Is 76 too old for prostate cancer surgery?

Posted by bobv48 @bobv48, May 25 11:35am

A urologist my brother asked regarding my wondering about surgery vs radiation said that no one 76 years old should get the surgery. Does this square with what anyone else may have heard?

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Not sure but will share a comment. My Dad was about 75 when his prostate cancer started. They told him they did not recommend surgery. He was basically healthy but had some heart blockage they were watching. They did radiation. They told him he would probably die from something else first. He lived to be 87. But he spent the last 5 years in constant battle with spreading of the prostate cancer. His QOL had deteriorated drastically. Was it old age, advancing prostate cancer, who knows. But it wasnt the way i want to go out. I had one out of 12 samples with cancer at 68. My PSA was 1.2. I said bullshit and told them to take it out. Appear to be cancer free 4 years later. But I have issues. impotence and incontinence.

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now 77, had surgery and a year of ADT and Erleada at 74 and at UCLA. if you’re in otherwise good health and cancer is contained in prostate and locally, then I think that 76 is not too old

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@tuckerp

Not sure but will share a comment. My Dad was about 75 when his prostate cancer started. They told him they did not recommend surgery. He was basically healthy but had some heart blockage they were watching. They did radiation. They told him he would probably die from something else first. He lived to be 87. But he spent the last 5 years in constant battle with spreading of the prostate cancer. His QOL had deteriorated drastically. Was it old age, advancing prostate cancer, who knows. But it wasnt the way i want to go out. I had one out of 12 samples with cancer at 68. My PSA was 1.2. I said bullshit and told them to take it out. Appear to be cancer free 4 years later. But I have issues. impotence and incontinence.

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In my case, cancer detected at low level at age 75, put on active surveillance and this year it had grown slightly. Because it was growing, even though still low level, my urologist suggested either surgery or radiation. It was a second urologist who suggested that no one at age 76 should have the surgery, just the radiation. I will be meeting with both radiation oncologist and surgeon in the next few days and am seeking any advice from community that might inform my decision. I had originally been leaning toward surgery.

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@tuckerp

Not sure but will share a comment. My Dad was about 75 when his prostate cancer started. They told him they did not recommend surgery. He was basically healthy but had some heart blockage they were watching. They did radiation. They told him he would probably die from something else first. He lived to be 87. But he spent the last 5 years in constant battle with spreading of the prostate cancer. His QOL had deteriorated drastically. Was it old age, advancing prostate cancer, who knows. But it wasnt the way i want to go out. I had one out of 12 samples with cancer at 68. My PSA was 1.2. I said bullshit and told them to take it out. Appear to be cancer free 4 years later. But I have issues. impotence and incontinence.

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What caused you to have the biopsy at 1.2 does not seem to bad for a 68 year old male. I'm 72 years old and have a 2.0. A biopsy was not ordered. Should I rethink it.

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@bobv48

In my case, cancer detected at low level at age 75, put on active surveillance and this year it had grown slightly. Because it was growing, even though still low level, my urologist suggested either surgery or radiation. It was a second urologist who suggested that no one at age 76 should have the surgery, just the radiation. I will be meeting with both radiation oncologist and surgeon in the next few days and am seeking any advice from community that might inform my decision. I had originally been leaning toward surgery.

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Pause button: What is your medical history regarding diagnosis and current status: PSA level, testing history, Gleason score, PSMA PET scan, rate of increase and general health/comorbidities?

I had surgery at 72. My health was not an obstacle to surgery, I have longevity in my family and have recovered well from prior surgeries (hips) and was willing to risk/deal with side effects.

My father had a biopsy at age 80 in 2000, had 1 positive core (Gleason not known), was offered treatment choices; chose watchful waiting and I never heard about it again. He passed at 95 w/o evidence of cancer.

In general I favor treatment for PCa, but the need for treatment should be clear.

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@carlwgordon

What caused you to have the biopsy at 1.2 does not seem to bad for a 68 year old male. I'm 72 years old and have a 2.0. A biopsy was not ordered. Should I rethink it.

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The rate of increase and doubling time for PSA, together with the test results, are important factors for diagnosis of PCa.

See Prostate Cancer Foundation free Patient Guide and "Surviving Prostate Cancer " by Patrick Walsh, MD.

What are the concerns that have caused you to follow this blog? A 2.0 PSA at 72 by itself does not seem worrisome.

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My radiation oncologist/medical oncologist say: at my age 75: you get the same results via surgery or radiation, so at my age I chose RT. 28 visits with ADT - now my PSA < .01. For a year now.

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@michaelcharles

The rate of increase and doubling time for PSA, together with the test results, are important factors for diagnosis of PCa.

See Prostate Cancer Foundation free Patient Guide and "Surviving Prostate Cancer " by Patrick Walsh, MD.

What are the concerns that have caused you to follow this blog? A 2.0 PSA at 72 by itself does not seem worrisome.

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Just the 2.1 psa to keep informed and 3.9 accending aorta inlargment. Thanks for you reply. And all the best.

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@carlwgordon

What caused you to have the biopsy at 1.2 does not seem to bad for a 68 year old male. I'm 72 years old and have a 2.0. A biopsy was not ordered. Should I rethink it.

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I cant really give you advice. I did not ask anyone when I first started except my urologist. He advised me against doing anything. Several on here have said I made a bad move having surgery. I went to see the urologist due to my urgency to pee. It was getting to be life altering. Urologist told me on physical exam my prostate was elongated. He suggested we could run other tests but a biopsy was really the only way to see if I had a problem. I had one out of 12 samples with cancer. Nothing in the margins. PSA was 1.2. Normal for me. Dr suggested we just watch it. I thought watch it for what. To get worse. I said no i want to remove it. I had nerve sparring robotic surgery. 4 1/2 yrs now and appears to be clean. Pet scan was clean. But I am incontinent and impotent. At least partially so on both. Joined this site to see about where to go from here. I caught mine very early by accident. My Dr believed in at least doing a biopsy. I would have to say I may not be a good role model.

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