Prostate cancer in the over 70s: updated guidance
Elderly patients with prostate cancer should be managed according to their individual health status and not according to age, say updated guidelines from the International Society of Geriatric Oncology (SIOG).
Physically fit elderly men with prostate cancer should be treated the same as younger, fitter patients. However, where patients are frail and have other medical problems, treatment should be individualised and based on health status and patient preference, says the guidance on managing prostate cancer in men over 70 years, published in European Urology.
Screening for cognitive impairment is mandatory at the initial evaluation to establish patient competence in making decisions. When patients are frail or disabled or have severe comorbidities, a comprehensive geriatric assessment is needed, the authors say.
Advances in geriatric evaluation and treatments for localised and advanced disease are contributing to more appropriate management of elderly patients with prostate cancer. A better understanding of the role of active surveillance for less aggressive disease is also contributing to the individualisation of care, the guideline concludes.