Prostate news article, March 2005
| THE IMPACT OF
AGE AND CO-MORBIDITY ON SURVIVAL OUTCOMES AND TREATMENT PATTERNS
IN MEN WITH PROSTATE CANCER.
WH Hall et al (California, USA) Article in Prostate cancer and prostatic diseases. 2005; 8: 22-30 Reviewed by: Mr. J Bhardwa MBChB MRCS |
In this interesting article the authors consider the relevance of age in influencing the treatment options offered to men with early prostate cancer.
There are two main changes that have occurred to the management of prostate cancer over the last decade. Firstly the widespread availability and use of PSA and prostate biopsies has led to prostate cancer being diagnosed much earlier on when it is potentially curable and secondly men are living longer. Thirteen percent of the population was over the age of 65 in 1990, this expected to rise to 20% by 2030. Current life expectancy for a man reaching 70 years is 12.4 years in USA. Traditionally, potentially curative options for prostate cancer have not been considered for older men. The reasoning behind this was that by the time that the prostate cancer had advanced to a stage where it would cause them harm that these men would be unlikely to survive other medical conditions. In the light of increasing longevity the cut off age for curable options for prostate cancer needs to be reviewed. Currently this is done by each clinician using mainly his/her judgement and clinical acumen and personal preferences. A set protocol does not exist for doing this.
The authors of this paper advocate that a standardised co morbidity scale which awards points for other medical conditions and advancing age should be researched with a view to using it routinely when advising men on their treatment options. This would also allow treatment options to be standardised and allow better comparison between treatments and between different centres.