Age matters in prostate cancer. The vast majority
of men diagnosed with prostate cancer, and nearly all of the men
who die from it, are over age 65. And yet, despite the recent compelling
evidence that surgical intervention for prostate cancer can save
lives, "many physicians do not routinely screen their older patients
for prostate cancer," notes gerontologist Sheila Gonzalgo, M.D,
M.P.H., the Carolyn and Bill Stutt Scholar. Even when they do, many
of these men "may not receive potentially curative treatment," because
their doctors think they're too old for it.
But general health matters, too, and not all men
in their late sixties and over are alike. Some are hearty and vigorous,
and some are plagued by health problems and frailty. This makes
a huge difference in how men recover from illness, Gonzalgo adds,
and it's going to become increasingly important as the Baby Boomer
generation ages. There is a "demographic imperative," Gonzalgo believes,
to determine which older men would benefit the most from prostate
cancer screening and surgical intervention — and which would benefit
Some men in their
are vigorous, and some are
plagued by health problems.
This makes a huge difference in
how men recover from illness.
"For example, we might expect an active 65-year-old
man with no other illnesses to recover fully from the common cold,"
she explains. But that same cold might be much rougher on a man
of the same age who is diabetic, who smokes, has heart disease,
and doesn't exercise. "Gerontologists are in the process of defining
what it means to age exceptionally. At the other end of the spectrum
are the most vulnerable older adults, people afflicted with frailty
— a biological syndrome characterized by muscle weakness, lack of
stamina, and weight loss."
Using information collected from the Cardiovascular
Health Study, Gonzalgo is working to see how a man's general health
— his likelihood of disability and death from other causes — affects
his chances of being helped by surgery.