How can prostate cancer be managed in a 70-year-old?

Question

Hello doctor,

My husband is 70 years old and was just diagnosed with early-stage prostate cancer. His PSA (prostate-specific antigen) was high, and the biopsy confirmed cancer. We are both worried and confused about what to do next.

Are all cases slow-growing?
Do men always need surgery or radiation?
What is the impact on sexual health or continence?
Is active surveillance safe, or does he need treatment right away?

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand how overwhelming a prostate cancer diagnosis can be. Still, the good news is that early-stage prostate cancer, especially in men around your husband’s age, is often slow-growing and highly manageable. Not all cases require immediate treatment, such as surgery or radiation. In many situations, especially if the cancer is low-grade and confined to the prostate, active surveillance can be a safe and effective approach.

This means closely monitoring the cancer with regular PSA (prostate-specific antigen) tests, digital rectal exams, and occasional biopsies, delaying treatment unless the cancer shows signs of progression. This strategy helps avoid potential side effects such as erectile dysfunction or urinary incontinence, which are more common with surgery or radiation.

However, if the cancer is more aggressive or there is a family history or other risk factors, curative treatments like radiation therapy or prostatectomy will be considered. It is important to share full details based on your husband’s Gleason score to make a proper plan for PSA treatment trends, health status, and personal preferences.

You are not alone. Many couples face this together, and with careful decision-making, outcomes are often very good. Always feel free to reach out at any time. I am always here to help.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.