Management of Older Men With Clinically Localized Prostate Cancer: The Significance of Advanced Age and Comorbidity

The majority of men diagnosed with prostate cancer are diagnosed later in life. Although localized prostate cancer is often an indolent disease, older men are more frequently diagnosed with high-risk disease and are more likely to die from prostate cancer than younger men. Comorbid medical conditions are also more prevalent in the later decades of life and can impact prostate cancer treatment tolerance and the likelihood of benefiting from aggressive cancer treatment. Older men diagnosed with prostate cancer are at risk for both overtreatment of low-risk disease and undertreatment of high-risk disease. Prostate cancer management decisions for older patients should be tailored based on an individual patient's health status, coexisting medical conditions, life expectancy, and tumor characteristics.