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Prostate Cancer In Older Men

Whos At Risk For Prostate Cancer

Older Men and Prostate Cancer

All men are at risk of having prostate cancer. About one man in nine will be diagnosed with it during their lifetime, but only one in 39 will die of this disease. About 80% of men who reach age 80 have cancer cells in their prostate. Besides being male, there are other things that contribute to the risk.

What Are Male Sex Hormones

Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.

Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .

Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make semen. Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .

Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .

What Are The Symptoms Of Prostate Cancer

Early-stage prostate cancer rarely causes symptoms. These problems may occur as the disease progresses:

  • Frequent, sometimes urgent, need to urinate, especially at night.
  • Weak urine flow or flow that starts and stops.
  • Painful urination .
  • Painful ejaculation and erectile dysfunction .
  • Blood in semen or urine.
  • Lower back pain, hip pain and chest pain.
  • Leg or feet numbness.

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Are There Any Options For Older Men With Prostate Cancer

Prostate Removal May Be Option for Older Men. Radical prostatectomy is the preferred treatment for men with prostate cancer that has not spread to other organs, but many doctors do not recommend the procedure for men over age 70 due to a perceived higher potential risk for complications. Compared with more conservative treatments,

The Top 7 Signs Of Advanced Prostate Cancer

Prostate Cancer Symptoms: Fatigue in Older Men

In the early stages, you may not notice any symptoms related to prostate cancer. This is why screenings are important. Symptoms can sometimes be noticed for the first time when the cancer advances.

Advanced prostate cancer, also called metastatic cancer, means the cancer has spread to other areas of your body beyond your prostate gland. The most common areas for prostate cancer to spread are your bladder, rectum, and bones. It can also spread to your lymph nodes, liver, lungs, and other body tissues.

Whether youve just been diagnosed or youre in treatment, its also important to know the signs of advanced cancer. Cancer can behave differently depending on your genetics, so not every person will experience the same symptoms in the same way.

Read on to learn more about the seven top symptoms of advanced prostate cancer and how to spot them.

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How To Make The Right Treatment Decision

Current expert guidelines for treatment of localized prostate carcinoma recommend potentially curative therapy for patients whose life expectancy is at least 10 years., Patients with limited life expectancy are more likely to die from health conditions other than prostate cancer. Men with a life expectancy of more than 10 years are more likely to die from progressive prostate cancer. This 10-year rule enjoys broad acceptance among urologists and radiation oncologists.,

Conservative management proved to be an acceptable treatment option for men with low-grade Gleason scores, clinically localized disease, and life expectancies of less than 10 years. Increasing age was described as a risk factor for receiving inadequate treatment for prostate cancer. Thus, older men have been shown to receive potentially curative therapy less often than younger men., Radical prostatectomy is preferred treatment in men younger than 70 years, whereas radiation therapy is applied predominantly in patients older than 70 years. Conservative therapy such as watchful waiting or androgen deprivation by luteinizing hormone-releasing hormone analogs is preferentially applied in men older than 80 years. Watchful waiting or hormonal therapy is used to treat 82% of men older than 80 years.

Deaths From Prostate Cancer

Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer.

Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.

National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.

Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA . SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018.

American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.

National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.

Last Revised: January 12, 2021

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Tests Used To Check The Prostate

This first step lets your doctor hear and understand the “story” of your prostate concerns. You’ll be asked whether you have symptoms, how long you’ve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.

Treatment Of Prostate Cancer In The Older Man

Prostate Cancer and Older Adults

There is no cure for metastatic prostate cancer, which means there is a strong desire to find the cancer before it grows outside the prostate and becomes incurable. The PSA test can aid in the early detection of prostate cancer before it causes symptoms, and many men subsequently diagnosed with localized disease will be offered treatments designed to cure or control progression of their cancer. Treatment options include surgical removal of the prostate , radiation therapy, hormone therapy and expectant management . Unfortunately, in the absence of data from large randomized controlled trials, the most effective treatment option for older men remains uncertain. Indeed, a recent systematic review of the effectiveness of treatment for localized prostate cancer summarized the limitations of the literature and concluded that there is insufficient evidence to assess the benefits of various treatments . One randomized controlled trial that did show a disease-specific survival benefit of radical prostatectomy compared with watchful waiting reported that this finding was restricted to men aged less than 65 years .

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Prostate Cancer Riskt Factors

One of the risk factors of prostate cancer is age. Once a man starts to be 40, it is wise to also start being cautious of the symptoms related to prostate cancer although most cases of prostate cancer symptoms in men appears at age around 65 years and above.

A man with prostate cancer history in his family should also be more cautious of prostate cancer symptoms by stages, especially if more male family members have already been known developing prostate cancer especially since young ages.

Diets and lifestyle also have some influences in preventing prostate cancer. Reduce the consumption of red meats and fatty food and increase the intake of vegetables and fruit to have more chance in preventing prostate cancer.

Is It Linked With Prostate Cancer

The answer, according to the latest studies as of 2018, is no. In fact, finasteride reduces the risk of getting a low-grade prostate cancer. One study did show it may cause a more aggressive form of prostate cancer if you were to get it, but later studies have shown the numbers behind this are not statistically significant.

The authoritative source for this conclusion is the Prostate Cancer Prevention Trial conducted in 1993 with follow up studies in 2013 and 2018. It was a randomized clinical trial designed to see whether the drug finasteride could prevent prostate cancer in men aged 55 and older. The participants were in good health and did not show any symptoms or signs of prostate cancer. The trial was placebo controlled. Participants who didnât get finasteride got a dummy pill. None of the patients knew whether they were taking real finasteride or a dummy pill.

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Impact Of Age On Treatment

The rising number of men diagnosed with prostate cancer is a result of increasing life expectancy as well as the current practice of screening by prostate-specific antigen blood tests. Besides PSA and Gleason score, age is considered a key prognostic factor in treatment decision making. Although organ-confined disease can be cured by radical prostatectomy and full-dose local radiation therapy, treatment options for advanced- stage disease remain palliative. They include active surveillance, or watchful waiting, early versus delayed hormonal therapy to control disease progression, and continuous or intermittent androgen deprivation. Observational studies of older men with early stage disease have suggested conservative management as a viable option.,

Chodak and associates evaluated 828 men who were managed expectantly in a series of nonrandomized trials. Median follow-up was approximately 6.5 years. Patients with poorly differentiated cancers had a 10-fold increased risk of death from prostate cancer as compared with men showing highly differentiated prostate cancer. A 5-year disease-specific survival of only 34% was found in men with poorly differentiated prostate cancer. In contrast a 5-year disease-specific survival of 87% was described in men with well-or moderately differentiated cancers.

Treat Prostate Cancer In Older Men

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Study Suggests Treatment Has Survival Advantage Over ‘Watchful Waiting’

Dec. 12, 2006 — To treat or not to treat? That is the question for older men with early-stage prostate cancer.

The jury is still out, but new research suggests a survival advantage for older prostatecancer patients with localized disease who chose active treatment over close observation without treatment, known as watchful waiting.

The look-back study included data from nearly 45,000 patients between the ages of 65 and 80 with low- to intermediate-risk prostate cancer.

Over 12 years of follow-up, patients treated with either surgery or radiation were found to have a 31% lower risk of death than patients who did not opt for treatment.

The National Institutes of Health-funded trial is published in the Dec. 13 issue of The Journal of the American Medical Association.

“Our findings suggest that there may be a benefit associated with treating older patients with early-stage disease,” researcher Yu-Ning Wong, MD, of Philadelphiaâs Fox Chase Cancer Center, tells WebMD.

“While treatment is clearly not the right decision for every patient, the potential for a survival advantage should enter into the decision making.”

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Watchful Waiting And Active Surveillance

Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities., Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery. For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.

Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression., This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.

Conditions With Similar Symptoms Like Prostate Cancer

Although prostate cancer symptoms by stages may appear, it is not necessarily certain that the diagnosis will be prostate cancer. The symptoms of prostate cancer might be similar to the symptoms of other non cancerous conditions of prostate such as:

  • Prostatitis .
  • Urethritis .
  • Benign Prostatic Hypertrophy .

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What Should I Look For

Regardless of age, prostate cancer often starts without warning signs until it has advanced further. This is why it is important to engage in appropriate screenings and talk with your provider regularly about your risk. When prostate cancer manifests, early symptoms include changes in urination, such as increased urgency and frequency of urination, blood in the urine or semen, interrupted or changed flow of urine stream, painful urination, erectile dysfunction, and pain in the pelvis, hips, thighs or lower back.

Common Urinary Problems In Elderly Men

Older Men and Prostate Cancer – Gulfstream Urology

These problems are not cancer. Acute prostatitis is an infection of the prostate caused by bacteria. It usually starts all of a sudden. It can cause fever, chills, or pain in the lower back and between the legs. It can cause pain when your aging dad urinates. If your father has these symptoms, see your doctor right away. Antibiotic drugs can kill the bacteria and help him feel better.

Chronic prostatitis is an infection of the prostate that keeps coming back time after time. This problem can be hard to treat. Sometimes, taking antibiotics for a long time may work. Talk with your doctor about other things you can do to help your elderly father feel better.

Benign prostatic hyperplasia, or BPH, is very common in older men. The prostate is enlarged, but it is not cancerous. Over time, an enlarged prostate may press against the urethra, making it hard to urinate. It may cause dribbling after an elder urinates or a need to urinate often, especially at night. Your doctor will do a rectal exam to check for BPH. And your elderly father may need to have special x-rays or scans to check his urethra, prostate, and bladder.

Treatments for BPH include:

Usually, men have surgery only if medicine hasn’t worked. Surgery does not protect against prostate cancer. Regular check-ups are important after BPH surgery. Talk with your doctor about this treatment choice. There are three kinds of surgery. All are done with anesthesia:

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Risk Factors For Prostate Cancer

Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn’t mean that you will get prostate cancer. It just means that your risk of the disease is greater.

  • Age. Men who are 50 or older have a higher risk of prostate cancer.
  • Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
  • Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a man’s relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
  • Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.

What Is Prostate Cancer

    Check out this factsheet for a summary of the video.

    Prostate cancer starts in the cells of the prostate. A cancerous tumour consists of cancer cells that can grow into nearby tissue and destroy it. The tumour can also spread to other parts of the body.

    Prostate cancer is the most common cancer in Canadian men. It is most common in older men. It is more common in Black men than in white men and less common in Asian men. Trans women and non-binary people who were assigned male at birth can also get prostate cancer.

    The prostate is part of the male reproductive and urinary systems. It makes some of the fluid that is part of semen. It is located below the bladder and in front of the rectum. The urethra goes through the prostate.

    The prostate is usually about the size of a walnut in younger men but can change as you age and grow larger in older men.

    Prostate cancer usually grows slowly and can often be completely removed or successfully managed when it is diagnosed before it has spread outside of the prostate. Older men with prostate cancer often die of other causes. Adenocarcinoma of the prostate is the most common type of prostate cancer. It accounts for 95% of all prostate cancers.

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