We face a lot of new possibilities and therapies for patients with advanced prostate cancer nowadays. We’ve got some evidence for new therapies but very often we are not having a clear answer about sequencing, about what dosage of the drugs we should choose and which to start first. Having no evidence in such a situation it is of great importance that we have meetings like the St Gallen Consensus Conference on Advanced Prostate Cancer. During such a meeting a panel of experts answered those questions which cannot be answered by evidence now. So we are using an expert opinion as the guidelines for our everyday practice and this is of value before we get evidence from prospective randomised trials.
Unfortunately, coming to the geriatric oncology population, which is the main population in advanced prostate cancer, most of our patients are elderly, St Gallen was not very much focussed on that topic. So unfortunately still on the part of physicians are using geriatric evaluation before they give a recommendation for a treatment of advanced prostate cancer. So we definitely need more work to be done in this field, more analysis about results which are very often as good in the elderly population as in the younger population. But we have to accept that it should be done with the tools of geriatric evaluation.