Prostate cancer age related

Hi Jerry. My husband is also 77 and was just diagnosed in April with a Gleason 4 + 4 and a PSA of 19.6. His Urologist sent us to both a surgeon and a radiation oncologist to listen to them both before making a decision as to treatment. Let me say that just because anyone is 77 DOESNT mean that sex is NOT important! We have been married over 50 years and it’s STILL important! When my husband told the surgeon- a VERY young doctor- that very thing, he closed his book and said, “You should have radiation “. Gave us a good chuckle in a very serious situation. In August, my husband had a Halop procedure to reduce the size of his “ginormous” (according to the urologist) prostate. He is to heal until after the holidays and then the amount/length of radiation will be determined. His incontinence lasted about 2 months, but never enough to keep him from living his usual life. The only drawback so far is the ADT. That has been hard. We hope by Spring it will be Spring for us too! Hope our experience helps. This is really the pits for everyone.

When I (67) was given the choice, my doctor said I was on the borderline age-wise. If I was younger, they would recommend surgery - older, they would recommend radiation. What he said was that either way, I would likely have a good outcome. I asked him what was good, and he said either way, I would survive at least 12 more years. So your expected lifespan is an important consideration.

I chose surgery, because I wanted the cancer out ASAP. And as a byproduct, my BPH is gone. It turns out that the post-surgery pathology showed the cancer was a bit more aggressive than they thought. So he and I were both glad that I chose surgery. The lesson being that they dont really know what's going on until they get in there and see. Radiation might have worked too, but its a best guess treatment.

I am 75 and faced a choice between surgery and radiation + ADT. Spoke with two urologists who said I was up to surgery. I also consulted an oncologist and radiation oncologist. My PSA was 10.1 and the Gleason was 4+3. Neither the MRI nor PET showed any spread beyond the prostate. After wrestling with this I chose surgery. It was back in August so I am about 4 months out now. My stay in hospital was two nights. The catheter presence and removal were fine. However, I am still incontinent, but have learned to deal with it as an inconvenience. Plus I am in PT. It should get better. Sadly I am a widower so the ED is what it is. We all are different with varying experiences. Best wishes.

jerryw478:

In your first post you wrote that surgery was recommended. I wonder by whom. Urologists tend to favor surgery; that's their craft. Just looking at your numbers, you SEEM to be a perfect candidate for radiation, but I don't know all the specifics.

Just for reference, I was 70 when prostate cancer was discovered (multiple Gleason 9 lesions). My urologist told me I was too old for surgery (bless his heart). Instead, he recommended two kinds of radiation + 'hormone therapy' and that's what I did. I believe that was pretty much SOC at the time. I recovered pretty well and (still) lead an active lifestyle, about ten years later. 😀

I highly recommend that you look into Stereotactic Body Radiation Therapy (SBRT). Often this is done with a Cyberknife instrument (there are others) in five sessions for a patient such as you. SBRT is yet another specialty in the radiation oncology domain and there may, or may not, be a facility in your neighborhood.

As is often mentioned, whatever therapy you choose, you want a doctor and institution with lots of experience.

Hi Central PA, here’s his results.

149 grams of tissue removed

Prostatic acinar adenocacinoma Grade 1 (Gleason 3+3) Don’t know why he had scored 4+4 previously

Tumor involves less than 5% of tissue

Glandular and stromal hyperplasia

Invasive carcinoma involves approx 2-3% of examined tissue.

Hope this helps. Long road ahead…