Is 76 too old for prostate cancer surgery?

At 75 I was Gleason 9 and had surgery at UCLA and I had a year of lupron and Erleada. I am now 79 and I have had a PSA of .01 for the last 4 years. I have not needed salvage radiation yet but that is probably in my future. I am hoping for many more years ( maybe make it to 90). I have had good results so I am thankful that my UCLA doctors got me into surgery but surgery is not the best route for every senior at Gleason 9.

Hello,
Well...there are two ways to view that question:
1. Your question could have as its premise in whether the body of a 76 year old man can tolerate and have a positive outcome after the surgery...survives the surgery with no short or long term negative consequences. Only your brother and his physician can determine that based on any other health conditions that he may already have and are already limiting his longevity. Or...
2. Your question could have the premise based on the often spoken saying that "most men will die of something else before they die of their prostate cancer." To that I say: "every cancer is different." When was it found? Was it found with a Gleason Score of 9, a PSA over 20, and a positive PET Scan suggesting metastasis, or was it found with a Gleason Score of 6 or 3+4=7, a PSA less than 10, and a PET Scan suggesting that it is prostate-confined? Those are two vastly different scenarios that suggest different potential longevity.
One last consideration is family history. Have other men in your family had prostate cancer...father, or either grandfather? If so, how long did they live "with" the cancer, or "after" any treatment like RP surgery or radiation? If they were diagnosed in their mid-70's...how long did they live with the cancer if they did not seek treatment?
My father lived with prostate cancer until he was 99 years 10 months old. He died of old age, although he had a horrific last five years with 10-12 UTI's per year. My maternal grandfather lived to 96 and died of Alzheimer's, not his prostate cancer that he had for between 15-20 years (between mid 1970's and 1992. If there is a familial history, then consider it...how long did each man live with it, or following RP surgery and/or radiation? Your brother will likely follow the same history, therefore help him base his decision on that. Good Luck to you.

Well, I had my RALRP at age 76. My surgeon advised against it at my age, suggesting radiation instead.

I wasn't having any of that & had him do the surgery (U. Wash Medical Center). It was a "non-event" with no pain & no incontinence. I've had worse dental cleanings.

I thought my experience was typical, but coming here, I find that some have the same experience, but some do not. There are many factors.

@paullvlc I was 77 with a good quality of life and loving sex at 40 yrs of marriage. I had surgery, radiation and 2 rounds of Lupron . My quality of life is gone and wish I did nothing. Only you can make such a serious decision. I’m almost 2 yrs post surgery, no sex which for some is mentally very difficult. My numbers were 3/4 and 4/3 I will always miss the way I felt before my decision

NO!!!!!

@graybeard46 Thank you for responding. I still have a PET scan due but am still leaning toward doing nothing. Anything I do will diminish my quality.

My uncle had prostate cancer & did nothing. He died an uncomfortable death at 84.

His brother (my father) had bladder cancer & had it promptly treated by multiple uncomfortable treatments via a probe up the urethra to zap the cancer, & subsequent uncomfortable probes to verify the cancer was gone. He was pronounced cured & lived to be 101.

I was offered "nerve-sparing" prostate surgery, but the biopsy showed the cancer had already reached the surface of the gland. It took literally all of three seconds to decide to continue to live rather than to die a stud. No regrets. If I did have regrets, there are treatments that many find successful.

When I was very young, I needed some expensive medicine for something, my father told me later. He asked the doctor what treatment was used before this medicine was available. The doctor said two words: "Kids died."

My friend who tried to weather his case of COVID without treatment, died. I volunteered with government health agencies helping to provide COVID testing, & later, vaccines. There was one case of a woman who was hospitalized with COVID & was properly treated for it. All the time in the hospital she kept denying that she had COVID, & in fact those were her very last words.

There's a theme here ...

I am 77, had a Robotic Surgery in Feb. 2026. I have no issue other than leaking issue. It had been almost 3 months and still leak. If you can deal with leaking then go for the surgery. The reason I did not go with radiation was 1) radiation for 5 weeks every day and 2) Fatigue after the radiation. The leaking issue will be with either option.
Good luck !!

@readandlearn I can definitely feel where you’re coming from.
My biopsy showed such diffuse 4+3 disease with PNI that I told my surgeon to remove anything and everything that even looked like it might be cancerous.
I told him I didn’t care about erections if my life was at stake. His young female assistant said “Wow, I’ve never heard any of our patients say that before!”
He looked at her and said, “He’s an educated man and he’s trying to save his life.”
The image of me lying in a coffin was a lot more powerful than the image of me sportin’ wood.
Phil