The British population is ageing with 15% (10 million) of the population now aged >65 years and those aged >85 years constituting the fastest growing cohort. As a result urologists are increasingly asked to manage the spectrum of urological malignancies in the elderly. Traditionally, older patients are thought to be better served by conservative approaches rather than aggressive surgical treatment; however, there is increasing evidence that older patients may have much to gain from surgery both in terms of morbidity and mortality. In the older population, surgical and oncological decision-making requires careful consideration of physiological status, comorbidities and geriatric syndromes, as well as patient choice. With the advent of minimally invasive surgical techniques and the presumed reduction in perioperative morbidity, new chemotherapy agents and more effective radiotherapy options, we look at whether elderly patients are indeed candidates for all that modern uro-oncologists have to offer.
Abu-Ghanem, JK Dhesi, BJ Challacombe
The Challenges of Managing Urological Malignancy in the Elderly
BJU Int 2014 Jul 01;114(1)12-15, Y