Is 76 too old for prostate cancer surgery?

I was diagnosed in late 3016 and after removing cancer from the bladder I had a prostatectomy in 2017. I was 76 years of age and had no problems with the robotic operation even though it's a 5+hours job. I had a Gleason score of 9.
Post op I have been on ADT (ZOLADEX) with a PSA of 0.001. Sex life is non-existent but I haven't suffered from incontinence at any stage.
If my Urologist had told me I was too old, then I would quickly have sought another opinion. I am now in the 9th year of fighting Prostate cancer, that has metastasized, bladder cancer with a visit to the hospital in 3 days to check out the bladder and an aggressive form of Leukaemia. I do suffer from fatigue and continue to work on that.
The decision is yours, I have always taken the position of being responsible for my health, I have a good medical team that advise me and I take their advice, research the issue, and then talk to them about my decision.
Stay strong and always check things out if you have any doubts. Good Luck.

@steve10114, have you had your encounter with the robot? 🙂 Is the big box of worry staying put in the garage?

Yes, I've weeded out a lot of unessesary information. Now I know, based on facts what the correct decesion is for me. There is so much information out there, overwelming. Thank goodness I had time to make up my own mind, what is right for me. If I never had the PSA test, like some doctors think is ok, would not have caught it early. I guy down the street went that route, untell he had blood in his urine. Doom! I think Everone should get the PSA test.

I am 78 and had my prostate removed last December. The urologist said I was on the edge of even being considered for surgery and recommended I meet with the radiologist so I could understand the pros and cons of each procedure. I didn’t want to deal with hormone therapy so I went the surgery route. For me it was the right choice as the cancer was completely within the prostate. The surgery was the robotic type and there were some lymph nodes removed but at 12 weeks the PSA levels were undetectable. I go tomorrow for my 24 week blood work. The only negative experience has been dealing with the incontenance. It’s driving me crazy and that makes it very hard on my wife. Even after 3 months of physical therapy for pelvic muscle strength there has been little improvement.

I had surgery at 74 & 8 months plus a year of Lutron and Erleada Now 40 months post surgery PSA is undetectable. I am G 9, CR , locally advanced, aggressive and reasonably happy for a 78 year old. Surgery was a good and lucky choice for me.

I am 71 similar to you the surgery was fine but incontinence is horrible

you might be interested in this article https://www.auanet.org/guidelines-and-quality/guidelines/non-oncology-guidelines/incontinence from the American Urological Association if you got the PDF version check out Table #1 according to this most make significant progress between five and ten months
I wish my urologist had made this article availabel to me

Thank you very much. My urologist said I would be fine at 12 weeks and treated incontinence as “everybody has it to some degree” but when you have no control and soak the pad that’s more than a dribble. It’s hard mentally and emotionally when I am scared to go out for the fear of what could happen.

I met a gentleman recently who wore a diaper 2-1/2 years following RP until he had a "sling" procedure and has been continent since.

I could not agree with you more. Incontinence sucks. I hate it

I really think many urologists are really good at surgery and diagnosis but many are not so good with the side effects and follow through.I have been doing extensive research on incontinence following RARP and have learned that my doctor is not aware of the current research and recommendations. In fact, I have had to disregard a few things he has recommended. ( I checked with other urologists and the research)

The research shows great variance in incontinence following RARP.
Some have no problem, some have life long problems. It seems the big trends are
1. the majority of men have incontinence issues (and ED and a small percentage other things like hernias, UTIs etc)
2. There is no consensus on how many Kegels one should do a day this is cited in the most recent meta-analysis of RARP and incontinence.
3. The research supports pelvic muscle rehab and bladder re-training following RARP and for Kegels. better results when the training starts prior and following surgery, better results with a pt and perhaps feedback.
4. evidence supports that you can definitely overdue kegels So while there is no consensus or even standard recommendation re Kegels (Pelvic muscle training) we need to beware not to do too many it can definitely be counterproductive
5 some medications can help
6 the results are mixed with regards to 'devices' such as pelvic muscle trainers ( Simulators), the emsella chair and other 'short cuts' Some report that these help, some report big problems and set back
7 It seems a majority of men recover between five and ten-12 months. Again better recovery with pelvic floor muscle retraining etc.
8, If after a year 9 for some six months, for some 18 months,t here are options.

Like you, it is both a physical and mental exercise. mentally, when I hear others say 'just live with it' "Get on with your life" I grit my teeth. if only it was that simple.
I think about incontinence almost every waking moment. I do not want to be around strangers and in many instance my family and friends. even alone, I hate it.
I spend most of my mental energy learning everything I can so I do not miss a trick, so I do not waste one day and can sooner or later get back to normal or close to my pre-surgery normal.

some ask would I do the surgery again?

In a heart beat. Incontinence is better than cancer.
Regrets?
I wish more urologists would be upfront about this very difficult price to pay.
I wish more urologists would learn more about incontinence and offer support. I would pay out of pocket if there were an area 'expert on incontinence following RARP>

I really hope the research continues and more is learned about this.
It worries me that so many men out there are being exposed to bad information ( e.g. ' do 100 kegels a day no pain no gain' just live with it' wear a clamp and pretend it is not a problem. How is any of this helpful??

What I learned about physical therapy and pelvic muscle strengthening is they teach you to contract the pelvic muscles when you make certain moves (exercises) and I know my muscles got stronger as they either increased the resistance or degree of difficulty but as soon as I walked out the door and relaxed I would ‘void’. If I could remember to contract 24/7 there would be no issues.