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How to optimally manage elderly bladder cancer patients?
Francesco Soria1, Marco Moschini2, Stephan Korn3
1Department of Urology, Medical University of Vienna, Vienna, Austria; ; Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, 10126 Turin, Italy.
Translational Andrology and Urology
|October 28, 2016
Summary
Bladder cancer management in the elderly is complex. A patient-centered approach focusing on biological age and functional reserves, rather than chronological age, is crucial for effective treatment.
Area of Science:
- Geriatric Oncology
- Urologic Oncology
- Public Health
Background:
- Bladder cancer (BCa) disproportionately affects the elderly, posing a growing public health challenge.
- Current management strategies for elderly BCa patients remain controversial.
- BCa appears more aggressive in older populations.
Approach:
- A non-systematic literature review was conducted using Medline (January 2000 - February 2016).
- Original articles, reviews, and editorials were selected for clinical relevance.
- The review aimed to summarize current knowledge on BCa management in the elderly.
Key Points:
- The definition of 'elderly' varies, often based on chronological rather than biological age.
- Non-muscle invasive bladder cancer (NMIBC) management is similar to younger patients, with considerations for adjuvant immunotherapy.
- Muscle invasive bladder cancer (MIBC) management may benefit from multidisciplinary geriatric evaluations.
- Radical cystectomy (RC) remains a curative option for MIBC and should not be withheld based solely on age.
- Bladder-sparing techniques are viable for elderly patients unfit for major surgery.
- Geriatric assessment can guide personalized perioperative care, including pre- and rehabilitation.
Conclusions:
- Bladder cancer treatment in the elderly requires a patient-centered strategy.
- Focus should be on biological age and functional reserves for optimal outcomes.
- Individualized care plans are essential for managing bladder cancer in aging populations.
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