Deciding treatment for ‘older’ prostate cancer patients should have little to do with age

URO TODAY: Older prostate cancer patients should be treated according to their health, not age, says an international panel of geriatric oncology specialists. READ MORE>

The panel calls for a revamp of international guidelines and says for this purpose older men – the average age of prostate cancer patients is 68 – can be divided into four groups:

• “Healthy” patients (controlled co-morbidity, fully independent in daily living activities, no malnutrition) should get the same treatment as younger patients.
• “Vulnerable” patients (reversible impairment) should get standard treatment after medical intervention.
• “Frail” patients (irreversible impairment) should have adapted treatment.
• “Terminal” patients should have symptomatic palliative treatment.

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PSA alone is not reliable for diagnosing prostate cancer in under-40s

URO TODAY: New research findings suggest that PSA alone, in the under 40 age group, is not effective for detecting prostate cancer. READ MORE>

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Better prostate prospects as we get older

URO TODAY: As overall life expectancy grows, clinicians will be confronted more often with diseases that will not affect survival and possibly even quality of life for older people. Prostate cancer is an example of this. READ MORE>

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Active surveillance for prostate cancer risky for older, fatter men or those exposed to Agent Orange

URO TODAY: Men with low-risk prostate cancer undergoing active surveillance have a bigger risk for cancer recurrence if they are older, obese or had exposure to Agent Orange. READ MORE>

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DNA damage can trigger the development of (prostate) cancer, accelerate aging, or both

NEW ENGLAND JOURNAL OF MEDICINE: DNA damage can trigger the development of cancer, accelerate aging, or both, writes Dr Jan H.J. Hoeijmakers, Erasmus University Medical Center, Rotterdam.

When the damage is not repaired, the outcome may be cancer – or, if cell death or senescence (aging) occurs, protection from cancer – but the trade-off is acceleration of the aging process.

The development of cancer and the process of aging can be delayed by reducing the load of DNA damage — by avoiding or limiting exposure to exogenous genotoxins and by suppressing metabolism — thereby producing fewer reactive species.

However, DNA damage, like caloric (calories) restriction, can also elicit a protective survival response that promotes longevity and healthy aging.

Recently, the use of (immuno-suppressant drug) sirolimus in mice was found to extend their life span and delay the development of conditions associated with aging, including cancer. Sirolimus is one of presumably many compounds that may elicit the survival response.

The frequent derailment of DNA damage-response systems in tumours presents another possible route by which new treatments can act selectively on the tumor.

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Younger men are being diagnosed with prostate cancer, according to latest US statistics.

URO TODAY: More US men were diagnosed with prostate cancer at a younger age and earlier stage in 2004-2005 than in earlier years and the racial disparity in cancer stage at diagnosis has decreased statistically significantly over time. READ MORE>

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The older you are with high-risk prostate cancer, the better the outlook

URO TODAY: Younger men with high-risk prostate cancer appear to have worse prognosis than older men with similar disease, according to a study of 4000 men receiving hormone treatment. READ MORE>

This, along with the other prognostic variables established in the current study, may help identify candidates for clinical trials evaluating secondary treatments for patients with castrate-resistant disease.

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