My spouse’s choices

[Pj10128]

In Nov 2018 my spouse who is 81 asked his urologist for a PSA test. The result was 7 and after antibiotics it was 8. A biopsy was scheduled resulting in a Gleason score of 7 (4+3) The radiation oncologist is doing 25 external beam followed by brachytherapy. The urologist wants him to start Lupron first. The oncologist does not think hormones are required. They say he will be cured but he doesn’t believe it.As the treatment approaches the realization becomes mor anxiety provoking. No matter how much I read as his caregiver and partner of 41 years I can’t anticipate what our experience will be.

[Darryl Partner]

Before you both do anything, please read and follow through on this: malecare.org/second-opinion...

ALSO, at 81 years old, ask your doctors how much lifetime he has with and without treatment. MY guess is ten years with or without. Many 81 year old men will have an elevated PSA and a Gleason of 6 or 7 or 4-3/7 From the little you posted, it certainly isn't time to worry.

[Tall_Allen]

Here's a "test" he can take to determine what the odds are that the prostate cancer will kill him in the next 15 years.

webcore.mskcc.org/survey/su...

This is why men his age are usually not given a PSA test. What, if anything, he wants to do about it is up to him. These are just population statistics, he may decide that his case is different.

The therapy his doctors are recommending, "brachy boost therapy", is the most curative. In men with GS 4+3 (unfavorable intermediate risk), 92% of men getting brachy boost therapy did not even see their PSA rise for at least 10 years:

pcnrv.blogspot.com/2017/05/...

Adding hormone therapy to brachy boost therapy will probably not improve results:

pcnrv.blogspot.com/2017/12/...

[Pj10128 in reply to Tall_Allen]

Thank you. I really appreciate your comments

[EdinBmore]

I agree with Tall Allen. After 7 yrs on AS, my numbers changed to 3+4 and a Gleason of22, often a trigger for treatment. I had 25 radiation treatments followed by brachy boost. Additionally, Firmago for 1 month, then, Lupron. One more injection to go. BUT, I'm 69 not 81. Obviously, your decision about treatment options but I can tell you that my experience with Lupron has been awful. I've been able to tolerate the side effects but they have taken their toll BIG TIME. I don't know what it's like to be 81 but I cannot imagine Lupron at that age.

Get another opinion (or two). As Tall Allen said, this is why most docs don't get PSA tests done at 81. Consider your quality of life! Trust me, it won't be pretty on Lupron.

Good luck to you.