Diagnosis and management of prostate cancer in the older man

Abstract

SummaryProstate cancer is the most common malignancy and the second leading cause of cancer death, in men, in western countries. Prostate cancer is diagnosed in very few people aged younger than 50 years (<0.1% of all patients). The mean age of patients with this disorder is 72–74 years. Most men aged older than 85 years have histological prostate cancer. Androgen deprivation reduces tumour activity in approximately 80% of patients with advanced disease, but most tumours relapse within 2 years to an incurable castrate-resistant state. Treatment options for patients with castrate-resistant prostate cancer are very limited and, even with toxic therapy, such as docetaxel, the life expectancy is only improved by a median of 2 months. Hence earlier diagnosis and improved treatments for prostate cancer are urgently required. Novel drugs, such as Abiratorone acetate and MDV-3100 have shown promise in pre-clinical and early clinical trials, and a number are now in phase III clinical trials, alone or in combination with docetaxel.