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Title: | Radical treatment of localised prostate cancer in the elderly. |
Epworth Authors: | Costello, Anthony |
Other Authors: | Everaerts, Wouter van Rij, Simon Reeves, Fairleigh |
Keywords: | Prostatectomy Prostatic Neoplasms Urinary Incontinence Erectile Dysfunction Radical Prostatectomy Prostate Cancer Quality of Life QoL Chronological Age Biological Age Aggressive Cancer Curative Treatment Prostate Cancer Care Primary Androgen-Deprivation Therapy pADT Radiotherapy Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia Australian Prostate Cancer Research Centre Epworth HealthCare, Victoria, Australia |
Issue Date: | Dec-2015 |
Publisher: | Wiley |
Citation: | BJU Int. 2015 Dec;116(6):847-52 |
Abstract: | Elderly men are more likely to be diagnosed with aggressive cancer, but are often inappropriately denied curative treatment. Biological rather than chronological age should be used to decide if a patient will profit from radical treatment. Therefore, every man aged >70 years should undergo a health assessment using a validated tool before making treatment decisions. Fit elderly men with intermediate- or high-risk disease should be offered standard curative local treatment in keeping with guidelines for younger men. Vulnerable and frail elderly men warrant geriatric intervention before treatment. In the case of vulnerable patients, this intervention may render them suitable for standard care. When considering radical prostatectomy outcomes a 'bifecta' of oncological control and continence is appropriate, as erectile dysfunction (although prevalent) has a much smaller impact on quality of life than in younger patients. Radiotherapy is an alternative to radical prostatectomy in men with a life expectancy of <10 years. Primary androgen-deprivation therapy is not associated with improved survival in localised prostate cancer and should only be used for symptom palliation. Further elderly-specific research is needed to guide prostate cancer care. |
URI: | http://hdl.handle.net/11434/693 |
DOI: | 10.1111/bju.13128 |
PubMed URL: | http://www.ncbi.nlm.nih.gov/pubmed/25810141 |
ISSN: | 1464-410X |
Journal Title: | BJU International |
Type: | Journal Article |
Affiliated Organisations: | Department of Urology, Royal Melbourne Hospital, Parkville, Vic., Australia Department of Surgery, Peter MacCallum Cancer Centre, East Melbourne, Vic., Australia |
Type of Clinical Study or Trial: | Review |
Appears in Collections: | Cancer Services Epworth Prostate Centre UroRenal, Vascular |
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