Prostate Cancer in Older Men

Dorothy A. Calabrese, MSN, RN, CURN, CNP

Disclosures

Urol Nurs. 2004;24(4) 

In This Article

Abstract, Introduction, and Overview

Prostate cancer (Ca P), the most commonly diagnosed male cancer, will be a health care issue that will have a significant impact on the American health care system as the population of the United States continues to age. It is anticipated that the number of men diagnosed with Ca P will continue to increase each year. Screening, diagnosis, and treatment modalities for Ca P in men over 65 years of age are discussed.

Cancer is a disease process that affects the older person at a higher rate than other age groups (Ershler, 2003). Prostate cancer (Ca P) is the most common male cancer excluding skin cancer, and it is the second leading cause of cancer deaths in men (following lung cancer) (Jemal et al., 2004). While most other cancers "peak," Ca P cancer incidence continues to increase as men age (Presti, 2004).

To discuss Ca P and the aging man, a definition of the "elderly" or "older" population is required. Literature often uses data from Medicare to define the "elderly" as anyone above age 65. While there is difficulty in using age (or numbers) to define the older patient, it may be the easiest way. There are people younger than 65 who seem older due to a variety of health problems, but there are also people older than age 65 years who seem "young" due to genetics, a healthy lifestyle, and a positive attitude. In this article, older patients will be divided into two categories: those 65 to 74 years of age and those above 75 years of age. For each of these age groups, the treatment options and outcomes for Ca P can be very different. An overview of prostate cancer, treatment options, and side effects will provide a background for the discussion regarding Ca P and older men.

Ca P is the most commonly diagnosed male cancer. The American Cancer Society estimates that in the year 2004, there will be 230,110 new cases of prostate cancer diagnosed (33% of male cancers diagnosed), and 29,900 deaths (or 10% of all male cancer deaths) (Jemal et al., 2004). How many older patients will be diagnosed or die of prostate cancer is unknown. Since the prevalence of Ca P increases with age and the population of the United States continues to age, it is expected that a significant number of older men will face this diagnosis. The dilemma becomes how to best treat and care for the growing number of men who will seek treatment for prostate cancer.

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