When Less is More: Assessing Functionality in Dermatologic Surgery

Doctor Tara Jennings discusses the importance of assessing patient functionality before dermatologic surgery, especially in the geriatric population where skin cancer incidences are rising. She emphasizes that older patients, particularly those over 85, often face unique challenges in treatment decisions due to their frailty and comorbidities. Jennings highlights two essential assessment tools: the Karnofsky Performance Scale (KPS) and the Geriatric 8 (G8) scale, which help identify patients' ability to undergo surgery and predict outcomes. She emphasizes that low scores on these scales indicate higher risks for complications and mortality, suggesting a need for personalized treatment strategies. In cases where surgery is deemed inappropriate, alternatives such as active surveillance and injectable therapeutics may be more suitable, with discussions on the best management approach being critical. Examples from her practice illustrate successful applications of these palliative options, demonstrating that comprehensive assessments can lead to improved patient outcomes and quality of life.