I have prostate cancer with high PSA. What options do I have?

Question

Hello doctor,

I am a 62-year-old who has just been diagnosed with prostate cancer. My PSA was 15, and the biopsy showed aggressive cancer. I am terrified. What are my options?

My urologist mentioned surgery or radiation, but I am scared of being incontinent or impotent.

What about that new focal therapy?
I am worried about it spreading. Should I consider watchful waiting?
Also, should I tell my sons to get checked?
My wife and I are still active. How will this affect my sex life?.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Surgery, like prostatectomy or radiation therapy, is a treatment option commonly recommended for aggressive prostate cancer.

Surgery (radical prostatectomy) involves removing the entire prostate gland and sometimes nearby lymph nodes. Side effects are urinary incontinence (difficulty controlling urine) and erectile dysfunction (trouble getting or maintaining an erection).
Radiation therapy targets and kills cancer cells in the prostate without surgery. It has a lower risk of urinary incontinence compared to surgery.
Focal therapy is a newer approach. It targets only the cancerous part of the prostate, minimizing damage to the surrounding healthy tissue.
Active surveillance is recommended for men with low-risk or slow-growing prostate cancer.

Both surgery and radiation can affect erectile function. Many men regain function with the help of medications. It is a good idea to talk to your sons about getting checked.

Family history plays a role in prostate cancer risk, and early screening with a PSA (prostate-specific antigen) test and digital rectal examination can help detect prostate cancer early when it is most treatable. So I suggest you discuss this with your oncologist.

I hope this has helped you. Please feel free to reach out to me again in case of further queries.

Thank you.