77 year old wants surgery

KD

Dad received diagnosis of Gleason 7, Stage II Prostate Cancer and is set to see a urologist in another city to discuss treatment options. The biopsies were positive "throughout" the prostate. The wait is very difficult and he's reading up on this. Would really like to have the surgery, but wondering if most surgeons truly have a cutoff age (70 or 75?). He's in excellent health otherwise, very active, but getting discouraged just thinking about surgeons turning him down because statistics say he's only got around 10 years anyway! Do others have experience with this type of "hard and fast" rule? Are some clinics (MD Anderson/Mayo/etc.) or some particular doctors known for being generous with their age limits?

Thank you so much for any assistance or comments.

Kongo

Options
Hi, KD and welcome to the forum. Sorry this is happening to your father but it's good that he has you to help him sort it all out. I'm sure you will get plenty of good advice and support from others who have had to deal with prostate cancer. Only a doctor can give you proper direction about a course of treatment your father should pursue and it is true that many doctors will not perform surgery on men your father's age but some will and you need to know the pros and cons of eacy type of treatment as there are many, many more treatment options that surgery. You need to give us a bit more information to get any meaningful suggestions from the discussion forum.

Do you know the Gleason score of your father's biopsy, his PSA at diagnosis, the PSA velocity or doubling time, and how many of the biopsy cores were positive and by what percentage? Also, any other information about size of his prostate, the results of the DRE, and whether or not there is evidence that the cancer has spread beyond the prostate.

If your father's cancer has spread beyond the prostate, surgery may not make much sense and another form of treatment might best be considered. Additionally, depending on the staging and Gleason scores, a radiation treatment may be much less stressful on your father and still have a very positive outcome. Also, depending on the numbers and staging, active surveillance may be an appropriate course of action and many doctors recommend that for someone your father's age.

Hope you are able to find a treatment that gives your father many more years of high quality life.

Best

Noniu

Diagnosed at 71
My dad was diagnosed at 71, Doctor recomended seed implant and hormone therapy. My father will be 80 next month and his cancer has metastesized to his spine. His PSA keeps rising, he is on the waiting list for Provence.

I will suggest your father consult with couple of doctors before making a decision. Best of luck to your father.

lewvino

I've heard that many
I've heard that many surgeons don't want to after age 70 but I think it depends on the mans overall health. One man in our local Prostate cancer support group had the Davinci at age 72.

Good luck.

Larry

georcass

lewvino said:

I've heard that many
I've heard that many surgeons don't want to after age 70 but I think it depends on the mans overall health. One man in our local Prostate cancer support group had the Davinci at age 72.

Good luck.

Larry

This happened to us
My husband is 77. He was diagnosed in January of this year. He was told by the uro that he would not do RP on anyone older than 65. So we went ahead with cryo. My daughter is a nurse. She found that there are docs in our area (Pgh) that will do the surgery regardless of a man's age. Her friends dad is 80, just rp, is doing great. My point is, don't take "no" for an answer. Shop around. I wish we would have.

Georgeann

daughter27

Dad
I am wondering if this is the problem my father is having.

He was also diagnosed last year at 70, now at 71 both the PSA and Gleason numbers have risen to 8.

My Father said he would just like to have the operation and they are suggesting yet another biopsy.

I have a urologist friend that is wondering why they are hesitating, while a Gleason of 8 is said to be aggressive...

I am going to suggest that he go to the Mayo clinic for a second opinion....

good luck on your journey...

hopeful and optimistic

daughter27 said:

Dad
I am wondering if this is the problem my father is having.

He was also diagnosed last year at 70, now at 71 both the PSA and Gleason numbers have risen to 8.

My Father said he would just like to have the operation and they are suggesting yet another biopsy.

I have a urologist friend that is wondering why they are hesitating, while a Gleason of 8 is said to be aggressive...

I am going to suggest that he go to the Mayo clinic for a second opinion....

good luck on your journey...

Good daughter
Some questions about your father:

Where does your father live?

When was he diagnosed?

What is his general health?

How many cores were taken, how many of those were positive, what was the involvement and gleason of each? What is the stage of his cancer? Did he get a second opinion on the pathology of his last biopsy?

HAS THE CANCER REMAINED WITHIN THE CAPSULE OR IT OUTSIDE AS WELL?

gleason 8 is aggressive, and in my opinion he needs to get very busy, stop messing around with the doc he is seeing, I don't understand why treatment or additional testing has not been done with this gleason .........there are various treatment options depending on whats going on with the his cancer...different hospitals specialize in different options.

What ever specialty You pick. , you want an expert in the field, the best.

The only thing that I know about the Mayo clinic is that it has a very good overall reputation, however I don't how strong or weak their prostate onchology department is.

ira

daughter27

hopeful and optimistic said:

Good daughter
Some questions about your father:

Where does your father live?

When was he diagnosed?

What is his general health?

How many cores were taken, how many of those were positive, what was the involvement and gleason of each? What is the stage of his cancer? Did he get a second opinion on the pathology of his last biopsy?

HAS THE CANCER REMAINED WITHIN THE CAPSULE OR IT OUTSIDE AS WELL?

gleason 8 is aggressive, and in my opinion he needs to get very busy, stop messing around with the doc he is seeing, I don't understand why treatment or additional testing has not been done with this gleason .........there are various treatment options depending on whats going on with the his cancer...different hospitals specialize in different options.

What ever specialty You pick. , you want an expert in the field, the best.

The only thing that I know about the Mayo clinic is that it has a very good overall reputation, however I don't how strong or weak their prostate onchology department is.

ira

diagnosis
Ira..

He was diagnosed in 2009 the first time....East coast...and has remained in the capsule as per last biopsy...

He is overweight and has had bi pass surgery as well as stents in the past - I think this was the reason why they elected watchful waiting...also they told him that generally prostate cancer is very slow moving so wouldn't be a problem...

The problem is that the numbers rose to 6 earlier this year and now 8...

He didn't get a second opinion per se, but I sent all info to a friend of mine that is a Urologist here where I live and she said watchful waiting was a normal reply to all that he was experiencing.....however now she doesn't understand the need for the next biopsy.

I won't be home for another month and I think he isn't sure what to do. It actually wasn't Mayo that is nearby but Rothmann perhaps...I forget, but he doesn't necessarily want to change doctors (think its more to do with paperwork and getting to the hospital etc asking others for help...)

I really feel quite lost in knowing how to help. He tells me that he would just like to get it taken out and not deal...but not really sure...Naturally he doesn't like any of the side effects that could happen but as he is recently single he is more worried about incontinence...which I heard can be an issue if you are overweight...

He is asking me for advice but I have no idea what he should do...his doctor just lists his options but doesn't seem to want to commit to anything....living 3000 miles away is not so easy...
any advice is appreciated...

KD sorry for taking over a bit here...I probably should have opened a new post...yesterday was my first day on here and when I saw your post I thought perhaps that was a reason for the postponement...now I am not so sure...

Wishing you an your father the best....

finbar

Age
Take heart. I was 83 when over a year ago I had
the daVinci prosectomy. At first I was told that
age 74 is the cutoff. Really depends on the doctor's
specialty. Age limits seem to be hard and fast for
non-surgeons. Anyway I was told to undergo
hormones, radiation and seeding. The prospects of
all the adverse side effects prompted me to seek a
second opinion. If my cardiologist gave me an okay,
which he did, I was set to go. Now about 1 1/2 years
later, I have absolutley no regrets. A truly experienced
surgeon and a first-rate anesthesiologist is important.
Need more info, be glad to help at alb212@gmail.com

bigxbadxjohn3

daughter27 said:

diagnosis
Ira..

He was diagnosed in 2009 the first time....East coast...and has remained in the capsule as per last biopsy...

He is overweight and has had bi pass surgery as well as stents in the past - I think this was the reason why they elected watchful waiting...also they told him that generally prostate cancer is very slow moving so wouldn't be a problem...

The problem is that the numbers rose to 6 earlier this year and now 8...

He didn't get a second opinion per se, but I sent all info to a friend of mine that is a Urologist here where I live and she said watchful waiting was a normal reply to all that he was experiencing.....however now she doesn't understand the need for the next biopsy.

I won't be home for another month and I think he isn't sure what to do. It actually wasn't Mayo that is nearby but Rothmann perhaps...I forget, but he doesn't necessarily want to change doctors (think its more to do with paperwork and getting to the hospital etc asking others for help...)

I really feel quite lost in knowing how to help. He tells me that he would just like to get it taken out and not deal...but not really sure...Naturally he doesn't like any of the side effects that could happen but as he is recently single he is more worried about incontinence...which I heard can be an issue if you are overweight...

He is asking me for advice but I have no idea what he should do...his doctor just lists his options but doesn't seem to want to commit to anything....living 3000 miles away is not so easy...
any advice is appreciated...

KD sorry for taking over a bit here...I probably should have opened a new post...yesterday was my first day on here and when I saw your post I thought perhaps that was a reason for the postponement...now I am not so sure...

Wishing you an your father the best....

Seeking a plan of action
Hello Daughter 27,

Do not hesitate to contact the Cleveland Clinic. Their urology-oncology is often rated #1 in the USA. I have been extremely pleased with my two prostate cancer related surgeries there.

Your father would not need a referral to see the a urologist there. You or your father can make an appointment by phone. You can Google this clinic for specifics.

Best wishes,

John