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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I had RP at 71 PSA 43 Gleasons 7-9 Left me a eunuch (ED) in a perpetually very wet diaper, (this was BY FAR the worst SE from the surgery) really no other choice as my PSA and Gleason scores were so poor. Recovery was O.K. A week with wound drain tube and urine bag and catheter. Uncomfortable for sure but only for a week. I was very fit after over 40 years of Rugby. No other health problems at all. "Sportin Wood" is a thing of the past. Bummer!
Best
SW

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@laccoameno5

I had RP at 71 PSA 43 Gleasons 7-9 Left me a eunuch (ED) in a perpetually very wet diaper, (this was BY FAR the worst SE from the surgery) really no other choice as my PSA and Gleason scores were so poor. Recovery was O.K. A week with wound drain tube and urine bag and catheter. Uncomfortable for sure but only for a week. I was very fit after over 40 years of Rugby. No other health problems at all. "Sportin Wood" is a thing of the past. Bummer!
Best
SW

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So sorry to hear that you have bad experience with side effects : (. How long ago was your surgery, if you do not mind me asking ? Did you consider restoring urinary control through procedures like male slings or the artificial urinary sphincter (AUS) ? There is also new method called ProAct.

Also, if you go through posts on this forum you will find a lot of advice about possibly solving ED problem.

I really hope that all will get better with time .

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@surftohealth88

So sorry to hear that you have bad experience with side effects : (. How long ago was your surgery, if you do not mind me asking ? Did you consider restoring urinary control through procedures like male slings or the artificial urinary sphincter (AUS) ? There is also new method called ProAct.

Also, if you go through posts on this forum you will find a lot of advice about possibly solving ED problem.

I really hope that all will get better with time .

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My RP was done May 2019. Those products you suggest are 1) some kind of valve or AUS implanted pressure point to control stress incontinence caused by lifting, sneezing, ccoughing. It's really just artificial plumbing. Quoting my oncologist: How many pads a day do you use? Pads? Well doc"I just use a trash can liner and wear it as a kilt". Stress incontinence? Ha! mine is more like a slightly running faucet all the time except slightly less when laying down. 2)Others suggested are just really heavy duty vinyl diapers, as above just loads of Depends with paper towels as a back up. I have also found it wise to check ahead at any upcoming social venue to make sure seating is plastic or vinyl. Just the best live in girlfriend 12 years now. No woman would tolerate an impotent old geezer leaking all the time.
My reality, coupled with the horrors of Lupron, I now know what hell is like
SW

REPLY
@laccoameno5

My RP was done May 2019. Those products you suggest are 1) some kind of valve or AUS implanted pressure point to control stress incontinence caused by lifting, sneezing, ccoughing. It's really just artificial plumbing. Quoting my oncologist: How many pads a day do you use? Pads? Well doc"I just use a trash can liner and wear it as a kilt". Stress incontinence? Ha! mine is more like a slightly running faucet all the time except slightly less when laying down. 2)Others suggested are just really heavy duty vinyl diapers, as above just loads of Depends with paper towels as a back up. I have also found it wise to check ahead at any upcoming social venue to make sure seating is plastic or vinyl. Just the best live in girlfriend 12 years now. No woman would tolerate an impotent old geezer leaking all the time.
My reality, coupled with the horrors of Lupron, I now know what hell is like
SW

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I can imagine how challenging it is and I am truly sorry that you have to endure that :(.

Did you ever have chance to talk to very competent urologist, somebody who specializes in correcting incontinence ?

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@surftohealth88

I can imagine how challenging it is and I am truly sorry that you have to endure that :(.

Did you ever have chance to talk to very competent urologist, somebody who specializes in correcting incontinence ?

Jump to this post

Urologist and oncologist? Yes on both counts. I have learned while both are full of suggestions which are pretty much the same as you stated. Really nothing can be done, I just carry on and try to not let the rage of my condition overcome me. Very sorry to sound so bitter. You have been so kind in your posts.
Best and leaking on,
SW

REPLY
@laccoameno5

Urologist and oncologist? Yes on both counts. I have learned while both are full of suggestions which are pretty much the same as you stated. Really nothing can be done, I just carry on and try to not let the rage of my condition overcome me. Very sorry to sound so bitter. You have been so kind in your posts.
Best and leaking on,
SW

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You have full right to feel upset, it is very uncomfortable and limiting condition. Maybe you can go and visit Mayo clinic to see what they can offer since I hear that they have many unusual and innovative treatments for about anything under the sun. Also, maybe you can try one of the above mentioned treatments and at least get to "stress incontinence" level for the beginning ? I guess it would give you much more freedom than having to worry about it 24/7 ? 🙁 There was one member here that mentioned AUS recently, I am sorry I forget who it was but he was very happy with it. He also had other surgeries done to help with mobility ( I think knee replacement and hip replacement) - sometimes we are dealt bad set of cards but we have to push forward, if nothing just "to spite" bad circumstance.. You mentioned that you were into sports - an athlete in you is still there, I am sure of it ! You can push thru this hurdle - don't give up looking for a solution. Just find really competent surgeon that specializes in this particular problem. Every specialist has "sub specialty" that he likes to pursue. Are you close to any big and well known medical center ?

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@surftohealth88

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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This is, a very clean and simply put definition of surgery vs radiation proceedures. Diagnosed with cancer in 2021 the yr I retired, and active surveillance for 3 yrs +. All was fine, until my last MRI revealed = Margin: Lesion is 2mm anterior capsular bulge. Now I have opted for surgery. 69yrs old, I want to live and enjoy my retirement without all this on going worry, worry, worry. Thanks for your post. You sound like a professional,, maybe are. I have a box in my garage full of info on the prostate, prostate cancer. Confirms a lot of what you said simply. A big box of Worry I put in my garage. Off to see the Robot coming up soon! Thanks for the post!

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