Is 76 too old for prostate cancer surgery?

Archtx
you may have been trained for the 'knack' (reteaching your pelvic floor to engage at certain times/movements for example when standing from a chair, when stretching, bending. lifting) this is a good technique
You hopefully are doing regular Pelvic Floor Muscle Retraining (PFM) Kegels in general as well.
Most sources recommend both long and short Kegels (engaging and holding for ten to 15 seconds for perhaps 5 or 10 or even 15 seconds and then series of short quick Kegels engage/contract for a second or two then release most will do these ten times in a series/
Engaging the long and short kegels target different muscle groups and responses and doing both is helpful.
I can send you some links on how to do these if you want/.

My pt also has me doing 'steps' this involves engaging about a 1/3 of the PFM hold it for a second or two then increase the engagement to about 2/3 hold this for a second or two then fully engage hold this then do the reverse. Going up and down these steps for about five or six times is part of my regular routine I do each day.two times

You are very correct in that part of the training that is very important is the releasing or resting between different engagements. It is just as important to learn to find the right muscle group, learn to engage as it is to learn to make sure you are relaxing and disengaging. This took me quite a while to learn and appreciate.
In fact, this led me to getting a hand held biofeedback device which has proved helpful., With this device I can make sure I am engaging and most importantly I am disengaging.
I have been doing Kegels for about four months and I still need to make sure I am disengaging especially with the short rapid ones. If I do not pay attention, I will quickly and fully engage with the short ones but not fully disengage before I start my next one.

Relatedly, overuse, overdoing the Kegels can really really be counterproductive. For the muscles to both relearn and grow stronger ( and build up some needed bulk) they need to be broken down and rebuilt, they need rest and a restorative process.

While I hate incontinence I do not want to blow it. I know I need to work on form and making sure that PFMs get needed rest. I lay down or recline a few times a day for 20-30 minutes, I resit the urge to push more even though psychologically I would pay the price, I would work all day long if that would only help.
I have learned via delayed reaction when I have overdone it. ( I leak more instead of less following days of too much activities)
I really hope you get better and your latest blood work is good.
Ed

My PSA was undetectable yesterday. I have worried I am not doing my muscle training correctly and made that known to the PT. I know when I started if I did a certain movement I would leak but now that is not the case even without contracting. They gave me a set of exercises to do at home which I am still doing and I try and engage the muscles throughout the day. I’ve started going back to the gym and for me that’s a good place to get them involved. I think since I stopped going to PT I am leaking more but I am not sure. Since I am just at the 6 month mark I may be expecting more of myself and just need more time. My surgeon said I would be fine at 12 weeks, boy was he wrong. Thanks for your help.

congratulations on the PSA!!!

I may not be correct but I feel like I am threading a needle sometimes. I love working out and doing things ( work, babysitting, gardening etc.) There are days when I do more and my mood definitely improves and then I feel like doing even more, for example instead of one or two walks ( just 20-30 minute walks) , I might do three. Also on days when I babysit, I feel better and do more (when babysitting getting up and down, lifting standing, sitting etc) then on those nights and even the next day I definitely leak more, Sometimes this interrupts my sleep, keeps me up more at night. It is almost as if I was being told to slow it down and allow for slower progress, If I do less, less leakage

still no matter what, I do my PFM training every day.

did you see that article on the American Urological Association website about Urinary Incontinence following RARP?? It indicates that most men get better by about nine months ( give or take a few months)
It also recommends that urologists give this information to patients

like you, I was told little about incontinence- I had to ask. then heard that it all depends, lots of variance, some guys really turn a corner at three months, etc. etc. I should have been shown this chart.
I am happy for guys that have no incontinence or turn a corner at three months, However, you and I -hopefully- may be among the majority of men that take longer closer to a year.

As an aside the recommendations for options to address incontinence if it does not resolve is eye-opening. There are some important warnings about some of the seemingly popular solution's on this list. even the clamp which I was considering seems problematic
For those who wait a year or two and may need a surgical solution this is a must read

I wonder if both of our surgeons read this report or at least keep these findings and recommendations in mind

recommendation #5 copied from this report

. Clinicians should inform patients undergoing
radical prostatectomy or transurethral resection of
the prostate after radiation therapy of the high rate
of urinary incontinence following these
procedures.
it goes into some depth about shared decision making and what patients should be made aware of

Age is different for everyone. At 70 I was a candidate for either surgery or HDR brachytherapy. I decided that the higher risks of incontinence and erectile disfunction (plus penis shrinkage) were not the way I was wanted to spend my final days. I went with brachy. It was out-patient, pain-free, and virtually no recovery for me. Your choice will depend on the state of your cancer. My prostate had lots of it and was pushing to get out (the reason I stopped waiting and had the procedure). The general view is that surgery gets rid of the cancer for sure but with a big risk of spending your life in diapers (actually pads) and no erections. While radiation can kill the cancer but might cause problems for you in 20 years. I decided that, when I hit 90, I would deal with those potential problems (also thinking that medical science will have advanced).

Have many of you opted for this treatment? I have a friend with 6 gleason and slightly rising PSA with PC in prostate gland only, no mets yet. He is thinking about this...

Sir, does this mean that you had surgery about a year after your biopsy? Asking because my Husband has to wait 6 months for surgery. Thanks!

No, my surgery was six months after biopsy. There was a long delay partly because I had to get up the courage to even have the biopsy. Like most guys I was a babe in the woods on all things prostate. I was stunend when I found out how they do the biopsy. You're going to take 12 needles and put them where?!

Then there was the big decision between radiation vs surgery and then about 3 months for the next available surgery date. I had requested to be put on a cancellation list and within a few weeks there was a cancellation!

By the way, it has now been 14 months since surgery and I still feel that for me, surgery was the right decision. My PSA has remained undetectable at 0.006, stable at 1 pad per day and ED that I can live with.
Overcoming fear was the hardest thing and my wife, was soooo helpful and patient. Best wishes to you and your husband for your successful outcome. You can do this!