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Title: Radical treatment of localised prostate cancer in the elderly.
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
Chronological Age
Biological Age
Aggressive Cancer
Curative Treatment
Prostate Cancer Care
Primary Androgen-Deprivation Therapy
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.
DOI: 10.1111/bju.13128
PubMed URL:
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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