Skip to main content
SpringerLink
Log in

Prostate Cancer: Management in Elderly Men Population in 2017

  • Living reference work entry
  • First Online:
Geriatric Oncology

  • 97 Accesses

Abstract

Prostate cancer is the most common cancer in elderly patients. Localized disease is treated following almost the standard of younger patients. However, the treatment depends on health status evaluation. Only patients in good health status with aggressive prostate cancer will benefit of curative treatment, based on the induced comorbidities. Surgery is often not the best option, based on the increased side effects with increased age, compared to external beam radiotherapy. In nonmetastatic situations, androgen deprivation monotherapy has only a minimal place, while it is the standard of care in metastatic situations. Most patients with castration-resistant disease can receive standard treatment. Early introduction of palliative care is mandatory in order to optimize the outcome. Disease aggressiveness and health status are the two main factors to consider, on top of patient’s wishes for final decision-making.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Adejoro O, Gupta P, Ziegelmann M, Weight C, Konety B. Effect of minimally invasive radical prostatectomy in older men. Urol Oncol. 2016;34(5):234.e1–11.

    Article  Google Scholar 

  • Adolfsson J. Watchful waiting and active surveillance: the current position. BJU Int. 2008;102(1):10–4.

    Article  PubMed  Google Scholar 

  • AJCC (8th ed) [Internet]. 2017. Available from: https://cancerstaging.org/references-tools/deskreferences/Pages/default.aspx.

  • Alibhai SMH, Leach M, Tomlinson G, Krahn MD, Fleshner N, Holowaty E, et al. 30-day mortality and major complications after radical prostatectomy: influence of age and comorbidity. J Natl Cancer Inst. 2005;97(20):1525–32.

    Article  PubMed  Google Scholar 

  • Basto MY, Vidyasagar C, te Marvelde L, Freeborn H, Birch E, Landau A, et al. Early urinary continence recovery after robot-assisted radical prostatectomy in older Australian men. BJU Int. 2014;114(Suppl 1):29–33.

    Article  PubMed  Google Scholar 

  • Beer TM, Tombal B. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(18):1755–6.

    Article  PubMed  Google Scholar 

  • Bill-Axelson A, Holmberg L, Garmo H, Rider JR, Taari K, Busch C, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med. 2014;370(10):932–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Borson S, Scanlan JM, Chen P, Ganguli M. The mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003;51(10):1451–4.

    Article  PubMed  Google Scholar 

  • Catalona WJ, Richie JP, Ahmann FR, Hudson MA, Scardino PT, Flanigan RC, et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men. J Urol. 2017;197(2S):S200–7.

    Article  PubMed  Google Scholar 

  • Cochetti G, Poli G, Guelfi G, Boni A, Egidi MG, Mearini E. Different levels of serum microRNAs in prostate cancer and benign prostatic hyperplasia: evaluation of potential diagnostic and prognostic role. Oncotarget Ther. 2016;9:7545–53.

    Article  CAS  Google Scholar 

  • Cornford P, Bellmunt J, Bolla M, Briers E, De Santis M, Gross T, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate Cancer. Eur Urol. 2016;70:675–83.

    Article  Google Scholar 

  • D’Amico AV, Moul J, Carroll PR, Sun L, Lubeck D, Chen M-H. Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21(11):2163–72.

    Article  Google Scholar 

  • D’Amico AV, Moul J, Carroll PR, Sun L, Lubeck D, Chen M-H. Prostate specific antigen doubling time as a surrogate end point for prostate cancer specific mortality following radical prostatectomy or radiation therapy. J Urol. 2004;172(5 Pt 2):S42–6; discussion S46–7

    Article  PubMed  Google Scholar 

  • D’Amico AV, Chen M-H, Renshaw AA, Loffredo M, Kantoff PW. Androgen suppression and radiation vs radiation alone for prostate cancer: a randomized trial. JAMA. 2008;299(3):289–95.

    Article  PubMed  Google Scholar 

  • Decoster L, Van Puyvelde K, Mohile S, Wedding U, Basso U, Colloca G, et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations. Ann Oncol. 2015;26(2): 288–300.

    Article  CAS  PubMed  Google Scholar 

  • Droz J-P, Efstathiou E, Yildirim A, Cabrera P, Soo Kim C, Horchani A, et al. First-line treatment in senior adults with metastatic castration-resistant prostate cancer: a prospective international registry. Urol Oncol. 2016;34(5):234.e21–9.

    Article  Google Scholar 

  • Droz J-P, Albrand G, Gillessen S, Hughes S, Mottet N, Oudard S, et al. Management of prostate cancer in elderly patients: recommendations of a Task Force of the International Society of Geriatric Oncology. Eur Urol. 2017;72:521–31. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0302283817300015

    Article  PubMed  Google Scholar 

  • Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA, et al. The 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol. 2016;40(2):244–52.

    PubMed  Google Scholar 

  • Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz J-P, Lichtman S, et al. Use of comprehensive geriatric assessment in older cancer patients. Crit Rev Oncol Hematol. 2005;55(3):241–52.

    Article  PubMed  Google Scholar 

  • Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):405–17.

    Article  PubMed  Google Scholar 

  • Fizazi K, Faivre L, Lesaunier F, Delva R, Gravis G, Rolland F, et al. Androgen deprivation therapy plus docetaxel and estramustine versus androgen deprivation therapy alone for high-risk localised prostate cancer (GETUG 12): a phase 3 randomised controlled trial. Lancet Oncol. 2015;16(7):787–94.

    Article  CAS  PubMed  Google Scholar 

  • Griebling TL. Re: management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology. J Urol. 2015;193(5):1543–4.

    Article  PubMed  Google Scholar 

  • Groome PA, Rohland SL, Siemens DR, Brundage MD, Heaton J, Mackillop WJ. Assessing the impact of comorbid illnesses on death within 10 years in prostate cancer treatment candidates. Cancer. 2011;117(17): 3943–52.

    Article  PubMed  Google Scholar 

  • Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, et al. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med. 2016;375(15):1415–24.

    Article  PubMed  Google Scholar 

  • Hayes JH, Barry MJ. Screening for prostate cancer with the prostate-specific antigen test: a review of current evidence. JAMA. 2014;311(11):1143–9.

    Article  CAS  PubMed  Google Scholar 

  • Heidenreich A, Pfister D. Prostate cancer: estimated life expectancy: integration of age and comorbidities. Nat Rev Urol. 2016;13(11):634–5.

    Article  PubMed  Google Scholar 

  • Hussain M, Tangen CM, Higano C, Schelhammer PF, Faulkner J, Crawford ED, et al. Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest Oncology Group Trial 9346 (INT-0162). J Clin Oncol Off J Am Soc Clin Oncol. 2006;24(24):3984–90.

    Article  Google Scholar 

  • Isenberg-Grzeda E, Huband H, Lam H. A review of cognitive screening tools in cancer. Curr Opin Support Palliat Care. 2016;11:24–31.

    Google Scholar 

  • James ND, Spears MR, Clarke NW, Dearnaley DP, De Bono JS, Gale J, et al. Survival with newly diagnosed metastatic prostate cancer in the “docetaxel era”: data from 917 patients in the control arm of the STAMPEDE trial (MRC PR08, CRUK/06/019). Eur Urol. 2015;67(6):1028–38.

    Article  PubMed  Google Scholar 

  • Joniau S, Briganti A, Gontero P, Gandaglia G, Tosco L, Fieuws S, et al. Stratification of high-risk prostate cancer into prognostic categories: a European multi-institutional study. Eur Urol. 2015;67(1):157–64.

    Article  PubMed  Google Scholar 

  • Kellokumpu-Lehtinen P-L, Harmenberg U, Joensuu T, McDermott R, Hervonen P, Ginman C, et al. 2-weekly versus 3-weekly docetaxel to treat castration-resistant advanced prostate cancer: a randomised, phase 3 trial. Lancet Oncol. 2013;14(2): 117–24.

    Article  CAS  PubMed  Google Scholar 

  • Kenis C, Decoster L, Van Puyvelde K, De Grève J, Conings G, Milisen K, et al. Performance of two geriatric screening tools in older patients with cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(1):19–26.

    Article  Google Scholar 

  • Lavallée LT, Breau RH, Fergusson D, van Walraven C. Trends in prostate biopsy in Ontario, 1992–2014: a cohort study. CMAJ Open. 2016;4(4):E698–705.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist. 1969;9(3):179–86.

    Article  CAS  PubMed  Google Scholar 

  • Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2016;196:1613–8.

    Google Scholar 

  • Motwani SB, Tendulkar RD. Hypofractionated radiotherapy for prostate cancer. Lancet Oncol. 2016;17(12):e517.

    Article  PubMed  Google Scholar 

  • NCCN guidelines on prostate cancer [Internet]. 2016. Available from: https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf

  • Noone A-M, Cronin KA, Altekruse SF, Howlader N, Lewis DR, Petkov VI, et al. Cancer incidence and survival trends by subtype using data from the surveillance epidemiology and end results program, 1992–2013. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2017;26(4):632–41.

    Article  Google Scholar 

  • Parmelee PA, Thuras PD, Katz IR, Lawton MP. Validation of the cumulative illness rating scale in a geriatric residential population. J Am Geriatr Soc. 1995;43(2): 130–7.

    Article  CAS  PubMed  Google Scholar 

  • Pashtan I, Chen M-H, D’Amico AV. The impact of PSA and digital rectal examination on the risk of prostate cancer specific mortality in men with a PSA level <2.5 ng/ml. Cancer Epidemiol. 2014;38(5):613–8.

    Article  PubMed  Google Scholar 

  • Ries LAG, Krapcho M. SEER cancer statistics review, 1975–2011 [Internet]. 2014. Available from: http://seer.cancer.gov/csr/1975_2011/

  • Ryan CJ, Smith MR, Fizazi K, Saad F, Mulders PFA, Sternberg CN, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol. 2015;16(2):152–60.

    Article  CAS  PubMed  Google Scholar 

  • Scher HI, Fizazi K, Saad F, Taplin M-E, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(13):1187–97.

    Article  CAS  PubMed  Google Scholar 

  • Scotté F. The importance of supportive care in optimizing treatment outcomes of patients with advanced prostate cancer. Oncologist. 2012;17(Suppl 1):23–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sweeney CJ, Chen Y-H, Carducci M, Liu G, Jarrard DF, Eisenberger M, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med. 2015;373(8):737–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tewari A, Johnson CC, Divine G, Crawford ED, Gamito EJ, Demers R, et al. Long-term survival probability in men with clinically localized prostate cancer: a case-control, propensity modeling study stratified by race, age, treatment and comorbidities. J Urol. 2004;171(4):1513–9.

    Article  PubMed  Google Scholar 

  • University California San Francisco. Eprognosis: electronic tools. 2016. http://eprognosis.ucsf.edu/index.php. Ref Type: online Source.

  • US Census Bureau DIS. International Programs, International Data Base [Internet]. [cited 2017 Jan 14]. Available from: https://www.census.gov/population/international/data/idb/worldpopgraph.php

  • Vale CL, Burdett S, Rydzewska LHM, Albiges L, Clarke NW, Fisher D, et al. Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data. Lancet Oncol. 2016;17(2):243–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Valerio M, Cerantola Y, Eggener SE, Lepor H, Polascik TJ, Villers A, et al. New and established technology in focal ablation of the prostate: a systematic review. Eur Urol. 2017;71(1):17–34.

    Article  PubMed  Google Scholar 

  • Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–6.

    Article  CAS  PubMed  Google Scholar 

  • Yaxley JW, Coughlin GD, Chambers SK, Occhipinti S, Samaratunga H, Zajdlewicz L, et al. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet Lond Engl. 2016;388(10049):1057–66.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Hospital University of Saint Etienne, Saint Etienne, France

    Victor Soulier, Sodara Thach & Nicolas Mottet

  2. Université Jean Monnet, St Etienne, France

    Nicolas Mottet

Authors
  1. Victor Soulier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sodara Thach
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicolas Mottet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicolas Mottet .

Editor information

Editors and Affiliations

  1. Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, Florida, USA

    Martine Extermann

Section Editor information

  1. Department of Medical Oncology, Institute Curie, Hôpital René Huguenin, Saint-Cloud, France

    Etienne Brain

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Soulier, V., Thach, S., Mottet, N. (2018). Prostate Cancer: Management in Elderly Men Population in 2017. In: Extermann, M. (eds) Geriatric Oncology . Springer, Cham. https://doi.org/10.1007/978-3-319-44870-1_34-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-44870-1_34-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44870-1

  • Online ISBN: 978-3-319-44870-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation