OBM Geriatrics is an Open Access journal published quarterly online by LIDSEN Publishing Inc. The journal takes the premise that innovative approaches – including gene therapy, cell therapy, and epigenetic modulation – will result in clinical interventions that alter the fundamental pathology and the clinical course of age-related human diseases. We will give strong preference to papers that emphasize an alteration (or a potential alteration) in the fundamental disease course of Alzheimer’s disease, vascular aging diseases, osteoarthritis, osteoporosis, skin aging, immune senescence, and other age-related diseases.
Geriatric medicine is now entering a unique point in history, where the focus will no longer be on palliative, ameliorative, or social aspects of care for age-related disease, but will be capable of stopping, preventing, and reversing major disease constellations that have heretofore been entirely resistant to interventions based on “small molecular” pharmacological approaches. With the changing emphasis from genetic to epigenetic understandings of pathology (including telomere biology), with the use of gene delivery systems (including viral delivery systems), and with the use of cell-based therapies (including stem cell therapies), a fatalistic view of age-related disease is no longer a reasonable clinical default nor an appropriate clinical research paradigm.
Precedence will be given to papers describing fundamental interventions, including interventions that affect cell senescence, patterns of gene expression, telomere biology, stem cell biology, and other innovative, 21st century interventions, especially if the focus is on clinical applications, ongoing clinical trials, or animal trials preparatory to phase 1 human clinical trials.
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Bladder Cancer in Older Adults
Submission Deadline: July 30, 2021 (Open) Submit Now
Frank Christoph, MD, PhD, FEBU
Universitätsklinik für Urologie und Kinderurologie, Otto-von-Guericke-Universität, Leipziger Str. 44, 39120 Magdeburg, Germany
Research Interests: Urology surgery; oncology; drug therapy of cancer
About This Topic
Bladder cancer belongs to the five most common cancer types with the majority of patients diagnosed being elderly people between the age of 75 and 84 who account for 30% of new cases per year. Given the fact that demographic prognostics suggest a 3-fold rise of the population aged 80 and over, treating uro-oncologists will face a rising number of patients diagnosed with either non-muscle or muscle invasive bladder cancer.
Therefore, diagnostic approach and therapeutic assessment is a growing matter of debate. It has been suggested that intravesical therapy of superficial bladder cancer can cause higher morbidity and might be less effective. In addition, radical cystectomy in muscle invasive bladder cancer has higher complication and mortality rates as compared to younger patient groups. The renal function is physiologically impaired in elderly patients which might compromise the use of platinum-based chemotherapy.
However, age is relative and various publications have recommended using the term “fit” rather than just “age” in their evaluation of treatment qualification.
Various questions arise if bladder cancer treatment in the elderly is discussed. The most frequent issues which will be content of this editorial are: the role of active surveillance of small superficial tumors, the efficacy of bladder preserving therapy in advanced tumors, the role of chemotherapy or alternatives, the impact of open versus robotic radical cystectomy, and the outcome of continent versus non-continent urinary diversion.
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