Am I too old to have prostate surgery?

How old is too old to have a radical prostatectomy?

William D. DeWolf, M.D., Chief of the Division of Urology at Beth Israel Deaconess Medical Center, says:

For surgery to make sense — that is, for the benefits to outweigh the risks — you need to be young enough to take advantage of the added survival time that surgery can offer. That’s why I generally don’t recommend this surgery for a man whose life expectancy is less than 10 years, or for a man who is older than 75, depending on his personal and family health history.

Radical prostatectomy  is a major operation that can cause serious and life-threatening complications such as blood clots in the legs and lungs, abnormal heart rhythms, heart attack, pneumonia, and infections. The risk increases in older men and in those with other medical conditions, such as heart and lung disease, high blood pressure, diabetes, or a history of blood clots. Some studies have shown that side effects, namely urinary incontinence and erectile dysfunction, also increase with age.

Operating by remote control

Operating by remote control

Many physicians recommend a robotic prostatectomy, shown here, over traditional “open” surgery because the recovery is less taxing. But complications can still occur.

Because many prostate cancers grow so slowly, an older man with the disease may choose active surveillance, which involves following the cancer to see if it advances and causes symptoms. If it does, or if the man prefers to have immediate treatment, radiation therapy can control the disease for years. Hormone therapy can also help.

The bottom line: If your doctor says that you are too old for surgery, don’t despair. Other, less-risky treatments may hold the cancer in check. Talk with your doctor about the options.

SOURCES: Alibhai SM, Leach M, Tomlinson G, et al. Rethinking 30-Day Mortality Risk After Radical Prostatectomy. Urology 2006;68:1057–60. PMID: 17113897.

Thompson RH, Slezak JM, Webster WS, Lieber MM. Radical Prostatectomy for Octogenarians: How Old is Too Old? Urology 2006;68:1042–45. PMID: 17095073.

Originally published July 1, 2009; Last reviewed April 8, 2011

Comments
6
Dennis Donohoe

I had a TURP operation ten weeks ago. I still have burning when I urinate. How long should I expect this to continue. If I exercise a lot I will get blood in the urine. Can I expect to have normal erections after this surgery? I still suffer from some incontinence. Can I expect this condition to get better and if so how long before it does? Thank you.

Victoria Larkins (wife)

What are the after effects of radiation for cancer that has just spread to the bladder in a 79 year old man who was first diagnosed at the age of 72? He has had laser surgery which removed half of the cancer in the bladder. Can he be O.K. with just hormone therapy and what are the disadvantages.

Where can one view the answers to all of these questions?

Antonis Diomidous

Hello,
I have a total PSA of 2.66 and a year ago was 2.11, and my FPSA is 1.025 and a year ago was 0.81. My PSA ration seems to have remained quite stable at 38.5%. Last year after the results i was examined by a urologist and he told there was nothing to worry about. By the way I’m 56 years old and i have no other symptoms.
Thank you
Antonis

Dianne Hayter

My dear father is 93-yrs-old, a very active man, preached in Florida last winter, plays badminton twice a week till 4-mos ago, when is 16-yrs.old Ca of Prostate prevented him from urinating. His PSA was 100, but with hormone therapy, went down to 40, 301, and now below 1 over the course of 4-mos. His bone scan, cat scan shows now metastasis. However, there were problems removing his catheter at times, as it has been a real hindrance in performing his daily interests. He has had many nurses daily changing catheters and bags, but I have talked him into managing this himself,( he was an RN from England and a pastor..)

Today, his heart was set on the catheter being removed as it PSA level is below one, thought the specialist may, but sadly he was told he would have to live with it and not return to Florida as per usual the last twenty years, where he often preaches. He suffers now from fatigue, probably related to the hormonal Rx. The Dr. also told him to forget travelling to Florida, as he uninsurable(but this has not prevented them from going previously)! They belong to a strong Christian community there, where all their dear friends live.

My question, as his daughter(also an RN) living quite a distance, is: ‘How is it determined that he needs the prostate scraped, and If it was necessary could it not be done under an epidural? The specialist said he could enter the prostate through the penis, but my father believes the physician does not want to do this for another reason. Dad had shingles twice and it was excruciating and thinks the Dr. does not want him to suffer, but I believe that’s my father’s choice.

My father felt all hope gone, except for heaven; he has a strong spirit and loves God, and life and feels resigned to ‘have to live the remainder of his years attached to this tube (and changing bags). He is more lethargic possibly from the meds, and I am hoping as i would like to understand more fully whether there is an alternative.

God bless you for allowing questions,
Sincerely
Dianne Hayter
(formerly Morley)

jenelyn l. antonio

my Father also is 92 years old. He is suffering his prostate also. from the start of this problem he is ill and last for one year after that due to a very active man again again he brought to hospital until now he suffered always the pain by changing his catheter and bags..the doctor offered him and operation. for me it is okey that he undergo operation by his age…my father due to suffer the pain he wants to have and operation but….?

toreh Bahrami

My fatter also 84 and doc suggests turn surgery for his prostate cancer that has grown in to his bladder and is blocking. Should he do this ? please advise

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