Is 76 too old for prostate cancer surgery?

A surgeon, in an interview with Dr. Geo, aired on the Dr. Geo podcast, I don't remember which surgeon or which episode, told a story about a guy over 80 who wanted surgery. The doc turned him down but the guy insisted. So the doc told him his usual story when he turns down a guy who he thinks is too old or too frail to undergo surgery: if you can bring your mother in and she tells me I need to perform surgery on you, I'll do it. The guy brings his mother in. The doc performs the surgery.

@readandlearn I am 70 and having surgery on March 3. I hope I have the same results.

@climateguy "... The guy brings his mother in. The doc performs the surgery."

Good story. He's measuring genetics (or longevity). I missed his ultimatum by one year: My mother died one year before my surgery (at 103).

Not only (at 81) can I get off the floor without using any nearby support, I can do it without any use of my hands (eg, to simulate a fall resulting in two broken arms). It's not a trick:

1. Start with laying on the floor with your hands clasped in front of you.
2. Sit up. Then bend your lower legs (both to the left or right) to get them as close to your body as is comfortable.
3. Then position your knees AS FAR AS POSSIBLE from each other (THIS IS THE KEY). The imaginary line that connects your two knees becomes the pivot edge for the next two maneuvers.
4. Bend your lower legs some more to get your feet on the same side of the pivot line as your butt is & as close to your butt as is practical.
5. You then rock your upper body back & forth toward the pivot line. Your objective is to rock forward far enough that your butt comes off the ground & your center of gravity passes over the pivot line.
6. AS SOON AS your butt comes off the ground & your center of gravity passes over the pivot line, you must quickly relax your rocking motion & assume an upright kneeling position. Your feet will now be where your butt was, & you should be in a stable kneeling position.
7. You then stand up from a kneeling position. This the only part that requires any strength.

With a little practice, you can show off in front of a great many people younger than you who can't do it. It is a useful emergency maneuver.

@readandlearn Great tip! I’m gonna cancel my LifeAlert!🤣🤣
Actually not that funny; my mother was enrolled in one of these and it took a death certificate to end the ‘contract’. Worse than Columbia Record House!!!
Phil

@ecurb
What were side effects like? I’m 75, just diagnosed, having PET Scan. Thinking of doing nothing, I have a good quality of life right now. Thank you

@paullvlc
My brother at 77 had five sessions of SBRT radiation. His PSA has pretty much settled down in the three years since. He did have small cribriform And it doesn’t seem to make a difference.

At your age, there’s no reason you need to have surgery, SBRT radiation is very common.

See what the pet scan shows, If it is clear then that’s probably all you need.

They did give him ADT for six months because he had a Gleason 4+3. The only problem that caused was some hot flashes. The radiation caused some cystitis and he had to take Flomax every other day for a couple of months, but then everything cleared up.

You don’t mention anything about your diagnosis, That could make a big difference. What was your PSA? What was your Gleeson score? Did you have a decipher test?

@jeffmarc

PSA 7.1. My primary first started watching about 7 years ago, been seeing urologist 3 years.
Gleason 7s and one 8 on one lesion. Thank you

@paullvlc side effects are loss of hair, low T, fatigue, weight gain. I was Gleason 8-9/ metastatic to lymph nodes, seminal vesicle. ADT-28 months of treatment/28 RT trips.. Been < .01 for over two years. Jeff Marchi is the Einstein on this Mayo forum. I m a novice reporting to you my ADT results. I m 77 today in remission.

@paullvlc
If you have one Gleason 8 you are a Gleason 8. The 7’s don’t matter to the doctors.

That is aggressive and ADT is usually called for with a Gleason eight. You probably could have SBRT radiation along with ADT and be done with it.

This may be pertinent...
https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/168250-natural-history-of-untreated-prostate-cancer-a-comprehensive-review-of-long-term-progression-patterns-and-survival-outcomes-beyond-the-abstract.html
Kevin