Is 76 too old for prostate cancer surgery?

I was 67 gleason 6 3+3 with only 1 out of 12 cancer and no margins. Post op confirmed. I would do RP again. I have both issues. My father was similar. He chose treatment. Cancer came back at age 80 with a vengeance. He lived to be 85. I had two guys at the gym both had RP and neither had issues. I am 73. No other treatments. Pet scan was clean. PSA < .01. Testosterone at 680. My issues are troublesome but I dont worry about whats next nearly as much. I think if I had used Mayo clinic maybe a different outcome. That is probably my only regret.

I guess I'm a sucker for fixing what's wrong so I can live a very full life. At age 75 (01/2022) I had RALP. But they found I was in A-fib in pre-op. Did it anyway, so wtf. That led to a small heart monitor (just to watch for A-fib) implant 11/2022 (just local anesthesia).
Though it never showed on the scans, pathology showed PC had escaped the capsule. That led to ADT for 2 years (last shot 01/2024).
Was/am totally incontinent so an AUS installed 3/2023 - 4-hour surgery. Works great now.
Then A-fib needed an atrial ablation 10/2023 (that's a catheter up a vein from the groin and into the heart's atria to burn the mis-firing neurons). No more A-fib since. Woot!!
Recently at age 77:
10/24 repair incision ventral hernia. Relief and success!
11/24 total replacement of worn out hip. So good!
12/24 (on my 78th birthday) total replacement of knee (same leg). Better already but still doing PT visits so I'll be ready to kick-ass, take names, and have a super fun summer.
PC is still there but like the others it's resolved (for now and some ?? future).
So "surgery over the age of 75" isn't a hard and fast rule. Do what you NEED and can give you a quality of life.
I didn't think I'd have life quality: changing pads and diapers every day with a spare in my bulging pocket, nursing a hernia, fearing A-fib, hobbling slowly/painfully around on a worn out hip and knee.
I don't know how many more days the Good Lord will give me but I have big plans for each and every one and am most thankful for each one.
May you have many more fulfilling days ahead of you.

The medical field has moved back on forth on the question. You will find some doctors that still follow the old standard of "you will likely die of something else first". My view is that, with the modern options for treatment, the cancer can be treated without causing much other harm. IF you are healthy and IF you expect to live a long life (health habits, exercise, weight, genetics), then it is not too old. Though I would look at the newer radiation options before surgery. If surgery is recommended it may mean that the cancer is more serious and could cause an early death so may be indicated anyway. Get multiple opinions and seek them from the best out there.

Your description is sad . You ve been thru the meat grinder and have been Bushwacked more than once. God is taking care of you. We must thank him for this. Take care. Bruce

Michael, that’s a good analysis of one vs the other. My decision to have surgery at age 64 (even though it was my least favorite option) was partly because my surgeon said that a Gleason 4+3 unfavorable had a higher chance of recurrence; I could then do salvage radiation /ADT. However, the reverse treatment was much more difficult and he had done quite a few of these salvage surgeries and complications were high.
So that, in addition to excellent health, formed my decision. A good one it turns out, since I did indeed require salvage treatment.
My friend, on the other hand, is overweight, diabetic (controlled), and has hypertension (as do many of us). And exercise is not a big - or even small - part of his life.
He said he was scared to death of bladder and bowel issues and just terrified of surgery “down there” in general.
So why go thru any of that when there are alternatives on a par with surgery? Of course, many men over 75 still choose surgery for their own personal reasons but for me - and my friend - the least upset to the system is the best way to go - especially when the new life expectancy tables say that 76.5 yrs is the new average lifespan. In other words, recurrence may never happen😳!
Phil

Anyone discuss the high radiation which has much fewer treatments??

I was diagnosed with prostate cancer, Gleason 3/4. For second opinion went to Mayo Rochester.
I was told surgery was not an option due to my age, 77. They informed me that the cut off age is 70, unless I wished to wear a diaper for the rest of my life. Radiologist recommended 5 Proton treatments administered over a 2-week period. I was injected with Space Oar with sedation. I am happy I chose sedation because even though I could hear voices, I couldn't understand the words, a relief since there were 2 female and one male tech present. I experienced only minor side effects from the treatments. After the 4th treatment I had some difficulty urinating. I was prescribed Flo Max which instantly took care of the problem. I now been 1 1/2 years since Proton treatments and PSA is 0.01

I'm 78 and scheduled for knee replacement at the end of June. I'm on AS for a 3+4 Gleason, 2 out of 23 samples. If things accelerate with the PC, I'm going to consider RP because my prostate is over sized and I'm not a good candidate for radiation. No one has said I'm too old for surgery. I'm pretty active physically so maybe that's why it's (RP) still on the table.

I had HIFU, High Intensity Focused Ultrasound, prostate treatment at age 70. Gleason 6. HIFU melts the cancer and surrounding tissue.
I went for my annual checkup yesterday and my Uro Doc said I was still doing great after 7 years. PSA is 1.3. No protons. No surgery. Minimally invasive.
I recommend this “cure” to everyone, unless the tumor has spread beyond the prostate.

Screw your age. You want to live-get it out