My father has prostate cancer. How to manage its side effects?

Question

Hello doctor,

My 68-year-old father was recently diagnosed with early-stage prostate cancer after a PSA test and biopsy. His doctor mentioned active surveillance versus surgery or radiation, and our family is confused about which option is best.

How do specialists determine whether immediate treatment is necessary, and what are the long-term side effects of each approach, especially related to urinary or sexual function?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have gone through your query, and your father has been diagnosed with prostate cancer. However, there is something very reassuring here: the doctor has decided to place him on active surveillance.

If that decision was made, it most likely means that his PSA (prostate-specific antigen) level is below 10 and his Gleason score is below 7 (based on the biopsy results).

When the PSA is under 10, and the Gleason score is under 7, this gives us a very good opportunity to manage the condition safely through regular follow-up.

With active surveillance, we monitor him closely, usually checking the PSA level every three months and reassessing periodically (including repeating the Gleason score evaluation when needed).

Active surveillance is often much better at this stage because it avoids medications or interventions that could cause side effects.

If at any point treatment becomes necessary, for example, if the PSA level rises, there are several effective options available, including hormonal therapy, radiotherapy, or surgery.

Generally, surgery can have more side effects, while radiotherapy is often precise with relatively manageable side effects. Hormonal therapy can also be an effective option. For now, since he is in the active surveillance stage, the most important thing is consistent and regular monitoring.

There is no need for excessive fear, anxiety, or stress. Many patients remain stable for years, sometimes one, two, or even more than three years, without any progression or complications.

I truly want to reassure you that choosing active surveillance is a very good and appropriate decision at this stage, and it helps avoid unnecessary side effects.

For your father to live a healthy life, you must pay attention to good nutrition, proper hydration, and light exercise, even if it is just walking. It is also important that he does not constantly focus on the cancer diagnosis or let it cause him mental stress.

I hope this helps.

Thank you.