When doctors create a treatment plan for prostate cancer, they typically consider factors like tumor type, spread, and overall health. However, a new study suggests that one more factor deserves serious attention—chronological age.
Researchers from University Hospitals Seidman Cancer Center have found that age can strongly influence how well patients respond to advanced treatments for metastatic prostate cancer. The study, published in *NEJM Evidence* on October 28, 2025, was led by Dr. Daniel Spratt, Chair of Radiation Oncology at University Hospitals Seidman Cancer Center and the Vincent K. Smith Chair in Radiation Oncology.
## Age and Treatment Success in Metastatic Prostate Cancer
Dr. Spratt’s team examined how age affects treatment outcomes in men with metastatic hormone-sensitive prostate cancer (mHSPC). This type of cancer means the disease has spread beyond the prostate but still responds to therapies that lower or block testosterone—a hormone that fuels cancer growth.
The researchers found that older men—especially those over 70—may not benefit as much from aggressive treatment combinations that include androgen receptor pathway inhibitors (ARPIs) and chemotherapy. These intense therapies, often referred to as systemic treatment intensification (TI), are designed to extend survival.
However, older men tend to have other health problems such as cardiovascular disease, diabetes, or frailty, which may limit their ability to tolerate such intense therapy. This makes managing prostate cancer more complicated when age-related conditions come into play.
## Balancing Cancer Control and Overall Health
Prostate cancer is one of the most common cancers among men, particularly older men. Many patients live with the disease for years, but currently, one in three men with metastatic prostate cancer dies from causes unrelated to cancer, such as heart disease or stroke.
This means treatment decisions need to balance cancer control with the risks posed by therapy itself.
## Key Findings from the Study
Dr. Spratt and his colleagues analyzed data from more than 10,000 patients across multiple randomized phase 3 clinical trials worldwide. They discovered that the survival benefit of adding ARPIs or chemotherapy was smaller—or even absent—for men over 70 who had low-volume disease, meaning their cancer had spread less extensively.
This was especially true for those who also received radiotherapy directed at the primary tumor.
“We must remember to treat the whole patient, not just the disease,” said Dr. Spratt. “Older patients who receive these therapies are more likely to experience falls, fractures, heart problems, or even fatal side effects. Sometimes, less can truly be more when it comes to treatment intensity.”
## Changing the Approach to Prostate Cancer Treatment
These findings underline a key shift in how doctors may approach prostate cancer treatment in aging populations. Traditionally, a “one-size-fits-all” strategy has been used, offering the same combinations of hormone therapy, chemotherapy, and targeted drugs regardless of age.
This study challenges that model, showing that older patients may require a more personalized strategy that considers not only their cancer stage but also their overall health and life expectancy.
## A Focus on Personalized, Safer Care
The research team—which included co-authors Drs. Angela Jia, Pedro Barata, Nicholas Zaorsky, Jorge Garcia, Jason Brown, Soumyajit Roy, and Prateek Mendiratta—emphasized that the goal is not to withhold care from older patients but to make it safer and more effective.
They suggest that future clinical trials should better represent older adults and evaluate how treatments affect both survival and quality of life in this group.
## Why Age Matters in Cancer Care
This study offers an important reminder that age is more than just a number in cancer care—it’s a major factor that shapes treatment outcomes. While advanced therapies have extended survival for many patients, they also bring side effects that can outweigh their benefits for older individuals.
For men over 70 with low-volume metastatic prostate cancer, aggressive treatment may not add meaningful years of life and could even reduce quality of life.
These findings may encourage oncologists to adopt a more balanced approach—one that integrates cancer biology with geriatric medicine. Rather than focusing solely on killing cancer cells, doctors may increasingly prioritize preserving function, independence, and well-being.
As life expectancy continues to rise, personalized care for older cancer patients will become even more crucial.
## Conclusion
The message from this research is clear: treating prostate cancer effectively means understanding the patient as a whole person, not just as a diagnosis. Age matters, and by considering it more carefully, doctors can help patients live not just longer, but better.
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If you are interested in prostate cancer, consider exploring studies about natural allies against the disease. Supplements and the keto diet have been shown to potentially boost immunotherapy for prostate cancer.
For more health information, you may also want to read recent studies on harnessing the power of anti-cancer foods and supplements. Additionally, evidence suggests that a low-fat diet may help slow cancer growth.
The study discussed is published in *NEJM Evidence*.
https://knowridge.com/2025/11/age-should-matter-more-in-prostate-cancer-treatment-study-finds/
