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Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology.

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Date
2010-08
Authors
Droz, Jean-Pierre
Balducci, Lodovico
Bolla, Michel
Emberton, Mark
Fitzpatrick, John M
Joniau, Steven
Kattan, Michael W
Monfardini, Silvio
Moul, Judd W
Naeim, Arash
van Poppel, Hendrik
Saad, Fred
Sternberg, Cora N
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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 article
Subject
Activities of Daily Living
Age Factors
Aged
Health Services for the Aged
Health Status
Humans
Life Expectancy
Male
Nomograms
Practice Guidelines as Topic
Prostatic Neoplasms
Permalink
https://hdl.handle.net/10161/11295
Published Version (Please cite this version)
10.1111/j.1464-410X.2010.09334.x
Publication 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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Scholars@Duke

Moul

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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