Prostate cancer in the elderly

The incidence of prostate cancer is age related and increased longevity increases the number of elderly men with the disease. Management of prostate cancer in the elderly requires a different approach. Screening and aggressive case finding to seek out early confined disease are contraindicated in those with a life expectation below 10 years. Early confined disease in the elderly is usually managed expectantly. Hormone treatment is more appropriate for locally advanced disease, and is a valuable non-surgical treatment for bladder outflow obstruction due to prostate cancer. A significant proportion of elderly men with prostate cancer still die from other diseases. Hormone refractory disease in the elderly should be managed by palliation of symptoms rather than toxic second-line therapies. The aim always is diagnosis where appropriate, treatment which will be of benefit, and quality rather than length of life.