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Gleason 3+4 , 82 years PSA 13.0

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Posted 8/12/2017 3:00 AM (GMT 0)
My father has been diagonised with Adenocarcinoma Prostrate, He is 82 years and a Gleason Grade of 3+ 4, His PSA is 13.0 at present and therefore he went for a biopsy and the above diagnosis was done .
He has no diabetes or any other health issues at present. How is surgery advisable for this age and what could be side effects any suggestions advise is most welcome. Tx
Posted 8/12/2017 3:18 AM (GMT 0)
I think surgery is a terrible idea for a man of your father's age. Please fill out the following nomogram for him:

/webcore.mskcc.org/survey/surveyform.aspx?&preview=true&excelsurveylistid=4

What does it tell you is his risk of dying of prostate cancer in the next 15 years?

I'm not saying that he should not get treated - that is entirely his choice. But I am saying that not treating it may be one good option. They call that "watchful waiting" - and they would only give him hormone therapy if symptoms arise.

He can also have any of several kinds of radiation therapy, depending on what is available to him wherever he lives. SBRT is only 5 treatments and doesn't involve any kind of anesthesia. I guess that seeds (brachytherapy) can be done with just a spinal block. A man in my support group had SBRT at the age of 80 , had minimal side effects, and is doing well- except for his other comorbidities.
Posted 8/12/2017 3:47 AM (GMT 0)
Thank You For your response .. & the survey did give some inputs for what to expect.. The consulting doctors may just go by external treatment which for his age is the best one. Will the PSA level go down if one is taking care of themselves ? Hope u can answer that.. Tx
Posted 8/12/2017 3:58 AM (GMT 0)
His PSA has nothing to do with taking care of himself. It will go down as a result of treatment.
Posted 8/12/2017 4:29 AM (GMT 0)
Yes I agree, I understand that treatment will only help in the reduction of the PSA level.

If treatement works well which is not a surgery is there any chance of the Gleason Grade changing ? Just curious to know. Will a consecutive biopsy when done determine that?
Posted 8/12/2017 4:44 AM (GMT 0)
Gleason score is just a portrait of what the cancer cells look like. After radiation, those cells are destroyed. Hormone therapy destroys many cancer cells too. They don't monitor his Gleason score after therapy - the cells are gone.
Posted 8/12/2017 4:52 AM (GMT 0)
Thanks got the picture. Much appreciate your replies. 🙏🏻
Posted 8/12/2017 4:56 AM (GMT 0)
Sorry your father has to face this. TA has given you some great info.

Radiation is often recommended for someone at that age. Post treatment monitoring is just PSA tests.

Hang in there,
Andrew
Posted 8/12/2017 5:20 AM (GMT 0)
Thanks Andew, Yes I also am in sync with what TA has mentioned. I want him to feel strong and positive with his life with the treatement he undergoes. 🙏🏻
Posted 8/12/2017 11:06 AM (GMT 0)
Age 82, good for him.

No, I wouldn't want surgery at that age. There is at least one well known and highly experienced surgeon in the US who has famously said, "I'll only operate on a prostate cancer patient over 75 if he brings both parents to the consultation". His point--and I think the point Tall Allen is making--is that unless he is going to live another 20 years, then it's entirely likely that something other than PC will his cause of death.

They can do spot radiation and/or hormone therapy to relieve symptoms if needed. Beyond that, he has PC, and most men his age probably do as well--they just don't know it. Again, here in the US, PSA is usually discontinued at his age.
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