Can a man's prostate cancer with a 9.2 PSA level be treated?

Question

Hello doctor,

I am a 62-year-old man recently diagnosed with early-stage prostate cancer. My PSA was 9.2, and the biopsy confirmed localized disease. My doctor suggested surgery, but I am worried about losing bladder control or sexual function afterward.

My questions are:

Are there less invasive treatments that can control the cancer without major side effects?
How do I know if “active surveillance” is safe in my case?
What lifestyle or diet changes can help me recover better?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

First of all, I am truly sorry that you have been diagnosed with prostate cancer. However, I would like to reassure you that this is still an early stage, and the beginning of any condition always gives us a valuable opportunity.

The first important point is that there are many different treatment modalities available. The second point is that we are able to achieve full control over the tumor and reach the cure rate we aim for.

To start with, your PSA (prostate-specific antigen) level is less than ten, which is a very good sign. Since the tumor is localized, we are interested in knowing the Gleason score. If the Gleason score also turns out to be favorable, meaning less than seven, then we have a very good opportunity to proceed with something called active surveillance.

This involves checking your PSA level every three months, assessing the Gleason score annually, and performing a prostate MRI (magnetic resonance imaging) once a year. This approach gives us the chance to completely avoid all cancer treatment modalities and allows you to live your life normally, as this indicates that your tumor is not aggressive.

However, if the Gleason score is high or if the PSA level starts to rise, then we begin to intervene. In that case, I suggest you completely avoid the surgical option because surgery, as you mentioned, can cause unpleasant side effects such as urinary incontinence and erectile dysfunction.

Therefore, in this situation, I suggest you prefer radiotherapy, as its side effects are usually mild, such as gastrointestinal upset or urinary tract symptoms, and these are reversible and resolve after completing radiation treatment. If, after radiotherapy, the PSA level remains high, I suggest you then proceed with hormonal therapy.

I hope this explanation has been clear to you and has helped you in choosing the most appropriate treatment option. If you have any questions or need any clarification at any time, we are always at your service.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.