Managing Prostate Cancer When You Have Other Conditions

Medically Reviewed by Nazia Q Bandukwala, DO on July 11, 2023
Written by Shishira Sreenivas
4 min read

Prostate cancer is more common among older men. Six out of 10 prostate cancer diagnoses are for men 65 or older.

While it's the second common cause of cancer death among men in the U.S., men in this older age group also tend to have other age-related health conditions along with their prostate cancer. (Your doctor may call these comorbidities.)

Depending on how severe these other conditions are, they may have a big effect on:

If you have other health conditions, your doctor will work with you to create a management plan tailored for you.

Before recommending treatment plans for your prostate cancer, your doctor will go over the status of your cancer and your medical history. You may hear them call it a pretreatment assessment.

They'll do this to get a clear snapshot of the pros and cons of different options. Research shows that many men with prostate cancer have at least one medical condition separate from their cancer diagnosis.

Some of the more common conditions that coexist with prostate cancer include:

Besides these things, before coming up with a treatment plan, your doctor will also take into account your:

  • Age
  • Race
  • Ethnicity
  • Alcohol and tobacco use
  • Use of mobility devices like wheelchairs, crutches, canes, or walkers

Among people who get prostate cancer, Black men are more likely to also have conditions like high blood pressure and heart problems. They are also twice as likely to die from prostate cancer.

After your diagnosis, your doctor will first see what stage your cancer is in and what the risks of treatment could be.

The staging depends on the:

  • Size of your tumor
  • Aggressiveness of the cancer cells
  • Amount that your cancer has spread

If you know that you have other serious health conditions along with prostate cancer, let your doctor know. Certain treatments and cancer drugs may interact with other medications you’re on. Combining them may cause you to have potentially dangerous reactions.

Having coexisting conditions may also affect:

  • How you’re screened for cancer
  • The treatment choice you may have to make
  • Your overall quality of life

For example, if you have high blood pressure or diabetes, it could take you longer to recover from aggressive treatments like radiation or surgery.

Which treatment you and your doctor decide on will depend on how severe your cancer is and which treatment you prefer.

If you have a low-risk cancer that’s in an early stage, you may not need immediate treatment. Discuss your options with your doctor. It can help you choose the best approach that’s right for you.

Here are some of the treatment options you and your doctor may discuss depending on the stage of your cancer:

Low-risk local cancer (stage I or II). Your cancer is unlikely to grow quickly or spread. So you could have:

  • Aggressive treatments like surgery or radiation therapy. This may help your body get rid of the cancer before it has the chance to grow or travel to other areas of your body.
  • Active surveillance. Your doctor will actively monitor the cancer with PSA tests to check its growth.

If your cancer is low-risk but you have other serious conditions, you can choose watchful waiting over surgery or radiation therapy. If you’re unsure about which way to go, ask your doctor about it. If time permits, feel free to seek a second opinion. But if you have a high-risk tumor, your doctor may recommend an aggressive approach.

Locally advanced cancer (stage III). If your tumor in the prostate is aggressive and advanced, your doctor may recommend a combination of therapies to best tackle the cancer. This can include surgery along with radiation therapy.

Radiation may or may not include something called androgen deprivation therapy (ADT). This lowers your body’s level of androgens (male sex hormones like testosterone) to slow your cancer's growth.

Advanced cancer (stage IV). If your cancer has spread from your prostate to different parts of your body, you’ll probably need aggressive treatment. This can include:

In some cases, you may need surgery.

  • While there's no cure for metastatic cancer, treatment can help control the cancer's growth, ease symptoms, and improve your quality of life.
  • If you have cerebrovascular disease or moderate to severe COPD, your doctor may choose treatment options like radiation over surgery.
  • If you notice any bad reactions or side effects from your treatment, let your doctor or cancer care team know right away. They may be able to switch your medications or modify your treatment plan.
  • If you have any other chronic disease, manage it as well as you can. Your doctor can help you with this. It'll help your prostate cancer treatment work as well as possible.