3
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Lee EH, Rossi AM, Nehal KS. Age and Treatment of Nonmelanoma Skin Cancer. JAMA Surg. 2018;153(9):865–866. doi:10.1001/jamasurg.2018.1675
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