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Prostate Cancer: Management in Elderly Men Population in 2017

  • Victor Soulier
  • Sodara Thach
  • Nicolas Mottet
Living reference work entry

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.

Keywords

Prostate cancer Elderly Urologic oncology 

References

  1. 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.CrossRefGoogle Scholar
  2. Adolfsson J. Watchful waiting and active surveillance: the current position. BJU Int. 2008;102(1):10–4.CrossRefPubMedGoogle Scholar
  3. 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.CrossRefPubMedGoogle Scholar
  4. 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.CrossRefPubMedGoogle Scholar
  5. Beer TM, Tombal B. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(18):1755–6.CrossRefPubMedGoogle Scholar
  6. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 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.CrossRefPubMedGoogle Scholar
  8. 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.CrossRefPubMedGoogle Scholar
  9. 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.CrossRefGoogle Scholar
  10. 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.CrossRefGoogle Scholar
  11. 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.CrossRefGoogle Scholar
  12. 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 S46–7CrossRefPubMedGoogle Scholar
  13. 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.CrossRefPubMedGoogle Scholar
  14. 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.CrossRefPubMedGoogle Scholar
  15. 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.CrossRefGoogle Scholar
  16. 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/S0302283817300015CrossRefPubMedGoogle Scholar
  17. 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.PubMedGoogle Scholar
  18. 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.CrossRefPubMedGoogle Scholar
  19. 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.CrossRefPubMedGoogle Scholar
  20. 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.CrossRefPubMedGoogle Scholar
  21. 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.CrossRefPubMedGoogle Scholar
  22. 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.CrossRefPubMedGoogle Scholar
  23. 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.CrossRefPubMedGoogle Scholar
  24. 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.CrossRefPubMedGoogle Scholar
  25. Heidenreich A, Pfister D. Prostate cancer: estimated life expectancy: integration of age and comorbidities. Nat Rev Urol. 2016;13(11):634–5.CrossRefPubMedGoogle Scholar
  26. 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.CrossRefGoogle Scholar
  27. 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
  28. 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.CrossRefPubMedGoogle Scholar
  29. 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.CrossRefPubMedGoogle Scholar
  30. 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.CrossRefPubMedGoogle Scholar
  31. 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.CrossRefGoogle Scholar
  32. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist. 1969;9(3):179–86.CrossRefPubMedGoogle Scholar
  34. 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
  35. Motwani SB, Tendulkar RD. Hypofractionated radiotherapy for prostate cancer. Lancet Oncol. 2016;17(12):e517.CrossRefPubMedGoogle Scholar
  36. 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.CrossRefGoogle Scholar
  37. 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.CrossRefPubMedGoogle Scholar
  38. 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.CrossRefPubMedGoogle Scholar
  39. Ries LAG, Krapcho M. SEER cancer statistics review, 1975–2011 [Internet]. 2014. Available from: http://seer.cancer.gov/csr/1975_2011/
  40. 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.CrossRefPubMedGoogle Scholar
  41. 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.CrossRefPubMedGoogle Scholar
  42. Scotté F. The importance of supportive care in optimizing treatment outcomes of patients with advanced prostate cancer. Oncologist. 2012;17(Suppl 1):23–30.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 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.CrossRefPubMedGoogle Scholar
  45. University California San Francisco. Eprognosis: electronic tools. 2016. http://eprognosis.ucsf.edu/index.php. Ref Type: online Source.
  46. 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
  47. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 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.CrossRefPubMedGoogle Scholar
  49. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–6.CrossRefPubMedGoogle Scholar
  50. 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.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyHospital University of Saint EtienneSaint EtienneFrance
  2. 2.Université Jean MonnetSt EtienneFrance

Section editors and affiliations

  • Etienne Brain
    • 1
  1. 1.Department of Medical Oncology, Institute CurieHôpital René HugueninSaint-CloudFrance

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