Prostate Cancer in Older Men and Its Unique Considerations

 

By Dr. Sandeep Kumar, Consultant – Surgical Oncology, HCG Cancer Centre, Ranchi

Prostate cancer is a major health concern that affects men around the world and one of the key factors contributing to its development is age. As men get older, their chance of developing prostate cancer increases. In this article, we will delve into different aspects of prostate cancer in men emphasizing the significance of tailored approaches when it comes to diagnosis, treatment, and post-treatment care for survivors.

The aging prostate

The prostate gland is about the size of a walnut that plays a crucial role in male reproductive health. As men age, the prostate undergoes natural transformations, such as enlargement and changes in the cell structure. These age-related changes may sometimes result in hyperplasia (BPH) which exhibits similar symptoms to prostate cancer but is not cancerous. It is essential to differentiate between the two for accurate diagnosis.

Symptoms of prostate cancer in older men

Some common symptoms of prostate cancer in older men include Urinary abnormalities such as frequent urination, particularly at night, weak urine flow, difficulty starting or stopping urination, and a feeling that the bladder is not completely emptying. In addition, some men may feel discomfort in their pelvis, hips, or lower back. Older men must be on the lookout for these symptoms and should consult a doctor immediately for an accurate evaluation and early diagnosis.

Challenges in diagnosis

Diagnosis of prostate cancer can be complicating in older men. Many times, the symptoms of prostate cancer often overlap with those of BPH, making it difficult to distinguish between the two conditions. Additionally, older men may have other underlying health conditions that complicate the diagnosis process.

The prostate-specific antigen (PSA) test is a significant tool used in the detection of prostate cancer. However, PSA levels can be affected by many different factors, such as age and prostate size. Older men tend to have higher baseline PSA levels, leading to a higher chance of false positives. Therefore, healthcare providers should consider age-specific PSA thresholds when analysing the test results in older patients.

Treatment Considerations

When it comes to treating prostate cancer in older men, a tailored approach is essential. Doctors would suggest treatment options based on individual’s general health status, life expectancy, and their preferences of the treatment combination. Here are some key considerations:

Active monitoring: For some older men with low risk of developing prostate cancer, active monitoring might be an appropriate option. This approach involves close monitoring the progression of the cancer rather than immediately actioning aggressive treatments. This may be especially relevant for people whose life expectancy is limited due to age or other health conditions.

Surgery: This type of treatment is usually recommended for certain older men with localized, aggressive prostate cancer. However, this option is usually reserved for people with good health and a longer life expectancy.

Radiotherapy: External beam or brachytherapy is used under radiation therapy, and it can be a successful prostate cancer treatment. Older patients might choose this treatment option, particularly when age-related health issues make surgery riskier.

Hormone therapy: Hormone therapy can aid in the management of prostate cancer when it has spread past the prostate gland. For older men who cannot have radiation or surgery, this may be the better option.

 

Preventive measures

Although taking precautions can significantly lower the prevalence and help in early detection, prostate cancer is still a serious health concern for older men. Hence, taking precautionary measures will be essential. Firstly, an individual has to maintain a healthy weight can lower the chance of developing prostate cancer and this can be achieved by engaging in regular exercise and following a balanced diet. If there is a family history of this cancer in the individual family, older men should undergo routine screenings and visit the doctor if any symptoms are experienced. Limiting the consumption of processed foods and red meat can also help in reducing the risk of this cancer. Alongside, smoking and alcohol should be completely avoided. Lastly, individuals should be aware of the most recent developments in prostate cancer prevention and treatment options which will help in making informed decisions.

 

Due to age-related changes and health issues, older men are more affected by this type of cancer. It is crucial to customise the diagnostic procedure, treatment options, and survival care to the requirements of affected individuals. Further, they should make decisions that can balance the potential advantages and disadvantages of prostate cancer management with the proper strategy, thereby improving their quality of life and general wellbeing.