Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology.
Abstract
Prostate cancer is the most prevalent cancer in men and predominantly affects older
men (aged >or=70 years). The median age at diagnosis is 68 years; overall, two-thirds
of prostate cancer-related deaths occur in men aged >or=75 years. With the exponential
ageing of the population and the increasing life-expectancy in developed countries,
the burden of prostate cancer is expected to increase dramatically in the future.
To date, no specific guidelines on the management of prostate cancer in older men
have been published. The International Society of Geriatric Oncology (SIOG) conducted
a systematic bibliographic search based on screening, diagnostic procedures and treatment
options for localized and advanced prostate cancer, to develop a proposal for recommendations
that should provide the highest standard of care for older men with prostate cancer.
The consensus of the SIOG Prostate Cancer Task Force is that older men with prostate
cancer should be managed according to their individual health status, which is mainly
driven by the severity of associated comorbid conditions, and not according to chronological
age. Existing international recommendations (European Association of Urology, National
Comprehensive Cancer Network, and American Urological Association) are the backbone
for localized and advanced prostate cancer treatment, but need to be adapted to patient
health status. Based on a rapid and simple evaluation, patients can be classified
into four different groups: 1, 'Healthy' patients (controlled comorbidity, fully independent
in daily living activities, no malnutrition) should receive the same treatment as
younger patients; 2, 'Vulnerable' patients (reversible impairment) should receive
standard treatment after medical intervention; 3, 'Frail' patients (irreversible impairment)
should receive adapted treatment; 4, Patients who are 'too sick' with 'terminal illness'
should receive only symptomatic palliative treatment.
Type
Journal articleSubject
Activities of Daily LivingAge Factors
Aged
Health Services for the Aged
Health Status
Humans
Life Expectancy
Male
Nomograms
Practice Guidelines as Topic
Prostatic Neoplasms
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https://hdl.handle.net/10161/11295Published Version (Please cite this version)
10.1111/j.1464-410X.2010.09334.xPublication Info
Droz, Jean-Pierre; Balducci, Lodovico; Bolla, Michel; Emberton, Mark; Fitzpatrick,
John M; Joniau, Steven; ... Sternberg, Cora N (2010). Management of prostate cancer in older men: recommendations of a working group of
the International Society of Geriatric Oncology. BJU Int, 106(4). pp. 462-469. 10.1111/j.1464-410X.2010.09334.x. Retrieved from https://hdl.handle.net/10161/11295.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Judd Wendell Moul
James H. Semans, M.D. Distinguished Professor of Urologic Surgery, in the School of
Medicine
Dr Judd Moul joined the Duke faculty in mid 2004 after a career in the US Army Medical
Corps mainly at Walter Reed Army Medical Center. He is a retired colonel and a noted
researcher and clinician in the area of prostate cancer and is a urologic oncologist.
He served as the division chief of Duke Division of Urology from 2004 to 2011 and
was named the James H Semans MD Professor of surgery in 2009 becoming Duke's first
named endowed chair for urology. He was awarded the Gold Cystosco

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