Age, Health, and Prostate Cancer Treatment

Prostate cancer is a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.5 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

Whether to aggressively treat prostate cancer, or monitor it carefully through active surveillance (watchful waiting), is a complicated decision. One thing that needs to be considered is life expectancy. Studies have shown that in many cases, when men live for less than 10 years after their prostate cancer diagnosis, it's because they have died of something else. That means they would have been unlikely to benefit from prostate cancer treatment. And they would have suffered needlessly from any unpleasant side effects of treatment.

Of course, people don't know in advance how long they're going to live. So researchers conducted a study, published in the Journal of Clinical Oncology, to help doctors and patients figure out when it makes sense to aggressively treat prostate cancer. They studied almost 20,000 men 66 years of age and older who had prostate cancer that had not spread. These men received no surgery or radiation for at least 6 months after diagnosis. The researchers concluded that few men with cancer that is found only in the prostate when they are more than 65 years old will actually die of prostate cancer within 10 years.

Men who also had other health problems, such as heart disease, diabetes, or other cancers, were more likely to die of something other than prostate cancer. This study and others like it suggest that older men may reasonably decide to hold off on active treatment and instead to monitor their prostate cancer with active surveillance. This usually means getting regular PSA tests, rectal exams, ultrasounds, and sometimes repeat biopsies to see if the cancer is growing. If it does grow, more aggressive treatment can be used.

When making decisions about treatment, it's very important to have an honest discussion with your cancer care team. When you visit, bring a list of questions about prostate cancer to ask your doctor. Also check out our Expert Voices blog Choosing the best prostate cancer treatment for you for more insight into making decisions about treatment.

The American Cancer Society Healthy Living Newsletter, September 2013

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