@kingsiang
I got prostate cancer at 62 and had surgery, That was followed by radiation 3 1/2 years later. I have a genetic problem that causes my cancer to keep coming back, so that was probably the best choice.

My brother got prostate cancer at 77, He was on active surveillance for six years before. He had a Gleason 4+3 and had 5 sessions of SBRT radiation. Three years later, his PSA has stayed stable. There is Usually no need at that age to do IMRT radiation. SBRT is just as effective and actually kills the cancer cells more aggressively. They usually don’t like to do surgery on somebody that’s 76, The long-term results are just as good with radiation.

You may need to find another center of excellence so that you can Have the option of SBRT radiation. You should talk to your radiation oncologist about this.

Yes, they do usually want you on hormone therapy (ADT) after radiation, for a Gleason eight they recommend 18 months. In some cases that may not work well. It can affect your blood sugar And cholesterol. The drugs I have taken for prostate cancer gave me high blood pressure, but I take three pills twice a day and they keep my blood pressure quite under control. You can control these problems by eating carefully, Watching how much sugar and cholesterol are in food you eat. I have very low cholesterol and a very normal blood sugar But I’m very careful about what I eat.

I am 78 and run 1 mile twice a day every day. I also go to the gym three days a week to do weight training. If you go on hormone therapy, you really need to exercise and do weight training or your muscles will deteriorate and you will frequently have fatigue. I’ve been on hormone therapy for eight years because my cancer keeps coming back due to genetic issues. While it seems counter productive to do exercises when you are fatigued by the hormone therapy. It actually works just the opposite and gives you more energy.

Just some things to think about and talk to your doctor about.

@kingsiang I’m surprised the oncologist wants surgery at your dads age and underlying medical problems. He must not be in that bad shape because if something goes wrong you can sue him. If it was me I’d go with surgery. I have too much going on hypertension, asthma and other things. Radiation after 8 treatments I developed bad diarrhea and couldn’t eat solid food for 2 weeks. Good luck making your decisions I wish you and your dad the best.

@kingsiang
I am 92 years old now and had IMRT radiation to my prostate a few months ago. During treatment and shortly afterwards I had more frequent urination and bowel movements. Some small incontinence when I go up at night to go to the bathroom. Wetted my pajamas on the way to the toilet. Now there are no side effects. I had been on ADT (Eligard and the Zoladex) for 20 months prior to the radiation and will continue for 2 to 3 years after because my Gleason score was 4+4 = 8, considered high risk. PSA prior to ADT was 14.1, immediately prior to the radiation it was 0.944. The PSA at 5 months after radiation is 0.037. All the literature I have read says that a PSA value like that means a low chance of recurrence in the near future. Basically the radiation of 28 sessions did not cause any fatigue, and I was able to continue life as normal including gym sessions right after radiation 3 days a week.