How to treat, or not treat, early prostate cancer is a question that has long bedeviled older men and their doctors.
If patients opt for surgery or radiation, they may face long years of impotence or incontinence, not to mention the risks inherent in these procedures — all to attack a slow-growing cancer that may never cause any symptoms. But if they opt for regular monitoring, a.k.a. “watchful waiting,” they face a small chance that their particular cancer is one of the more aggressive ones and could kill them.
On the blog called GeriPal, written by a group of geriatricians and palliative care specialists at the University of California, San Francisco, Dr. Ken Covinsky just posted a clear and useful summary of a prostate cancer study recently published in The New England Journal of Medicine. After following almost 700 patients for 15 years, the researchers reported that age is a crucial factor: Among men under age 65, surgery extends survival, but men over age 65 (or in worse health generally) see no survival benefit. They die at the same rate whether they’ve undergone the surgery (and suffered its aftermath) or not.
Another case, then, in which older bodies respond differently — to procedures, medications, cocktail hours, lots of things — than younger ones. That’s important to know.
Credit: NY Times
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