Is 76 too old for prostate cancer surgery?

Posted by bobv48 @bobv48, May 25, 2024

A urologist my brother asked regarding my wondering about surgery vs radiation said that no one 76 years old should get the surgery. Does this square with what anyone else may have heard?

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Patrick Walsh MD the father of Robotic Surgery once said that he would not do prostate surgery on a man over 70 unless he brought his parents in too.

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I had surgery when I was 73. I’m grateful to be continent and able to embrace an active lifestyle.
Good luck with your decision.

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What is more important to you now? Quality or Quantity of years? Make sure you understand the side effect of the treatment that you choose. Once it is removed there is no turning back. Good luck with whatever you choose.

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I was 74 when I had robo surgery at UCLA and that was about 4 years ago. My initial prognosis was very poor. I have had good results, G9, locally advanced, CR, aggressive. My treatment was part of the Erleada clinical trial and I am thankful for the results and inclusion in this trial. PSA still undetectable and no salvage radiation thus far, knock on wood!

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Hi Bob, I think depends a lot on your current health they don’t call “radical” for no reason besides the surgery it’s the healing and recovery processes that also takes a toll on our bodies. I would have a second opinion perhaps you could find a alternative treatment, I’m not a Doctor so that is just my opinion

Zzotte

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I agree with this comment. I went into PC surgery in really good shape otherwise, but I was pretty much confined to just walking for months after my surgery.

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I am 71 and just had prostratectomy. It is no walk in the park however, I would do it at 75.
I would imagine your fitness level, how aggressive the cancer is and how comfortable you are with surgery and then possibly ED and incontinence need to be considered among other things
If you believe you will live longer than the prostrate cancer (in other words putting it off might take away some years you want)then I would go for it
just my two cents

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@jbonsoe

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

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Wow, that’s surprising - 70 is the cutoff for all surgery? Seems kind of rigid since some men would still want it over radiation. But I think it is a very honest, realistic assessment of how far radiation has come in the last 10 years. Thanks for the info!
Phil

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I don't think there should be any arbitrary limit for surgery - everybody is different. There are men who are super healthy at 70, very active and fit and on the other hand there are 50 year old patients that are overweight, have diabetes, high BP and live sedentary lives. How is 69 different than 70 ???

BOTH methods have pros and cons and one should choose the one that is the most promising for good results and possible long term remission.

Both methods can cause incontinence and ED, and radiation can cause problems with chronic proctitis, secondary cancers, strictures, scar tissue, cystitis etc.

Unfortunately neither method is walk in the park. What will one choose should be first and foremost determined by type and grade of cancer. If there is no difference in possible outcome than patient can choose but with understanding that both can have negative side effects .

It is also very important to know that results will greatly be influenced by experience and expertise of surgeon and radiologist.

There is one more very important factor IMHO - the fact that one can have radiation after RP if needed, but one can not have radiation twice for the same area. Also, RP is the only way to actually examine prostate and see in detail what is going on and if there is a possible breach of cancer outside of a gland. During RP doctor can also harvest some of the lymph nodes and examine them for metastasis and according to findings adjust further treatment course.

Bottom line - there are so many factors that need to be considered and it is not just matter of simple "preference" or just "age".

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@hbp

I was 74 when I had robo surgery at UCLA and that was about 4 years ago. My initial prognosis was very poor. I have had good results, G9, locally advanced, CR, aggressive. My treatment was part of the Erleada clinical trial and I am thankful for the results and inclusion in this trial. PSA still undetectable and no salvage radiation thus far, knock on wood!

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Hi HBP - I am so glad to hear about your good results. Are you still on Erleada if you do not mind me asking ? Thanks in advance : )

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