This topic intrigued me to go looking for some hard data on occurrence and treatment of PCa in men specifically age 80 and older.
The article linked below, probably typical of what I found, cites some facts about
this.
It's a collection of short write-ups on issues, such as overall picture of PCa in this age group, subtreatment of such patients, as well as overtreatment of them, and discusses patient options in various situations.
There is, for example, a discussion of a study of octogenarians who had undergone radical prostatectomy (yes, controversial in some quarters) which concluded:
"At the last follow-up visit, 10 patients had survived more than a decade after surgery, and 3 patients had died within 10 years of surgery. The remaining 6 patients were alive at less than 10 years of follow-up. Seventy-four percent of patients were continent. No patient had died of prostate cancer, and the 10-year, all-cause survival rate was similar to that observed in healthy patients 60 to 79 years old undergoing radical prostatectomy. These findings indicate that careful selection of patients even older than 80 years can achieve satisfactory oncologic and functional outcomes after surgery. It is important to note, however, that the rate of urinary incontinence after surgery exceeds that of younger counterparts." (Above boldface mine)
Also:
"The median time from diagnosis to death from prostate cancer for men with nonpalpable disease is approximately 17 years., Considering that the US male life expectancy at the age of 65 years is 16 years, aggressive therapy will hardly extend life expectancy of older men with no palpable prostate cancer at the time of diagnosis." (Ditto boldface)
On the matter of undertreatment in older patients (also maybe controversial):
"It was concluded that most men older than 70 years with moderately or poorly differentiated tumors and no to mild comorbidity were given suboptimal treatment. Most of these men were undertreated, receiving watchful waiting therapy when potentially curative therapy could have been applied. With optimal treatment, clinical outcomes could have been improved."But then mention of a more standard (?) approach:
"Radical prostatectomy is preferred treatment in men younger than 70 years, whereas radiation therapy is applied predominantly in patients older than 70 years. Conservative therapy such as watchful waiting or androgen deprivation by luteinizing hormone-releasing hormone analogs is preferentially applied in men older than 80 years. Watchful waiting or hormonal therapy is used to treat 82% of men older than 80 years."And the article also suggests:
"Depending on your age and general health, you might care more about feeling well than curing cancer permanently. This might be especially true if you have a chronic health condition or you feel that your quality of life is poor. But if you are very healthy and enjoy many activities, you might want aggressive treatment. You might have plans many years in the future. If so, you might want your health care team to do everything possible for a cure."Some food for thought, I guess.
https://www.prostateprohelp.com/prostate-cancer-treatment-for-80-year-old/