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  • Kongo
    Kongo Member Posts: 1,166 Member
    #22
    meita33 said:

    My Dad's Prostate cancer
    I found this room last night and an grateful for the love and support. My Dad is 80 and his urologist says that going by his Psa #'s (5?) and combined 13 that he has PC.they decided to wait 6 months because of his age and just see what happened, but they went up.He also said he felt a little hardness.But everyone seems to contradict each other.3 different doctors ( my48 year old brother also has PC, but he isn't speaking to me )have said DOn't GET SURGERY NO MATTER WHAT!!.His two doctors seem OK with just doing nothing.I know he's 80, but he is in excellent health and his Mom lived to 99! He decided to get a biopsy so he can at least know What he is on the Geason scale.Another doctor told him ,aggressiveness doesn't matter to someone his age. I am trying to find out as much as I can, but am hearing alot of contradictions.I do know I'm not ready to just give up on him.Any suggestions on where to go for more info? I tried mayo Clijnic and john Hopkins, but again there wasn't much about 80 year old patients.Positive thoughts and prayers go out to all of you. Thanks.

    Welcome Meita
    Meita,

    Welcome to this forum although I wish you didn’t have a need to be here. I know that sorting out ground truth regarding medical conditions for aging parents is a challenge.

    Your post is a bit confusing and I am not sure what you’re saying…did he have a PSA of 5 or 13 or was it something else? Assuming your father has been having regular physicals for several years, there is most likely a very thorough history of what his PSA readings are. This trend can help you and his medical team to determine the severity and potential aggressiveness of his cancer (if that is what is causing it). I don’t understand the urologist’s statement that “going by his PSA he has PC.”

    The only way a doctor can positively confirm prostate cancer is through a biopsy. Many things can cause an elevated PSA reading such as a hard stool shortly before drawing blood, a urinary infection (common with older patients), an enlarged prostate caused by benign factors that are not related to cancer, or even doing the rectal exam before drawing the blood. Waiting six months also doesn’t make much sense…typically a one month or three month interval between elevated PSA readings is recommended. I would encourage you to ask the doctors if they have ruled out another cause for the elevated PSA and how they did that.

    As you have already discovered, you are likely to receive lots of conflicting advice from different specialists, particularly because of your father’s age. Most surgeons will not consider surgery for a patient in his 80s for a variety of reasons. Radiation is an option but there are side effects that should be considered within the context of your father’s overall quality of life. Also, if your father does have prostate cancer, having it detected at this stage in his life is a fairly good indicator that he will die with the disease not of it. In other words, even if he has PCa, the odds are that it will not adversely affect him or shorten his life.

    Several studies have shown that most men in their 80s have some form of prostate cancer (as much as 80%). It seems to be one of those diseases that will inevitably show up if you live long enough. Many, if not most of the men who have prostate cancer discovered at this age have an indolent form of prostate cancer that will never pose a life threatening risk.

    Having a biopsy can confirm the presence of prostate cancer and enable a pathologist to determine the Gleason score. On the other hand, if your father has only a small amount of cancer, the biopsy may not detect it. It doesn’t mean he doesn’t have cancer, it just means that they didn’t find it. There are some slight risks associated with a biopsy and you should have the doctor's explain these in detail.

    Something else to consider when children become involved in the medical care and decisions of parents is who is going to be the lead sibling in dealing with these issues? It should be someone that all the siblings can agree upon, you should have legal documents drawn up that give you access to all the necessary medical records, and you should have the authority to make the necessary decisions should your parent be unable to make them. Once you’ve gone through that process, then the others need to back off and not get involved with quizzing the doctors and so forth as it can get very, very confusing for everyone concerned. There are several who contribute to this forum that are going through similar situations as yourself and can offer sound advice on how to deal with these issues.

    At this point you have much to be thankful for. Your father is not suffering from any symptoms and is otherwise in good health. If he does have cancer then there is a very good chance that it is a low risk, indolent form of prostate cancer that will never pose a threat to your father. And finally, there are several treatment choices that can address the issues should it come to that which do not involve surgery.

    Please keep us informed of your progress and best of luck to you and your father.
  • meita33
    meita33 Member Posts: 3
    #23
    Kongo said:

    Welcome Meita
    Meita,

    Welcome to this forum although I wish you didn’t have a need to be here. I know that sorting out ground truth regarding medical conditions for aging parents is a challenge.

    Your post is a bit confusing and I am not sure what you’re saying…did he have a PSA of 5 or 13 or was it something else? Assuming your father has been having regular physicals for several years, there is most likely a very thorough history of what his PSA readings are. This trend can help you and his medical team to determine the severity and potential aggressiveness of his cancer (if that is what is causing it). I don’t understand the urologist’s statement that “going by his PSA he has PC.”

    The only way a doctor can positively confirm prostate cancer is through a biopsy. Many things can cause an elevated PSA reading such as a hard stool shortly before drawing blood, a urinary infection (common with older patients), an enlarged prostate caused by benign factors that are not related to cancer, or even doing the rectal exam before drawing the blood. Waiting six months also doesn’t make much sense…typically a one month or three month interval between elevated PSA readings is recommended. I would encourage you to ask the doctors if they have ruled out another cause for the elevated PSA and how they did that.

    As you have already discovered, you are likely to receive lots of conflicting advice from different specialists, particularly because of your father’s age. Most surgeons will not consider surgery for a patient in his 80s for a variety of reasons. Radiation is an option but there are side effects that should be considered within the context of your father’s overall quality of life. Also, if your father does have prostate cancer, having it detected at this stage in his life is a fairly good indicator that he will die with the disease not of it. In other words, even if he has PCa, the odds are that it will not adversely affect him or shorten his life.

    Several studies have shown that most men in their 80s have some form of prostate cancer (as much as 80%). It seems to be one of those diseases that will inevitably show up if you live long enough. Many, if not most of the men who have prostate cancer discovered at this age have an indolent form of prostate cancer that will never pose a life threatening risk.

    Having a biopsy can confirm the presence of prostate cancer and enable a pathologist to determine the Gleason score. On the other hand, if your father has only a small amount of cancer, the biopsy may not detect it. It doesn’t mean he doesn’t have cancer, it just means that they didn’t find it. There are some slight risks associated with a biopsy and you should have the doctor's explain these in detail.

    Something else to consider when children become involved in the medical care and decisions of parents is who is going to be the lead sibling in dealing with these issues? It should be someone that all the siblings can agree upon, you should have legal documents drawn up that give you access to all the necessary medical records, and you should have the authority to make the necessary decisions should your parent be unable to make them. Once you’ve gone through that process, then the others need to back off and not get involved with quizzing the doctors and so forth as it can get very, very confusing for everyone concerned. There are several who contribute to this forum that are going through similar situations as yourself and can offer sound advice on how to deal with these issues.

    At this point you have much to be thankful for. Your father is not suffering from any symptoms and is otherwise in good health. If he does have cancer then there is a very good chance that it is a low risk, indolent form of prostate cancer that will never pose a threat to your father. And finally, there are several treatment choices that can address the issues should it come to that which do not involve surgery.

    Please keep us informed of your progress and best of luck to you and your father.

    Thank You Kongo
    Thank You so much for your time and information.I lost my mother last Sept. to breast cancer, adn she made me executor, so my two siblings are not speaking to me.The one who lives by my dad was also recently diagnosed with prostate cancer.He chose not to share his experience with my dad, because he didn't want him to tellme about it.Anyway, from what we could get out of his daughter, (he's 48) he chose the seed, because radiation would interfere with work.She said if the cancer returns,ther willbe nothing they can do, because of the seed.Is this true?And my stepmother is actually the one who has legal say so over my Dad, but he relys on me because I research everything (like I did for Mom)until I can't find any more info.What you wrote is just what the doctors have said, but he is in such good shape according to his labwork, and his MOm lived to be 99,so he wants the biopsy tofind out the Gleason #.I mean if you're 80 and get diagnosed with prostate cancer, and there is nothing really wrong with you, what happens? So he decided to at least have the biopsy, and if it is not the aggressive kind he very wellmay leave it alone, althoughhis friend who is two years younger also had it and went through radiation and hormone therapy and is doing great.Anyway you really reassured me and this is a great site.He isn't getting his biopsy until January, but willupdate if anything chages.Thank you for the grace and strength you have shown me.May all go well for you.
  • Kongo
    Kongo Member Posts: 1,166 Member
    #24
    meita33 said:

    Thank You Kongo
    Thank You so much for your time and information.I lost my mother last Sept. to breast cancer, adn she made me executor, so my two siblings are not speaking to me.The one who lives by my dad was also recently diagnosed with prostate cancer.He chose not to share his experience with my dad, because he didn't want him to tellme about it.Anyway, from what we could get out of his daughter, (he's 48) he chose the seed, because radiation would interfere with work.She said if the cancer returns,ther willbe nothing they can do, because of the seed.Is this true?And my stepmother is actually the one who has legal say so over my Dad, but he relys on me because I research everything (like I did for Mom)until I can't find any more info.What you wrote is just what the doctors have said, but he is in such good shape according to his labwork, and his MOm lived to be 99,so he wants the biopsy tofind out the Gleason #.I mean if you're 80 and get diagnosed with prostate cancer, and there is nothing really wrong with you, what happens? So he decided to at least have the biopsy, and if it is not the aggressive kind he very wellmay leave it alone, althoughhis friend who is two years younger also had it and went through radiation and hormone therapy and is doing great.Anyway you really reassured me and this is a great site.He isn't getting his biopsy until January, but willupdate if anything chages.Thank you for the grace and strength you have shown me.May all go well for you.

    Melita
    About your brother: Seeds are also radiation. They implant 80 or more radioactive "seeds," each about the size of a grain of rice, into the prostate. This is known as internal radiation because the curative effect comes from inside the prostate instead of from outside the prostate. Seeds are generally very effective in treating prostate cancer but if it recurs, there are indeed other methods to treat it so the statment "there will nothing they can do" is not correct at all.

    Like many families (including mine) it sounds as if you have a complicated set of relationships between siblings, step mothers, and so forth. This obviously complicates a lot of things, including the information available to you, so you have to find out what you can can control and let go of those things you can't control.

    As far as treating an 80-year old with prostate cancer...the answer is "it depends." A lot of it depends on the stage and aggressiveness of the cancer. The odds are that if PCa is only discovered at the age of 80 it is probably an indolent, low risk cancer that may be safely handled by an active surveillance protocol where PSA readings are DRE exams are closely monitored on a regular basis to see if there is any change. If a biopsy shows a more worrisome form of cancer there are some new radiation techniques using delivery methods such as IMRT or SBRT (you can research these on the web) that pose minimum risk of adverse side effects that could affect your father's quality of life. Depending on the extent and stage of any cancer, hormone therapy may also be used either as a stand alone treatment or in conjunction with radiation. Surgery is generally not recommended for someone your father's age.

    The first thing I would do, even before a biopsy, is to be sure that the PSA readings are not being caused by some other condition such as a urinary infection or BPH. If your father has difficulty in passing urine or he experiences pain with urination it may be a urinary tract infection that can be treated with standard antibiotics. If his prostate is enlarged (the doctor can tell this from a digital rectal exam) there are drugs or physical procedures that can be used to reduce the size of the prostate. If your father allows you access to his medical records, you should carefully review them for a history of PSA readings or any other condition which might cause an elevated PSA.

    You are likely going to get different opinions from different experts. Often men tend to trust their GP but keep in mind that they are not specialists in prostate cancer. Other specialists will give you recommendations based upon their specialty or impression of what your father may want at his age. I would be on guard for any doctor who dismisses the seriousness of a potential situation based soley on your father's age. Regardless of how old he is, you deserve clear, compassionate, and understandable recommendations.

    Hang in there.
  • shubbysr
    shubbysr Member Posts: 87
    #25
    meita33 said:

    My Dad's Prostate cancer
    I found this room last night and an grateful for the love and support. My Dad is 80 and his urologist says that going by his Psa #'s (5?) and combined 13 that he has PC.they decided to wait 6 months because of his age and just see what happened, but they went up.He also said he felt a little hardness.But everyone seems to contradict each other.3 different doctors ( my48 year old brother also has PC, but he isn't speaking to me )have said DOn't GET SURGERY NO MATTER WHAT!!.His two doctors seem OK with just doing nothing.I know he's 80, but he is in excellent health and his Mom lived to 99! He decided to get a biopsy so he can at least know What he is on the Geason scale.Another doctor told him ,aggressiveness doesn't matter to someone his age. I am trying to find out as much as I can, but am hearing alot of contradictions.I do know I'm not ready to just give up on him.Any suggestions on where to go for more info? I tried mayo Clijnic and john Hopkins, but again there wasn't much about 80 year old patients.Positive thoughts and prayers go out to all of you. Thanks.

    What is old enough?
    Hi Meita,

    My research and talking with many doctors in Michigan (my hometown), South Carolina and at John Hopkins seem to have the same conclusion. Which isthat prostate cancer is slow growing and most men will die of "something else" before it is from prostate cancer.
    Kongo is right with his comments and it is a tough decision. Your dad is healthy so he may have no problems with radical prostate surgery but, why or why not?

    I will send some good thoughts and prayers your way. try to put this aside for now and enjot the holiday break.

    Jim

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