The role of urodynamic studies and imaging
Beyond PSA testing, certain additional examinations take on particular importance at this age. Uroflowmetry makes it possible to objectify the real strength of the urinary stream, rather than relying solely on the patient's perception, which may underestimate or overestimate the discomfort depending on habits formed over the years. An post-void ultrasound, which measures the post-void residual urine volume, also helps to assess the actual impact of the obstruction on urinary function.
These examinations directly guide the choice between simple monitoring, drug treatment, or a more invasive procedure, based on objective data rather than a general impression.
BPH or cancer: how to tell them apart at this age
These urinary symptoms, although they often point to benign prostatic hyperplasia, do not alone allow it to be stated with certainty. That is why a comprehensive evaluation remains essential: PSA test, rectal examination and, depending on the results, imaging or biopsy. It is these additional tests, and not the symptoms experienced alone, that make it possible to decide between a benign hypertrophy and cancer.
It is also useful to remember that persistent pain in the back or hips, combined with urinary problems, deserves to be reported to a doctor. This symptom is not specific and has many possible causes, but its association with prostate issues means it should not be ignored.
What treatment options at 70 years old
1. For benign prostatic hyperplasia
Several approaches remain available at this age, with a choice that depends as much on the severity of the symptoms as on the patient's general health. Drug treatments often constitute the first step. When they are no longer sufficient, minimally invasive techniques such as prostatic artery embolization may be considered, particularly in patients for whom more invasive surgery presents an increased risk. Transurethral resection is also still offered when the patient's profile is suitable, especially for prostates of moderate volume.
The anesthetic risk often weighs more heavily in the decision at this age than at 50 or 60, particularly in the presence of associated cardiovascular conditions, which are common after 70. This is a criterion that the doctor systematically takes into account, along with prostate volume and symptom severity, to guide toward the most appropriate technique.
2. For localized cancer
At 70 years old, the treatment strategy is often adjusted based on the aggressiveness of the cancer and the estimated life expectancy.. Surgery, offered less systematically than at a younger age, remains discussed on a case-by-case basis depending on the patient's general condition. Radiotherapy, whether external beam or brachytherapy, constitutes a frequently chosen alternative. For low-risk cancers, active surveillance often makes it possible to avoid burdensome treatment without compromising the prognosis, as many prostate cancers progress slowly at this age.
Preserving quality of life above all
In men aged 70 and over, the therapeutic goal often shifts: it is no longer solely about seeking a cure at all costs, but rather about best preserving quality of life and autonomy. This approach, sometimes called onco-geriatrics when it concerns cancer, takes into account the patient's overall profile, any other existing conditions, and personal priorities, rather than just the isolated prostate diagnosis.
This is also why the preservation of sexual function, often mistakenly perceived as secondary at this age, remains a criterion to be openly discussed with one's doctor when choosing treatment, whether for benign prostatic hyperplasia or localized cancer.
Regular follow-up remains the best protection
Consulting a urologist regularly after the age of 70 makes it possible to detect early changes in prostate issues, whether benign or more serious, and to adjust the management before symptoms become too debilitating. This follow-up should not be seen as an additional burden, but as the best guarantee of maintaining a good quality of life over the long term.
For any questions regarding your situation, contact our team.
This article is for general informational purposes and does not replace medical advice.