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Prostate cancer in elderly patients

Jonathan L Wright, MD, MS
Paul H Lange, MD, FACS
Section Editors
Jerome P Richie, MD, FACS
Nicholas Vogelzang, MD
W Robert Lee, MD, MS, MEd
Deputy Editor
Michael E Ross, MD


Prostate cancer in elderly men is particularly important because of the high incidence and prevalence of disease and mortality in this group of patients:

The incidence of prostate cancer is strongly correlated with age and disproportionately affects the elderly. In the United States, 35 percent of cases from 2003 to 2007 were in men aged 65 to 74, and another 25 percent were in men 75 years or older [1]. Prostate cancer incidence rates rapidly rise with increasing age starting around age 50 years, with the highest rates seen in those aged 70 to 80 years (figure 1). Thus, the estimated prevalence for men aged 75 years or greater is over one million men [1].

Prostate cancer is the third most common cause of cancer death among men aged 80 years and older [2]. Although the case-fatality rate of prostate cancer is quite low, deaths occur disproportionately in the elderly, owing to the long natural history of the disease. Thus, 41 percent of men who die of prostate cancer are between age 75 and 84 years and 30 percent are 85 years or older.

Recommendations for the management of prostate cancer in the elderly are particularly difficult because of issues specific to this group and because clinical trials in prostate cancer often excluded elderly patients.

The initial treatment for elderly men with prostate cancer and the management of advanced disease will be reviewed here. The approach to these issues in younger patients is reviewed separately. (See "Initial approach to low- and very low-risk clinically localized prostate cancer" and "Initial management of regionally localized intermediate, high, and very high-risk prostate cancer" and "Overview of the treatment of disseminated prostate cancer".)


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Literature review current through: Sep 2016. | This topic last updated: Sep 12, 2016.
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