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User
Posted 16 Oct 2024 at 17:27

My friend who is 86 years old had a PSA test about 6 months ago. The result was 28 ng/ml. He then had two MRIs one for the pelvic area and another full body. I went with him to the consultant appointment to discuss the results. The pelvic MRI show a growth in the prostate which was scored PI-RADS 5. The full body MRI showed that there was no spread from the prostate.

He decided at this visit not to proceed with a biopsy but to go on the watchful waiting pathway.

A further PSA test 3 months later showed a small rise to over 30 ng/ml.

At his latest appointment a few weeks ago the consultant discharged him from the pathway without a further PSA test.

Is his treatment reasonable?

 

User
Posted 16 Oct 2024 at 18:04

Not enough info.

Without a biopsy, they won't know how aggressive it is, but a rise of 28 to 30 in 6 months is a very slow doubling time, which might suggest not very aggressive at all.

What do you think his life expectancy is, ignoring the prostate cancer? On average, it's 5½ years for a male of that age. For a non-aggressive cancer and a life expectancy of 5½ years, he's unlikely to benefit from treating it.

If you think his life expectancy is longer than the average for his age, getting periodic PSA tests would be a good idea.

User
Posted 16 Oct 2024 at 18:09

To be honest, at 86 I would be surprised if he didn't have Prostate Cancer? Looks like the doubling time is around 2.5 years. I would imagine the consultant has balanced quality of life, reaction to treatment and survival rate for surgery against radical treatment. Most males that age die with PCa as opposed to from it (I stand to be corrected if that stat has changed now).

Edited by member 16 Oct 2024 at 18:10  | Reason: Not specified

Good luck to everyone coping with the insidious big C

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User
Posted 16 Oct 2024 at 18:04

Not enough info.

Without a biopsy, they won't know how aggressive it is, but a rise of 28 to 30 in 6 months is a very slow doubling time, which might suggest not very aggressive at all.

What do you think his life expectancy is, ignoring the prostate cancer? On average, it's 5½ years for a male of that age. For a non-aggressive cancer and a life expectancy of 5½ years, he's unlikely to benefit from treating it.

If you think his life expectancy is longer than the average for his age, getting periodic PSA tests would be a good idea.

User
Posted 16 Oct 2024 at 18:09

To be honest, at 86 I would be surprised if he didn't have Prostate Cancer? Looks like the doubling time is around 2.5 years. I would imagine the consultant has balanced quality of life, reaction to treatment and survival rate for surgery against radical treatment. Most males that age die with PCa as opposed to from it (I stand to be corrected if that stat has changed now).

Edited by member 16 Oct 2024 at 18:10  | Reason: Not specified

Good luck to everyone coping with the insidious big C

 
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