PSA jump 16 to 30 in 6 months. Radiation candidate?

One important thing is what Gleason score they found. I would assume you had a biopsy since they want to do radiation. Fact that the pet scan found nothing is really a positive thing.

Was anything else found in the biopsy like intraductal, cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions)

All of these can mean it is more aggressive, and that treating it may make sense.

If none of those things are found, and you have a Gleason score of seven You could ask your doctor to just put you on Nubeqa. It is the one drug that will stop your cancer from growing and spreading with very few side effects. It has the least side effects of any of the drugs available.

You don’t need ADT if you get on Nubeqa. I know a lot of people in their 80s that are using that as their only drug. I’m 78 and I’ve had prostate cancer for 16 years, Nubeqa Has made a major difference in my status because I’ve been undetectable for the last 24 months.

Hopefully this is some information you can use to get the type of treatment you are looking for. This gives you some things to discuss with your doctor.

What is your Gleason score? If by ‘late 80’s’ you mean ‘almost 90’ you are probably one of those men we’ve all heard so much about, but have never actually met: one who will die WITH prostate cancer, but not FROM it. Best,
Phil

I believe the videos on the PCRI-org You-Tube have ideas on the subject. 5 sessions of SBRT. 5 sessions ( e. g. , Cyberknife), for if you are up for a procedure low dose brachytherapy ['permanent seeds'] My father had an atrial valve and 3 vessel by pass at 88, then a two chamber pacemaker at 92. He was called to the next assignment at 95. Jeff's medical approach sounds like the best option with Nubeqa.

What is your:
> PSA? PSA Doubling Time?
> Gleason score?
> SUVmax score?

Will you be continuing with watchful waiting or active surveillance?

Agree with @brianjarvis about those additional data being important to making a decision to treat or not.

Also, some other numbers to weigh. If you do radiation therapy for six weeks (42 days) and live three more years (1095 days), the stretch of radiation therapy will involve ~4% of your remaining life. Big question: Is that a worthwhile investment for you?

I am just finishing 8 weeks of radiation therapy (age 73). It has gone well, but it is not a cake walk, and requires some dietary and lifestyle commitments to mitigate side effects and improve the outcome.

Bear in mind too that radiation does not instantly kill off the cancer cells. It could be 3 to 6 months (or more) after treatment before the maximum effect of the radiation takes hold, and that is generally determined by follow-up PSA testing.

Pre-diabetes (I’m pre-diabetic) should not be a problem with radiation treatment, but absolutely discuss all your health concerns with your doctors and care team.

I really can’t weigh in what looks like the best course for you. All the previous comments have laid out the types of information that will help you make a decision that is right for you.

Best wishes,
M

Augustahus: The radiation proposed by your Oncologist looks like the correct course of action. Why are you waiting?.

You have not given your Gleason score but the PSA doubling time of about 7 months appears to indicate a fairly aggressive and fast-moving cancer.

I just turned 92, had a Gleason score of 8, fully active, in good health with hypertension. high lipids and pre-diabetic glucose, all under control with diet, exercise and medication. PSMA-PET scan showed one tumor in the prostate with no spread beyond the prostate.

I was treated with Androgen Deprivation Therapy (ADT) for 20 months before my radiation treatments. I expect to continue the ADT for 2 to 3 years after the radiation.

I completed 28 sessions of Intensity Modulated Radiation Therapy (IMRT) as my primary treatment 4 months ago. Very easy, I was able to go to my exercise classes after the therapy, and had minimal side effects during and for 2 months after radiation. Now there are no side effects. For me, the radiation was a “cake walk”.

The PSA decreased to less than 0.1 within 3 months following the therapy, and it is still falling.

Good luck with your treatments.

@overage
At your age, it is fantastic to hear you are not having a problem with ADT and that radiation didn’t affect you and you were able to continue your activities even though you were going every day for treatment.

I had eight weeks of radiation so I had lower amounts of radiation and I had no side effects and went to work right after, Had it done first thing in the morning. Not many people are able to say they don’t have a problem with it.

A lot of people in their 60s and 70s are crippled by ADT.

I’m 78 and I’ve had ADT for eight years now. Can’t stop because my cancer keeps coming back because I have BRCA2. Still going strong after 16 years of PC.

The guy that runs ancan.org Had a Gleason eight and had radiation at UCSF 17 years ago and he has had no recurrences since. They have some really great meetings for advanced prostate cancer and many other issues. They have a great news newsletter that comes out every week that discusses some of the latest things going on in prostate cancer. Worth signing up just to get that newsletter. He could also watch some of the older weekly meeting since they are recorded.

@jeffmarc Thanks Jeffery your response is appreciated. Urologist hasn't mentioned ADT yet but I will certainly ask him about it at our next get together as well as the Nubeqa. Cancer was found in 3 areas, out of 12 biopsys with gleason scores of 8,8,7. Reason jump suggests more agressive treatment may be recommended by the Urologist.

I am 89 and in reasonable health however on lots of pills for Coronary Artery calcification plaque problems with moderate reduced blood flow. Cardio doc thought that would eventually get me as the best I can do now is to slow down the plaque buildup.
Art

@jeffmarc Thanks for your reply Jeff. Ok on the newsletter, I will check it out.
I forgot to mention gleason scores in my original note, they are 8,8, 7 found in3 of 12 areas in the prostate. I haven't had radiation but have discussed that at length with an oncologist.
I have been doing watchful waiting since early in 2025 with no meds being taken for prostate
cancer .

@heavyphil Gleason scores were 8,8,7 in 3 of 12 areas biopsies. My age is 89 and my main problem currently is CAD (coronary artery disease) which has slowed me down a good deal due to a reduced blood flow. Seems that having a low LDL for many years has contributed to more calcification buildup. That was likely going on for years and the MDs did know that but hadn't recommended any treatments of meds until this year when I developed moderate symptoms.
Art