Rethinking Prostate Cancer in Older Men

Research suggests aggressive treatment is viable, even for patients in their late 70s

By Karen Pallarito
HealthDay Reporter

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FRIDAY, Oct. 17 (HealthDay News) -- With increasing life expectancies, improved surgical tools, and better information on patient results, many older men diagnosed with early prostate cancer are taking a pass on the traditional advice to hold off on treatment for a period of time.

So-called "watchful waiting" -- or closely monitoring the cancer's progression -- is still a viable option. But many experts now believe that aggressive treatment -- even for older men -- may be the better way to go.

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"We're pushing the limits on the upper end," said Dr. Edouard J. Trabulsi, assistant professor in the department of urology at Jefferson Medical College and co-director of the Jefferson Prostate Diagnostic Center in Philadelphia.

A study published recently in the Journal of the American Medical Association helped shake up the conventional wisdom. The study, which involved some 44,000 men, found that the death risk for those who received prostate cancer treatment was nearly one-third lower than for men who received no treatment. And that was true across all age categories, including the oldest men in the study, aged 75 to 80.

"We often think of prostate cancer as an indolent disease, and it is for many men, which is why observation is a very reasonable treatment option for patients with low and intermediate risk disease," said the study's lead author, Dr. Yu-Ning Wong, a medical oncologist at the Fox Chase Cancer Center in Philadelphia.

"However, the life expectancy for a 70-year-old man is about 13 years, and patients who are otherwise healthy should recognize that if they live long enough, they may be at risk of developing complications from prostate cancer," she added.

Prostate cancer is the second most common type of cancer in American men, after skin cancer. In 2008, about 186,320 new cases of the disease will be diagnosed, and about 28,660 men will die from it, according to the American Cancer Society.

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