It is time to start active treatment in senior adults with prostate cancer

Prostate cancer (PCa) is the most common malignancy in men in developed countries. Most patients have clinically localized and potentially indolent tumors at diagnosis; however, this disease holds third place in the leading cause of cancer deaths with 136,500 deaths in 2008 [1]. Considering these results, the question arises, who are those men with lethal PCa?

Age distribution of men with PCa at diagnosis and mortality using the Surveillance Epidemiology and End Results database (SEER) between 2005 and 2009 shows that 71% of PCa deaths occur in men aged ≥75 years. Scosyrev et al. confirmed these findings showing that PCa-related death gradually increases with age. These age-specific differences can be explained by a higher incidence of lethal high-risk disease in senior adults and/or less frequent use of PSA testing and further diagnostic evaluation [2]. Demographic changes are currently occuring with an emerging worldwide increase of men aged 65 years or older. Using this information Smith et al. estimated a 70% increase of yearly diagnosis of PCa in patients aged >65 years by 2030 [3].

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