When it comes to prostate cancer, age really is just a number.
New prostate cancer treatment guidelines issued by the International Society of Geriatric Oncology encourage doctors to make treatment decisions based on a patient’s individual health status, not on their age. The new prostate cancer treatment guidelines represent the consensus opinion of a special taskforce that reviewed published studies from 2013–2016.
“Treatment in the individual patient should be based on health status and patient preference,” the Task Force of the International Society of Geriatric Oncology concluded.
Older patients that are healthy and in good physical condition should not be ruled out for aggressive treatments simply because of their age, the new prostate cancer treatment guidelines say. Conversely, aggressive cancer treatment could be the wrong treatment for older patients that are frail or have multiple health conditions.
“If the health status of the patient is okay, the treatment of elderly patients is basically the same as their younger counterparts,” Dr. Jean-Pierre Droz of Claude-Bernard Lyon 1 University in France, told Reuters Health. “There is no real difference in the approach, however, there are adaptations of treatment based on the patient’s health status.”
Ultimately, the taskforce recommends assessing each patient based on food intake, weight loss, body mass, mobility, neurological issues, medications and health status.
We believe health care should be focused on getting the right patient, the right treatment. One-size-fits-all works great for manufacturing widgets, but not when it comes to making medical decisions.
These updated prostate cancer treatment guidelines move us in the right direction — towards more personalized medicine and individualized care. This study is a great reminder that even objective criteria have subjective effects. Yes, we can quantify every patient’s age, but that number doesn’t mean the same thing for everyone.
“You don’t get old from age,” the legendary fitness guru Jack LaLanne used to say, “you get old from inactivity, from not believing in something.”
Anyone who can pull 70 boats on his 70th birthday probably demands a different treatment than your typical patient of the same age. When you start treating patients as numerical shorthand, it moves us away from the best decision for each individual patient.
Health care that forces all patients to use the same treatment jeopardizes every patient’s health and adds unnecessary costs to our health care system.
Getting the right patient, the right treatment also requires the right timing.
Patients, doctors and providers need to be aware how stress and emotions immediately after diagnosis can affect our decision-making.
After reviewing the treatment decisions of 1,500 men with prostate cancer, researchers from the University at Buffalo and Roswell Park Cancer Institute have found that stress and anxiety may alter the treatment chosen by prostate cancer patients. Researchers found a correlation between a man’s level of emotional distress shortly after diagnosis and a greater likelihood of choosing surgery over active surveillance.
“The goal of most physicians treating men with prostate cancer is to help their patients and family members through a difficult process and help their patients receive appropriate treatment,” said Dr. Willie Underwood III, an associate professor in Roswell Park’s department of urology and co-author of the study. “To do so, it is helpful for physicians to better understand what is motivating men’s decisions and to address negative motivators such as emotional distress to prevent men from receiving a treatment that they don’t need or will later regret.”
Heather Orom, associate professor at the University at Buffalo and co-author of the study, said she hopes the research will help doctors provide better advice to patients.
“If distress early on is influencing treatment choice, then maybe we help men by providing clearer information about prognosis and strategies for dealing with anxiety,” she said. “We hope this will help improve the treatment decision-making process and ultimately, the patient’s quality of life.”