Getting Aggressive with Prostate Cancer

After being diagnosed with prostate cancer, the wide variety of treatment options can be confusing for even the most educated of patients. Advice comes from all angles: your doctor, friends and family, reports in the news, and even doctors’ advertisements, making it difficult to know which the best treatment for you is.  

Young Men with Prostate Cancer

For younger patients, the general consensus is to treat aggressively. This means definitive treatment, namely surgery and radiation, aimed at curing prostate cancer, rather than just managing it. 

This aggressiveness is great for younger men who are diagnosed with prostate cancer, but according to the Prostate Cancer Foundation 65% of all prostate cancers are diagnosed in men over the age of 65.  In fact, the average age of diagnosis in our country is 69 years old.  

How Prostate Cancer is Treatment

According to a new study from the University of Pennsylvania, School of Medicine, the standard treatment for aggressive prostate cancer in men over the age of 65 isn't surgery or radiation, but hormone therapy alone. There is a clear gap in prostate cancer care based on age.  With more American men living well into their 70s and 80s, treating aggressively rather than with hormones alone could be a great benefit to this age group.  This is among the first radiation and hormone therapy treatment research targeting elderly men.

Aggressive Prostate Cancer Treatments

The study sought to fight prostate cancer aggressively in elderly patients by adding radiation therapy to hormone treatment in older patients.  What researchers estimate is that by adding radiation to the treatment plan of older men they could potentially cut cancer deaths in older patients by a third.  

Among the study participants, those receiving radiation plus hormone therapy had about 50% better chance of survival than those on hormones alone.  

Fifty percent!  Of course, the chance of cure needs to be weighed against the long term side effects of radiation therapy like erectile dysfunction, bowel and bladder complications.  This will need to be a personal choice among patients and their physicians.

Deciding Between Treatments for Prostate Cancer

Life expectancy and health status, rather than patient age, should be the major factor to consider in treatment selection. For a good amount of patients over the age of 65, surgery still may be an option depending on some key factors of the state of the disease, the present state of health of the patient and whether a surgery can be safely performed, and the skill of the surgeon performing the surgery.  At no point should the patient’s safety be compromised, but as the team at UPenn illustrated in there study – there are better options out there for elderly men with prostate cancer.  Treating aggressively when possible should always be the first line of defense.