Tailored treatment for bladder cancer in older patients

Abstract

Bladder cancer is increasingly prevalent among older patients and requires a specific two-step approach: screening first, then the identification of geriatric problems. A good renal function is absolutely crucial for metastatic bladder cancer patients who are candidates to receiving chemotherapy. Most elderly patients with localized disease are likely to receive the same treatment options as younger patients (i.e., radical cystectomy), although specific interventions might be needed to minimize the occurrence of postoperative complications. Internationally accepted guidelines are generally valid in the population of patients with localized disease, even if more attention should be paid to health status than to life expectancy. Conversely, little knowledge is available on how best to manage metastatic disease: it is therefore mandatory to recruit patients into well-designed quality studies, after the appropriate assessment of their health status.