Average age of prostate cancer diagnosis is 68

[SteveH]

By: Jessica Wynne Lockhart Special to the Star, Published on Mon Sep 02 2013

Prostate cancer is the most common non-internal cancer in men and the third most common cause of cancer deaths in Canada. But it’s the average age at diagnosis—68—that can make treating the disease all that more difficult.

“Older adults often have more complex issues to deal with because they have competing medical illnesses and they’re on competing medications. They have other priorities when it comes to decision-making,” explains Dr. Shabbir Alibhai, a researcher at the University Health Network who focuses on cancer in older adults.

One of the more complex issues that men undergoing treatment must face is the side effects of androgen deprivation therapy (ADT). Used to treat prostate cancer, ADT is highly effective, but in addition to contributing to an increase in falls and loss of muscle mass, it accelerates bone density loss, a potentially deadly combination. With up to 20 per cent of men already having osteoporosis prior to ADT treatment and an additional 40 per cent having low bone mass, the odds are stacked against prostate cancer patients.

“Osteoporosis is a silent killer in the sense that you don’t have any symptoms of bone loss until you get a fracture,” says Alibhai, noting that patients typically aren’t screened for the disease until it’s already too late.

Although osteoporosis, which causes a thinning of the bones and an increased risk of fractures, affects up to one in eight men, it’s still considered a women’s disease by both patients and health care practitioners. This is particularly problematic because men are more likely than women to suffer permanent disabilities or death as result of fractures.

“Family doctors are less likely to systematically screen and treat older men with bone loss compared to women, whether they have prostate cancer or not,” explains Alibhai. This is why, with funding from the Canadian Cancer Society’s 2013 Innovation Grants, Alibhai is developing interventions and educational materials that focus on not only educating patients about the side effects of ADT, but educating family health care practitioners as well.

“We’re trying to emphasize to people ways to optimize and assess your bone health before you start ADT to understand what the risks are going forward,” he says. Age and genetics are major factors in development of the osteoporosis, but risks can be decreased through developing healthy behaviours including engaging in physical activity such as jogging or weight-lifting; increasing calcium and vitamin D intake; and optimizing lifestyle choices in terms of alcohol, caffeine and smoking. In addition, Alibhai encourages prostate cancer patients to get a bone density test prior to treatment to understand their baseline risk.

“My desire is to do more than just describe all these horrible things,” he says. “It isn’t something you can ignore in many of these men with prostate cancer. You can’t simply tell the doctors, ‘Well, find an alternative treatment.’ For many of these men, ADT is a life-saving treatment.”

http://www.thestar.com/life/cancerresou ... is_68.html