From the Guidelines
The life expectancy for an 82-year-old male with Gleason 9 prostate cancer is generally reduced, with a predicted survival of less than 10 years, as indicated by the NCCN guidelines 1.
Factors Affecting Life Expectancy
Several factors can influence life expectancy in this patient population, including:
- Overall health and presence of comorbidities
- Effectiveness of treatment and response to therapy
- Presence of metastatic disease
- Patient's performance status and ability to tolerate treatment
Treatment Options
Treatment options for an 82-year-old male with Gleason 9 prostate cancer may include:
- Androgen deprivation therapy (ADT) such as leuprolide (Lupron) or goserelin (Zoladex), often combined with an anti-androgen like bicalutamide
- Radiation therapy, which may be recommended in some cases
- Newer medications like abiraterone or enzalutamide for metastatic disease
- Regular PSA monitoring every 3 months during treatment to assess response, and bone scans or imaging to evaluate disease progression 1
Quality of Life Considerations
Treatment decisions should balance efficacy against quality of life considerations, particularly important at this age. Comorbidities significantly impact prognosis, and a healthy 82-year-old may have better outcomes than someone with multiple health conditions 1.
Risk Stratification
The NCCN guidelines recommend using risk groups to begin discussing options for treatment of clinically localized prostate cancer, and nomograms to provide additional and more individualized information 1.
Active Surveillance
Active surveillance may be considered for some patients, but the criteria for recommending active surveillance and the schedule for active surveillance are still being researched and debated 1.
In summary, the life expectancy for an 82-year-old male with Gleason 9 prostate cancer is generally reduced, and treatment decisions should be individualized based on the patient's overall health, treatment response, and quality of life considerations, as supported by the NCCN guidelines 1.
From the Research
Life Expectancy for 82-Year-Old Male with Gleason 9 Prostate Cancer
- The life expectancy for an 82-year-old male with Gleason 9 prostate cancer is not directly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 3 reports the risks of death from prostate cancer in men with Gleason score 9-10 at 5 and 10 years, which can be used as a reference point.
- According to study 3, the risks of prostate cancer death for men with Gleason scores 4+5+4, and 5+5 at 10 years of follow-up were 0.45,0.56, and 0.66, respectively.
- Study 6 compared the survival outcomes of radical prostatectomy vs. external beam radiation therapy in prostate cancer patients with Gleason Score 9-10 at biopsy and found that there were no significant differences in cancer-specific mortality rates between the two treatment groups.
- The overall survival rates for patients with Gleason score 9-10 prostate cancer are not explicitly stated in the provided studies, but study 2 reports that the 5-year and 10-year overall survival rates were similar across all three treatment cohorts (EBRT, EBRT+BT, and RP).
Treatment Options and Outcomes
- Study 2 suggests that extremely dose-escalated radiotherapy with androgen deprivation therapy (ADT) may be the optimal upfront treatment for patients with biopsy Gleason score 9-10 prostate cancer.
- Study 4 reports that intense androgen-deprivation therapy with abiraterone acetate plus leuprolide acetate may reduce tumor burden in patients with localized high-risk prostate cancer.
- Study 5 discusses the use of Leuprolide acetate for the treatment of advanced prostate cancer and notes that it is still a leading option for ADT.
- Study 6 found that radical prostatectomy did not reach independent predictor status of lower cancer-specific mortality, but in sensitivity analyses, RP seemed to be associated with a minor improvement in cancer-specific survival compared to EBRT in patients who did not receive adjuvant radiation therapy.