Ever since I started learning about prostate cancer, which was when I was diagnosed five years ago, I have believed that men over 80 shouldn’t get treated for the disease.
More accurately, I thought that surgery for prostate cancer for men that age was both worrisome and unnecessary. This was because I believed the research that suggested that men that old with most prostate cancers would not live long enough to die of prostate cancer, but would die of other things. And, equally important, that surgery for men in their eighties and nineties was dangerous, given complications that are possible at that age.
I based these opinions on discussions with doctors and research on the internet, most specifically the National Cancer Institute site, a highly reputable government resource.
And I will admit that my book, The First Year: Prostate Cancer, promulgated that idea strongly. I told friends with elderly fathers not to hasten surgery and not to worry too much about milder prostate cancer, since their parent was likely to die of something else.
Now comes some new research from the Mayo Clinic that suggests – as with everything else in this complicated field – individual differences need to be considered. If, for instance, a man of 80 is in relatively good health aside from his prostate cancer, and if that prostate cancer returned a Gleason of seven or more (on a 1-10 scale), surgery (a radical prostatectomy) can be a viable option.
Life expectancy (family history, general health, etc.) and the aggressiveness of the cancer are more important than age alone.
So, once again, individual differences, individual preferences, and a good discussion between patient and oncologist turn out to be the best determinants of what treatment to follow.
I stand corrected.
Published On: December 06, 2006