I have prostate cancer. How is its prognosis at 71?

Question

Hello doctor,

I am a 71-year-old man who was recently diagnosed with prostate cancer after my PSA came back very high. The doctor mentioned options like radiation therapy, surgery, or just monitoring since my cancer seems slow-growing.

I am worried about side effects like urinary incontinence and sexual dysfunction. How do I decide which treatment gives me the best chance of survival while maintaining quality of life at my age?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I hope you are doing well. Based on your description, you have been diagnosed with prostate cancer. I completely understand and appreciate the fear and anxiety you may be feeling.

However, I would like to reassure you that there are now many new treatment modalities available that can manage prostate cancer effectively and smoothly.

If you were considering active surveillance, that option is typically suitable when the PSA (prostate-specific antigen) level is below 10, and the Gleason score is below 7. Since you mentioned that your PSA is very high, intervention would be necessary in this case.

Regarding surgery, many oncologists do not prefer it as a first option because it can cause significant side effects such as permanent urinary incontinence and erectile dysfunction. The main concern with surgery is that these side effects are often irreversible.

On the other hand, radiotherapy has advanced significantly. There are modern techniques such as CyberKnife and IMRT (intensity-modulated radiation therapy), which are highly precise and target the prostate gland specifically without significantly affecting the surrounding tissues.

This precision greatly reduces the risk of urinary incontinence and erectile dysfunction. Some mild side effects may occur during treatment, such as diarrhea or urinary tract irritation or infection, but these are usually temporary and resolve after the treatment period. Importantly, most side effects from radiotherapy are reversible.

For these reasons, radiotherapy is often preferred over surgery in similar cases. After treatment, we continue monitoring the PSA level to assess the response and determine whether hormonal therapy may be needed.

I hope this helps you.

For more queries, feel free to reach out to me anytime.

Thank you.