Is Ageism Affecting Prostate Cancer Treatment?

Prostate cancer treatment in older men should consider comorbid conditions

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) There's been a great deal of debate about if and/or how to treat men in their mid-70s who have prostate cancer. A new study shows that doctors are either under- or over-treating the disease in this age group.

A recent study finds that men over the age of 75 are often undertreated for prostate cancer. Conversely, older men who have one or more comorbid (accompanying) conditions are often treated more aggressively for the cancer and not faring well in the process.

"Your overall health - not just your age - should be considered in making prostate cancer treatment decisions."

Researchers at the University of California - Los Angeles (UCLA) Jonsson Comprehensive Cancer Center analyzed the records of 1,031 men diagnosed with localized (hasn't spread) prostate cancer treated at Veteran's Affairs (VA) centers between 1997 and 2004.

The study found men with certain medical conditions had extensive prostate cancer treatment, even though they were at greater risk of dying from causes other than cancer.

Along with prostate cancer, these men had such comorbid conditions as diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD) and peripheral artery disease, among others.

Because VA care is subsidized by the federal government, there was no financial incentive to offer or withhold treatment.

The study found that only about 25 percent of men over the age of 75 were being treated for prostate cancer. This was the case even though the likelihood of their living another 10 years was 58 percent.

Meanwhile, men with comorbid conditions were being treated aggressively for their cancer while the other health concerns were more likely to kill them.

Dr. Karim Chamie, a postdoctoral fellow in urologic oncology and health services, thinks many doctors believe that men with only one comorbid condition are healthier than they actually are.

Dr. Mark S. Litwin, professor and chairman of the urology department and a researcher at UCLA's Jonsson Comprehensive Cancer Center, says this study illustrates the other, potentially more lethal health conditions need to be considered when making decisions about prostate cancer treatment.

This study was published in the September 26, 2011 online ediiton of the Journal of General Internal Medicine.

Reviewed by: 
Review Date: 
September 29, 2011
Last Updated:
September 30, 2011