What is treatment for Gleason Score 8 at 80 years old in good health?

@sodogo I'm your age and recently finished a course of SBRT two months ago. My psa had spiked to 17 and two adjacent biopsy cores had G9 lesions. I started taking Orgovyx a month before the SBRT and am still taking it. My PC was mostly localized to the prostate (clean PET and bone scan) but with two small lesions in adjacent lymph nodes. Except for the pre-treatment prep each day, the treatment was easy. I walked a couple of miles to and from the hospital and never felt affected by the radiation. Starting a couple days later, I had frequent urination and GI issues, all of which slowly abated over two weeks. I now feel fine with no side effects except for the irritating warm flushes that come with the ADT. Surgery was not recommended and I had the choice of 28 sessions of IMRT given locally or SBRT at another hospital which is a center of excellence. I'll have my first PSA and T sample taken in a couple of weeks. Hoping for a good outcome.

@heavyphil Oh, for sure I do. (Know limitations of AI) I heavily researched side effects, and just found it easier to link/show the compilation of research rather than lots of individual studies.

Totally agree that WE are all individuals and our reactions are somewhat unpredictable. My urinary discomfort, as I call it, put me in minority of patients, yet here I am.

@overage What I plan to do is go to a end of life act state before I’d allow prostate cancer to take me.

@tdoriausername Low on the list of things to worry about. The leading cause of death for men with prostate cancer is cardiovascular disease. That should be higher on the list as it relates to end of life planning.

Deaths due to heart disease, stroke, suicide, & lung cancer are higher - again, higher on the list of concerns as it relates to end of life planning.

Though prostate cancer is the most diagnosed cancer in men, its mortality rate is one of the lowest.

@brianjarvis I have to agree with you. I believe the medical profession has spent more time on treating the PC diagnosis than necessary. I was diagnosed in 2015 and told I had five years unless it treated it. Here I am eleven years later and I’m still in active surveillance… no treatment. The doctor that diagnosed me wanted to remove my prostate. That would obviously have been a mistake.

Watchful waiting is the term normally used. Research the best diet (Med diet is recommended); exercise, and the usual "no go items" like smoking, excess alcohol, etc. No one lasts forever...

How long do they want you on ADT? My husband has a similar situation PSA 9, Gleason 7 unfavorable 76 yrs old in excellent health, diet and exercises daily. He was treated in France with 8 wks of radiation and the radiologist recommended 2-3 yrs of ADT which seems to be an established protocol. He is in the 6th month and starting to have fatigue, weakness and joint pain. We are trying to find out if that is a similar duration in the United States for his situation or a protocol applied systematically in France. I know there is more and more controversy over ADT duration vs side effects and quality of life and progression of the cancer.

@lamer25
One thing that can beat the fatigue is to exercise, walking, Running doing weightlifting can be really good for the fatigue and prevent the borne deterioration and muscle deterioration the drugs cause. It does seem counterproductive, but it works for almost everyone.

As for the joint pain, You should speak to your doctor about this and maybe try to get a palliative care doctor to work with him to resolve the problem. I take gabapentin and it works for me, but it is something you need a prescription for so you need to talk to a doctor and see what they recommend.

I’ve been on ADT for eight years and I’m 78. I have no fatigue really but I run a mile twice a day on a track and go to the gym three days a week to do weight training.

@jeffmarc

Everyone is different. At age 82 my side effects were absolutely horrible, and I believe that an additional month of Lupron beyond 4 months would have killed me. Soaking cold sweats 24 hours/day, 24 hour/day migraine headaches, pain in my bones and joints, frequent urination, no libido, and brain fog. Started with PSA = 11 and Gleasons of 3 ea. 3+4 and 1 ea. 4+4. Six months after 44 radiation treatments and 4 months of Lupron my PSA has been undetectable, and my testosterone has risen to 122 from < 8. Side effects just started to wane 6 months after stopping Lupron. I have always exercised hard at least 4 days/week and still do but had to reduce my speed on the treadmill from 4 mph to 3.3 mph at 10% incline for 40 minutes.

@pesquallie
Must admit your side effects are quite unusual. I go to nine online meetings every month and never really hear people describe such extreme problems. Hopefully your rising testosterone is gonna resolve this for you.

As you probably noticed on here, your side effects are a lot more serious than almost anybody else describes. I do try to tell people that if they are over 80 it can be really tough on them. Getting on a drug like Nubeqa Alone and can keep the PSA undetectable and also reduce the side effects to almost nothing. If you have to go back on treatments, see if you can talk to your doctor about having that option. I know a lot of people in their 80s doing that, solo Nubeqa.