IL CANCRO DELLA PROSTATA NEGLI ANZIANI
S. Bordonaro, A. Di Mari, S. G. Rametta, F. Romano, H. Lipari, P. Tralongo
Vol.1 (2017), issue 4, pag. 1-24
|Accepted for pubblication||17/01/2017|
Prostate cancer is the most common malignant tumour in men, account- ing for about 20% of all diagnosed cancers. Its estimated incidence is 36000 new cases in Italy in 2016, with an incidence rising dramatically with aging. The mean age at diagnosis is over 60 years, and death usually occurs in patients over 70 years old. Recent improvements in medical care have increased life expectancy of these patients. Elderly patients (over 80 years older) represent an expanding subgroup, and currently more than 9 million men in the United States are over eighty. The most appropriate treatment for prostate cancer in elderly patients is complex and should be based on the clear defnition of the aim, the evauation of both benefts and risks related to the therapy, and its potential effects on functional loss and quality of life. During the last decades, thanks to the effcacy of secondary prevention (PSA testing) and the use of new drugs, survival has increased from 62%, to 91% (2004-2007). Despite the potential benefts of the treatment, elderly patients are often under-treated, due to the fear about toxicity related to more aggressive drugs, such as chemotherapy. The choice of the most suitable treatment should based not only on the age, but also on a full assessment of the risks, the extent of the disease, the performance status, the expectation of life and the possible changes in the quality of life of the patient. We will review the main therapeutic strategies for the treatment of prostate cancer at different stages of its natural history and how they can be applied in clinical practice in elderly patients.