Should an 80-year-old man with bladder cancer undergo surgery?

Whether or not to have surgery for bladder cancer in an octogenarian should be based on a comprehensive assessment of the patient's condition, physical condition, and willingness. Treatment options include surgery, radiotherapy, chemotherapy, and conservative treatment.

1. Assessment of the condition

The severity of bladder cancer directly affects the treatment options. Early-stage bladder cancer can be treated with surgery to remove the tumor, and the prognosis is good; late-stage bladder cancer may have spread to other organs, and the effect of surgery is limited. Doctors will use imaging examinations, pathological biopsies, and other methods to assess the tumor stage and grade to determine whether surgery is suitable.

2. Physical condition

The physical condition of elderly patients is a key factor in determining the feasibility of surgery. Surgical risks include anesthesia tolerance, postoperative recovery ability and complication rate. Doctors will evaluate the patient's cardiopulmonary function, liver and kidney function and overall health to determine whether they can withstand the trauma of surgery. If the physical condition is poor, conservative treatment or minimally invasive surgery may be chosen.

3. Patient’s wishes

Treatment decisions must respect the wishes of patients and their families. Some elderly people may prefer conservative treatment to maintain their quality of life, while others want active treatment to prolong their survival. Doctors should fully communicate with patients and their families, clarify treatment goals and expected results, and jointly develop personalized plans.

4. Surgical treatment

Surgery is one of the main treatments for bladder cancer. Common surgical methods include transurethral resection of bladder tumors, partial cystectomy and radical cystectomy. Transurethral resection of bladder tumors is suitable for early non-muscle-invasive bladder cancer, with less trauma and faster recovery; partial cystectomy is suitable for patients with tumors confined to a certain area of ​​the bladder; radical cystectomy is suitable for muscle-invasive bladder cancer, which requires removal of the entire bladder and urinary diversion.

5. Non-surgical treatment

For patients who are not suitable for surgery, radiotherapy, chemotherapy or immunotherapy can be selected. Radiotherapy kills cancer cells through high-energy rays and is suitable for locally advanced or metastatic bladder cancer; chemotherapy inhibits the growth of cancer cells through drugs and is often used for preoperative adjuvant therapy or postoperative prevention of recurrence; immunotherapy activates the patient's own immune system to fight cancer cells and has made significant progress in the treatment of bladder cancer in recent years.

6. Conservative treatment

Conservative treatment aims to relieve symptoms and improve the quality of life. It includes pain relief, nutritional support, and psychological counseling. For patients with advanced bladder cancer, conservative treatment may be a more appropriate choice.

Whether or not to have surgery for bladder cancer in an octogenarian should be determined by comprehensive consideration of the patient's condition, physical condition, and willingness. Treatment plans should be personalized to extend survival and improve quality of life. Patients and their families should fully communicate with their doctors to make the best decision together.