Can I get cancer treated with a less invasive procedure at 58?

Question

Hi doctor,

I just got my biopsy results back, and I am honestly terrified. I am 58, and they found cancer in six out of 12 samples with a Gleason score of seven. My PSA jumped from 3.2 to 8.4 in just one year. The urologist is pushing for immediate surgery, but I have read horror stories about incontinence and erectile dysfunction. I am recently remarried, and this is really affecting my relationship with my new wife. She is being supportive, but I can tell she is scared, too.

My father died from prostate cancer at 72, but he was much more advanced.

The surgeon mentioned robotic surgery and radiation as treatment options, but I do not know which one is better. I run a small business and cannot afford to be out for months recovering. I am also worried about the cost since my insurance has a high deductible. Are there any less invasive treatments? How quickly does this type of cancer usually spread?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

It is very painful. But your diagnosis of Gleason 3+4=7 is considered favorable intermediate-risk prostate cancer, which is very treatable. The rise in your PSA (prostate specific antigen) and your family history understandably add urgency, but this is a type of cancer that is often caught early and treated effectively.

You also have a window of a few weeks to a few months to make a well-informed decision without significantly affecting your outcome. There is time to get a second opinion.

Both surgery and radiation are excellent, curative options for your situation. There is no single “better” choice; it depends on which option suits you personally.

Robotic surgery offers precise removal and provides a complete pathology report for accurate staging, and recovery usually takes weeks, not months. Side effects such as incontinence and erectile dysfunction are possible, though they are often temporary with modern techniques and proper rehabilitation. Radiation treatments like IMRT (intensity-modulated radiation therapy) or SBRT (stereotactic body radiation therapy) are non-invasive, preserve the prostate, and have cure rates comparable to surgery. The side effects are different, rather than necessarily better or worse.

For a Gleason seven with multiple positive cores, active surveillance is generally not recommended because of your PSA velocity and family history. However, advanced radiation techniques are highly targeted and are considered less invasive than surgery.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.