[Management of prostate cancer in patients older than 75 years]. / Prise en charge diagnostique et thérapeutique des cancers de la prostate chez l'homme de plus de 75 ans.

Prostate cancer is a disease of the elderly men. Prostate cancer in the elderly men is often poorly managed and under-treated. The digital rectal examination is an effective screening test for elderly prostate cancer patients. In order to choose the appropriated therapeutic option, evaluation of life-expectancy is essential to offer an optimal individualized treatment. It is essential to take into account the patients' aspirations before starting any diagnostic and therapeutic approach. Therapeutic options should be adapted in elderly prostate cancer patients according to their comorbidities and needs. Elderly patients should be included in clinical trials specifically designed for this population.

[FRancilian Oncogeriatric Group (FROG)'s focus on management of elderly patients with bladder cancer]. / Mise au point du FRancilian Oncogeriatric Group (FROG) pour la prise en charge du cancer de vessie du sujet âgé

Bladder cancer is diagnosed more often in the elderly. The most effective treatment strategies are mostly very aggressive and are not applicable to all patients in a very heterogeneous population. However, effective options exist to treat the most vulnerable subjects. A multidisciplinary approach including a geriatric assessment is essential for optimal adaptation of treatment. The FRancilian Oncogeriatric Group (FROG) conducted a comprehensive literature search in order to review the applicable therapeutic options according to oncological and geriatric settings. International recommendations are essential to harmonize the management of elderly patients with bladder cancer.

[Chemotherapy-induced cardiotoxicity in the elderly]. / Cardiotoxicité de la chimiothérapie chez le sujet âgé.

Chemotherapy-induced cardiotoxicity can concern major effects, inducing severe impairments of vital functions: systolic or diastolic function, hypertension, rhythmic or conducting pathology, Elsewhere, cardiac and vascular aging induces alterations, which concern roughly the same points and are enhanced by vascular risk factors. We wish to analyse the correlation and increase of the consequences of the first one toward the second one and the safe attitude we must have for those patients (prevention and early treatment). Echocardiography seems to have more and more a major status to assess cardiac function, chiefly in systolic and diastolic manor. We insist on the interest of stress echo for assessment of impaired contractility and for evaluation of vascular risk in ischemic disease. We suggest a vulnerability score to predict the risk of complication due to chemotherapy.

[Chemotherapy in the elderly: how and for whom?]. / Chimiothérapie chez le sujet âgé: quelles modalités? Quelles implications?

Management of cancer in the older-aged patient is an increasingly common problem in our occidental societies. Cancer is a disease primarily of older persons: over 60% of all cases of cancer are diagnosed after age 65 - an age group that constitutes less than 20% of the western population and the risk of persons over 65 years of age developing cancer is at least 10 times that of those under 65. Cancer in older persons may be considered a different disease from cancer in the younger in that way that biology of the host could influence the growth of cancer, that the management of the disease deserved an individualized approach. Indeed, the normal process of aging is associated with a progressive age-related reduction in function of many organs, including losses such as renal, pulmonary, cardiac, immune, hepatic, haematological, muscles, osseous, sight, hearing and brain functions. The consequences of these changes with age, added to comorbid diseases, have major implications on toxicities of anti-cancer therapies, surgery, radiotherapy as well as chemotherapy. However chronologic age should not be used as a guide to cancer therapy. Performance status and physiologic performance of the older patient are of prime importance to decide and conduct chemotherapy.

[Anticancer chemotherapy in the elderly: a review of the literature]. / Chimiothérapies anticancéreuses et personnes âgées: revue de la littérature.

Few elderly cancer patients are included in clinical trials, resulting insuffisant data of the effectiveness and tolerance of anticancer drugs in this patient population. The aim of this study was to analyse the studies concerning the effectiveness and tolerance of chemotherapy prescribed for elderly patients treated for colorectal, breast and lung cancer. The data of this population showed that the older patients are less likely to receive chemotherapy than the younger. The age is considered as significant important factor for the decision of chemotherapy of this population. However elderly patients seem to have the same benefit as compared with younger patients. Rather than the criteria of age, comorbidities should be considered. It is necessary to develop specific geriatric assessment and development of clinical trials specifically including elderly patients remains a necessity.