My old Father

Since it is generally considered that all men of 80 & over have prostate cancer ( 1 in 5 men aged 40 have it and most men over 60), the Urologist was correct in what he said. His manner, if that is exactly what took place, was not, shall we say, patient friendly, and was obviously upsetting for your father. A PSA reading of 26 is not out of the ordinary for a man of your fathers age and at his age there is very little medically that can be done for his prostate cancer. That said, if your father is not experiencing any urinary symptoms  and has not had an MRI scan or biopsy (which would probably be unwise at your fathers age) then there is no real evidence that he does indeed have the cancer. Any treatment for the cancer if he did have it would, because of his age, probably be worse than the cancer itself.

Dad had been referred and it was quite disgraceful to treat him in this way. This experience may well deter him from seeking medical advice/treatment for any problen in future. I would also report the experience to PALS.. It seems Dad is suffering from his situation and is entitled to have some treatment to alleviate his situation even if this does not include radical treatment which might cause other problems. If his condition didn't merit exploration, his GP wouldn't have referred him.

What is your source for suggesting that a PSA of 26 is not out of the ordinary for a man in his nineties Oh Dear?

'Conclusion:
Our findings suggest that the prevalence of clinically significant prostate cancer in the elderly population may be higher than previously thought. As the population continues to live longer and healthier lives, it will become more common to confront prostate cancer morbidity in the eldery population. Using higher serum PSA thresholds to eliminate unnecessary biopsies in older men does not appear to help identify patients at greater risk of having clinically significant prostate cancer. Patients with prostate cancer having aggressive clinical features may benefit from treatment of their prostate cancer well into their eighth and ninth decades of life. Testing and diagnostic recommendations should reflect the potential benefit of identifying patients with aggressive prostate cancer even after age 75.' From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692165/

Edited by member 23 Aug 2021 at 22:11  | Reason: to highlight link

Morning Old Barry

During my biopsy and the conversation I had whilst undergoing it, I was told by the surgeon that the general view was that there was no point  just testing PSA levels for cancer for men over 80 as the levels would always be high  (he mentioned well over 20) and that unless quality of life was being affected it was best to leave alone.

Ivan

In reply to OhDear I would say that sometimes consultants use hyperbole to make a point. I can find nothing to support the contention that it is nothing out of the ordinary for a man to have a PSA of 26 in his nineties. On my regular PSA results age specific ranges where referral should be made excepting confounding factors such as UTI are:- 40-49years 0-2.5 ug/L
50-59 " 0-3.5 "
60-69 " 0-4.5 "
70+ " 0-6.5 "
So although the PSA range escalates with increasing age, it's not dramatically so.

As regards the reported response of Dad's consultant, we could only go on what was said and not the way it was delivered. It is well known that many elderly men just accept what they are told and don't complain about the way they are talked to. Often they are very reluctant to seek medical help in the first place so may well be deterred from going to a doctor in future if spoken to like Dad was.

We don't know what can be done to alleviate Dad's condition until he is properly assessed.

It is the case that there can come a point when late in life some forms of treatment may be counter productive in terms of quality of life but this should be carefully explained and men given options which I fear it not always the case.

I will be 85 next week DV and having my second HIFU because I think this is a better option for me than having HT, although this is probably my last chance of a more radical treatment before having to rely on HT. My father had his Prostate treatment at about my age and lived to 97 or 98, dying due to complications of a fall, not PCa. I hope to emulate him in this respect as I am a carer for my wife. I strongly agree with the 'Conclusion' extracted from the link I gave in my previous post.

Edited by member 24 Aug 2021 at 12:42  | Reason: Not specified