1. < Prostate Cancer

I am 83 years old with a PSA of 6.5. Will have a prostate biopsy soon.

Posted by artb @artb, Feb 27 9:31am

Would be interested to know what kind of treatment options I have available, depending of course on the biopsy results. I am in reasonable good health, with high blood pressure being treated. How limited are my options based on my age of 83?

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stew80 | @stew80 | Mar 11 12:43pm
In reply to @artb "Stew: Thanks for your comments. It seems our situation may be similar. Will let you know..." + (show)
@artb

Stew: Thanks for your comments. It seems our situation may be similar. Will let you know how I make out. Best to you on your future plans. Art

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I appreciate your response Art, and please do keep us posted. I'll do the same. I get the sense there may be a bit of age discrimination in play but I also know expected longevity and grade of cancer growth vs treatment side effects and quality of life are all part of the choices we make.

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ava11 | @ava11 | Mar 12 10:47am
In reply to @psmick "My Urologist was quite upset when another MD ordered a PSA that had a result of..." + (show)
@psmick

My Urologist was quite upset when another MD ordered a PSA that had a result of 14.6. The results found their way to his desk and he called me in saying that now he 'had' to do something about it. I was 88 at the time.
A few months later, at 89, I had an MRI, biopsy, and PSMA, the latter indicating that the cancer was contained in the prostate. My Gleason was 4 + 3, as the MRI, and follow-up biopsy confirmed the presence of cancer.
Because of my age, the Urologist recommended that I do an 18 month course of ADT which included 1 month of Casodex tablets, and my first injection of Lupron D. I am on the time release 3-month Injection cycle, and at age 90, had my 3rd one on Valentine's Day.
My PSA has dropped to .03 after 6 months of treatment, and was .05 after the first 3 months. The MD wants it to be undetectable.
Side effects were hard to take during the first 2.5 months with hot flashes, muscle weakness, weight gain, and no energy/fatigue. The only remaining one is a 6:30a hot flash, the others having dissipated.
I do my best to stay active walking 2-3 miles each morning and watching my diet.
Other that the Urologist's disdain, I am pleased with how treatment is progress thus far.

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Did you have a PSMA-PET scan before treatment? I have 2 gleason 4+5 cores on my biopsy.
Should I get a PSMA-PET scan before starting Radiation treatment?
Thank you

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psmick | @psmick | Mar 12 6:17pm

Yes, I had a PSMA as my last test before starting treatment. Gleason is 4+3. Am in my 8th month of ADT, and my PSA has dropped from 14.6 to 0.2.
I would think that a PSMA is advisable before starting any PC treatment.
Good thoughts!

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artb | @artb | Sep 6 9:30am
In reply to @ava11 "artb: I am 88 years old and in good health. My PSA was 9.6 last october...." + (show)
@ava11

artb: I am 88 years old and in good health. My PSA was 9.6 last october. DRE found a nodule. MRI showed a lesion with PIRADS score of 5.My Urologist said to wait couple of months. PSA went up to 13.0 in January 2024. Now my transperenial biopsy is scheduled for next week, March 5th at UCI.
I am very surprised your GP didn't refer you to a urologist earlier! but, no worries. Waiting will have not reduce out longevity or quality of life from what I read.
Good luck to you.

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Since then with 2 1/2 months of Adt (Abieterone) and now 2 weeks of IMRT my testostorone is Zero and the PSA is .o5. Will be on ADT for at least 2 years. Have noticed that since the radiation treatments have started, my lower back/hip is starting to act up. Is this one of the typical side effects of ADT and IMRT? Has anyone out there had similar side effects and if so, what is recommended for treatment. Art B

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1 reply
jeffmarc | @jeffmarc | Sep 6 10:27am

This question is from February. Really is time to close it out.

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ecurb | @ecurb | Sep 6 10:29am
In reply to @artb "Since then with 2 1/2 months of Adt (Abieterone) and now 2 weeks of IMRT my..." + (show)
@artb

Since then with 2 1/2 months of Adt (Abieterone) and now 2 weeks of IMRT my testostorone is Zero and the PSA is .o5. Will be on ADT for at least 2 years. Have noticed that since the radiation treatments have started, my lower back/hip is starting to act up. Is this one of the typical side effects of ADT and IMRT? Has anyone out there had similar side effects and if so, what is recommended for treatment. Art B

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My response: probably not. I went to a CHIRO, had X-ray done in his office- I have spondylolithesis. He made an adjustment to my lower back and I was fine the next day. Had radiation treatments in March 2023- 28 visits. Had. O effect on my back pain. Go see if something else is causing the back pain as I did. Just my suggestion- good luck guy.

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heavyphil | @heavyphil | Sep 7 7:46am
In reply to @ava11 "artb: I am 88 years old and in good health. My PSA was 9.6 last october...." + (show)
@ava11

artb: I am 88 years old and in good health. My PSA was 9.6 last october. DRE found a nodule. MRI showed a lesion with PIRADS score of 5.My Urologist said to wait couple of months. PSA went up to 13.0 in January 2024. Now my transperenial biopsy is scheduled for next week, March 5th at UCI.
I am very surprised your GP didn't refer you to a urologist earlier! but, no worries. Waiting will have not reduce out longevity or quality of life from what I read.
Good luck to you.

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My hat’s off to you for still pursuing diagnosis and treatment at age 88. Most men would probably do nothing in your situation.
Hope all goes well with your biopsy. My only suggestion as a layman is to treat whatever it is in the least invasive way possible. Surgery really should be off the table at your age - or anything that poses a greater harm to your longevity than the disease. Best to you!

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1 reply
chipe | @chipe | Sep 7 8:07am
In reply to @rick137 "Additional comment: One good, no great, aspect of being in your 80s is that "The Tyranny..." + (show)
@rick137

Additional comment:

One good, no great, aspect of being in your 80s is that "The Tyranny of the Testicles" has abated.

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"The Tyranny of the Testicles"??? Never heard this before. lol. What does it mean?

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1 reply
rick137 | @rick137 | Sep 7 8:41am
In reply to @chipe ""The Tyranny of the Testicles"??? Never heard this before. lol. What does it mean?" + (show)
@chipe

"The Tyranny of the Testicles"??? Never heard this before. lol. What does it mean?

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@chipe

Just my joking way of saying how much the thought of sex occupies your mind during most of your life. It is Nature's way of constantly reminding you that your function is to reproduce.

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Sicetnon3 | @sicernon3 | Sep 7 10:20am

Hi RonC,

I was is a similar situation and was told by my urologist that they would discourage surgery at my age because of the high probability of incontinence. They recommended radiation followed by androgen deprivation treatments (hormone therapy). I didn’t want to be wearing a diaper in my old age so I opted for the radiation and hormone therapy. So far, so good. My PSA has been at 0.0 for quite a while now. My biggest issue has been fatigue. Still that might just be age related. Hope his helps

All the Best,

David

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