The implications of ageing and life expectancy in prostate cancer treatment

被引:8
|
作者
Kalra, Sarathi [1 ]
Basourakos, Spyridon [1 ]
Abouassi, Angela [1 ]
Achim, Mary [2 ]
Volk, Robert J. [3 ]
Hoffman, Karen E. [4 ]
Davis, John W. [2 ]
Kim, Jeri [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Genitourinary Med Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Urol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Hlth Serv Res, 1515 Holcombe Blvd, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
关键词
ANDROGEN-DEPRIVATION THERAPY; ILLNESS BURDEN INDEX; RADICAL PROSTATECTOMY; EAU GUIDELINES; OLDER PATIENTS; CO-MORBIDITY; MEN; COMORBIDITY; AGE; PREDICTION;
D O I
10.1038/nrurol.2016.52
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
In patients diagnosed with prostate cancer, the selection of treatment, including the type of therapy and its aggressiveness, is often based on a patient's age and life expectancy. Life expectancy estimates are too often calculated solely on the patient's chronological age, overlooking comorbid conditions and their severity, which can greatly affect life expectancy. If, in addition to chronological age, comorbid conditions are used to assess a patient's life expectancy, the most appropriate treatment options are more likely to be selected. Older, healthy patients might be able to tolerate more aggressive treatment than would be administered on the basis of their age alone, and younger patients with numerous comorbid conditions could avoid harsh therapy that might not be appropriate given their current state of health. The key idea to consider in treatment selection is what a patient's quality of life would be like with or without a particular treatment option. In an era of precision medicine, decisions regarding the provision of health care should be made rationally and on the basis of objective estimates of the threat of disease and the benefits and costs of intervention and within the context of the patient's characteristics and desires.
引用
收藏
页码:289 / U78
页数:7
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