The Frailty Factor and Prostate Cancer

Sheila Gonzalgo

Does age discrimination affect prostate cancer treatment? Very often, it does. Some otherwise healthy men with prostate cancer are ruled out as candidates for curative treatment because their doctors think they’re too old. It works the other way, too; some men in their sixties, who have other serious health conditions in addition to cancer, probably won’t benefit from surgery.

Does age discrimination affect
prostate cancer treatment? Very
often, it does.

The key is frailty — and its reverse condition, general good health, says geriatrician Sheila Gonzalgo, M.D., M.P.H., the Carolyn and Bill Stutt Scholar. “Some people are afflicted with it as they age,” she explains. “For reasons we don’t yet fully understand, frailty is a biological syndrome, characterized by weight loss, weakness, exhaustion, and loss of muscle mass and strength.” She has been working to quantify frailty as a factor in determining how well a man will recover from a serious illness, such as cardiovascular disease, dementia, lung disease, and cancers including prostate cancer. She has also been looking at frailty in data collected from the Cardiovascular Health Study, involving more than 2,200 men, ages 65 to 100, to determine how a man’s general health affects his chances of being helped by surgery.

“Our preliminary findings appear to support the notion that some men with prostate cancer aged 65 to 74 years, and possibly aged 75 to 84, might be amenable to more aggressive forms of therapy,” she says. Further studies are needed to determine which men would benefit the most — and the least — from prostate cancer screening and surgical intervention.


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