recommendations treatment







14 April 2010

Management of prostate cancer in older men

With the rapid ageing of the population and the exponential increase of life-expectancy in developed countries, experts expect that the burden of prostate cancer to rise up dramatically in the future. The problem is, to date, no specific guidelines on the management of prostate cancer in older men have been published.

Recently, a Prostate Cancer Task Force of the International Society of Geriatric Oncology (SIOG) has issued new recommendations regarding the management of prostate cancer in "older men" (men of more than 70 years of age in SIOG meaning).

The basic consensus statement of the Task Force can be drown as follows:

Older men with prostate cancer should be not managed solely according to their chronological age, but according to their overall, individual health status. age.

Existing international recommendations should be the basic level for prostate cancer treatment - localized and advanced disease -, but should be specifically adapted to every patient health status.

Acording to their status, the patients can be classified into four different groups:
  1. Healthy patients (controlled comorbidity, fully independent in daily living activities, no malnutrition), who should receive the same treatment as younger patients
  2. Vulnerable patients (with manageable or "reversible" clinical status), who should receive standard treatment for their prostate cancer after medical intervention for their other conditions
  3. Frail patients (with "irreversible" forms of impairment), should receive modified forms of treatment for their prostate cancer
  4. Patients who are too sick because of some form of terminal illness and who should receive only symptomatic, palliative therapy.
In referring to "existing international recommendations" the task force specifically calls out guidance documents issued by the European Association of Urology, the National Comprehensive Cancer Network, and the American Urological Association.

A background document assigned to this topic was published by the task force in January this year, and the detailed recommendations appear in the March issue of BJU International. Unfortunately the full recommendations do not appear to be available on line on the SIOG web site, witch is a big pity. It seems that is not in task force intention to develop new guidelines for older patients. What they are doing in encouraging a clinical approach based on individual characteristics of specific patients - in other words, the personalization of care and the treatment of the patient as a whole person, not just his prostate cancer.



NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for information only, and are not meant to substitute for the advice of your own physician or other medical professional. Prostate-Report.org does not endorse any specific product, service or treatment.





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