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Prostate Cancer Screening in the Elderly

It is generally recommended that elderly patients not be screened for prostate cancer, but many elderly men are quite vital and younger than their chronological age. According to an article published in the Annals of Internal Medicine November 19, 2013 physicians may be better able to tailor cancer screening for them by using a new tool that estimates co-morbidity-adjusted life expectancy.

The report from the National Cancer Institute analyzed Medicare data on 407,749 elderly persons, both male and female, to develop tables that can be used to estimate life expectancies for patients who have or do not have co-morbid conditions.

The researchers found that persons with more co-morbidities such as diabetes, chronic obstructive lung disease, or congestive heart failure had shorter life expectancies when compared with an average person the same age, whereas persons with no co-morbid conditions had life expectancies beyond the average.

For example, the researchers estimate that a 75-year-old healthy person has a life expectancy of 6 years longer than a person of the same age with multiple conditions.

The study population included Medicare beneficiaries who were alive and at least 66 years old during the period 1992 and 2005. Beneficiaries who had previously had a cancer diagnosis were excluded from the study. The functional status and the severity of the co-morbidity were not available from the Medicare data reviewed.

The authors conclude that “Life expectancy varies considerably by co-morbidity status in elderly persons. Comorbidity-adjusted life expectancy may help physicians tailor recommendations cancer screening for individual patients.”

“This research confirms what I have seen in my practice, says Dr. Hill, “There are men who are biologically much younger than their stated age.”

If prostate cancer is proven on biopsy, treatment options are active surveillance or interventional treatment such as radical surgery, external beam radiation, permanent seed implant or [High Dose Rate Brachytherapy __title__ ]. In low risk disease the cure rate excellent with any of the treatment methods. However, High Dose Rate Brachytherapy has a very low complication rate compared to the other modalities. There are essentially no rectal complications, no incontinence and a low percentage of erectile dysfunction.

About Dennis R. Hill MD

Dr. Hill is a board certified radiation oncologist doing High Dose Rate brachytherapy exclusively since 2004 and has published scholarly articles on the subject. His office is located at: Dennis R. Hill MD, 3012 Summit Street, Suite 2675, Oakland, CA 94609 510-869-8875. His email is drh(at)dennisrhillmd(dot)com and his website is