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Optimal Management of Recurrent Prostate Cancer in Older Patients

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Abstract

With a large, aging population in the USA and continued prolongation of life expectancy, treatment of cancer in the elderly will continue to be of importance. The most common cancer in men is prostate cancer, which is most often diagnosed in those over the age of 65 years. Initial therapies for prostate cancer are local treatments in those with localized disease and for whom definitive therapy is appropriate. Optimal treatment of an older patient with recurrent prostate cancer now involves more of a decision process than treatment has in the past, with the recent approval of several new medical agents for advanced prostate cancer. Through this article we will focus on treatment options for recurrent prostate cancer, keeping in mind the unique characteristics of the elderly population. A majority of the discussion will focus on many of the newly approved agents used to treat castration-resistant prostate cancer, and exciting agents currently under investigation. Improved androgen blockade has improved overall survival in patients with metastatic disease but carries many of the same adverse effects as previous agents. Newer approaches with immunotherapy, radiopharmaceuticals, or second-generation androgen receptor blockers introduce a different adverse-effect profile for older patients. As data matures, these too may improve survival for patients with metastatic disease. Throughout all stages of disease, one must keep in mind the unique needs of an older patient population.

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Acknowledgments

This work was supported in part by the Herbert Crane Endowment and the William Meyn Foundation. T.W. Flaig has consulted for Sanofi Aventis and has received honorarium from Amgen. E.R Kessler has no conflicts of interest to declare that are directly relevant to the content of this article.

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  1. Division of Medical Oncology, Department of Medicine, University of Colorado Denver School of Medicine, Mail Stop 8117, 12801 E. 17th Avenue, Room L18-8117, Aurora, CO, 80045-0511, USA

    Elizabeth R. Kessler & Thomas W. Flaig

  2. University of Colorado Cancer Center, Aurora, CO, USA

    Thomas W. Flaig

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Correspondence to Thomas W. Flaig.

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Kessler, E.R., Flaig, T.W. Optimal Management of Recurrent Prostate Cancer in Older Patients. Drugs Aging 29, 871–883 (2012). https://doi.org/10.1007/s40266-012-0021-4

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