Age bias may affect treatment for prostate cancer

[Guest guest]

Age bias may affect treatment for prostate cancer

Last Updated: 2004-01-21 16:01:58 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Age bias among urologists and other doctors

may account for the undertreatment of older men with early prostate

cancer, new research suggests.

Several previous studies have reported that older men receive

potentially curative therapy less often than do younger men, the authors

explain, but none of these studies determined whether age or other

diseases were appropriately considered in the treatment decisions.

Dr. Shabbir M. H. Alibhai, from University Health Network, Toronto, and

colleagues evaluated the influence of age, other diseases, tumor

severity, and remaining life expectancy on the treatment received by 379

men with prostate cancer. The results are published in the medical

journal Cancer.

Men under age 60 years were more likely to receive potentially curative

surgery rather than radiation therapy, the authors report, whereas those

between 60 and 69 years were more likely to receive radiation therapy

than surgery.

Men in the age 70 to 79 age group were likely to receive no therapy, the

report indicates, and virtually all men over age 80 years received no

therapy.

An increasing number of co-existing diseases decreased the likelihood of

receiving curative surgery but did not influence receipt of radiation

therapy in patients up to age 69, the researchers note.

As remaining life expectancy increased so did the chances of receiving

potentially curative treatment. However, older men were less likely than

younger men to receive such therapy when both shared the same remaining

life expectancy. Similar findings were noted when older and younger men

had tumors of comparable severity.

The educational experience of the urologist also seemed to influence the

decision to offer potentially curative surgery. Docs who graduated from

training more than 22 years ago were less likely to recommend such

surgery than more recent graduates.

Doctors " may be systematically undertreating older patients with

localized prostate cancer [in ways] that are not consistent with ...

expert recommendations, " Alibhai told Reuters Health.

Doctors " need to realize that many older patients who are otherwise

healthy and in their early or mid seventies have an excellent life

expectancy and should be considered for aggressive treatment, " the

investigator said.

" Even though there is only one randomized trial that has demonstrated

that potentially curative therapy is better than conservative

management, we are trying to emphasize that (doctors) must be consistent

when thinking about treatment, " Alibhai concluded.

SOURCE: Cancer, January 1, 2004.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org