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Prostate Removal May Be Option for Older Men

Prostatectomy to Treat Prostate Cancer May Be Safe in Men up to Age 79

WebMD Health News
Reviewed by Louise Chang, MD

Oct. 18, 2005 -- Aggressive treatment of prostate cancer with removal of the entire prostate gland, known as a radical prostatectomy, may be a safe option for otherwise healthy men up to age 79, according to a new study.

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, like radiation and chemotherapy, previous studies have shown that treating men with localized prostate cancer with radical prostatectomy is associated with a lower risk of the tumor spreading to other organs or causing death.

Despite these advantages, researchers say recent surveys show more than half of American and Canadian urologists believe age 70 should be the upper limit for the invasive surgical procedure.

Prostatectomy Age Limit May Not Apply

To determine if this upper age limit was justified, researchers compared the risk of complications and/or death within 30 days after radical prostatectomy in more than 11,000 men who underwent the procedure in Canada from 1990 to 1999.

The results, published in the Journal of the National Cancer Institute, showed that 0.5% of men died following the procedure and 20% experienced one or more complications.

Increasing age was associated with an increasing risk of complications, but the absolute risk of death was still relatively low for older men up to age 79. For example, the absolute risk of death was 0.66% among men aged 70 to 79 -- only slightly higher than the overall risk.

Instead, researchers found the risk of complications or death was more closely related to the presence of other medical problems, such as heart disease or stroke, than age alone.

Researchers say these results suggest that radical prostatectomy is a relatively safe treatment option for otherwise healthy older men up to age 79. But more research should look at the use of detailed risk assessments and interventions to reduce the risks to men considering prostatectomy with other health conditions.

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