#ProstateCancer

Donate to PCRI: pcri.org/donate
For more information. visit www.pcri.org
0:07 How is prostate cancer approached for men diagnosed over 80?
2:14 PSMA PET Scans
3:41 Would it ever be advisable for a man over 80 to undergo radiation treatment?
4:57 PROSTOX Genetic test
5:17 What should an older patient do if their hormone treatment is too intense?
7:37 How is metastatic treatment approached for men over 80?
10:22 Can some patients with Gleason scores higher that 6 attempt active surveillance?
11:07 Alex's conclusion
Don't know your stage? Take the quiz: visit www.prostatecancerstaging.org
To learn more about prostate cancer, visit www.pcri.org
Sign up for our newsletter here to receive the latest updates on prostate cancer and the PCRI: pcri.org/join
Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

[@EarlBritt]

Hi, Thanks for this video. It confirms my recent actions in my case. I'm 75. My PSA before 2018 has been below five. In the last two years my PSA is about 7.2. Still under 10. My prostate MRI in 2021 was PI-RADS 4. I started eating totally plant based in Nov 2022. My most recent prostate MRI in April 2023 showed my PI-RAD score was 2. Significant improvement in my book All of my Biopsy's prior to April 2023 were Gleeson 3+3. I fired my urologist for wanting to do another BIOPSY because I felt I was being over treated. My new urologist wants me to continue with the plant based diet but get a PSA every 6 months with office call in one year. Any in my book, 75 is close enough to 80 so I don't want to be over treated so my corpse will not have prostate cancer. Thanks again confirming my thoughts about my treatment.

[@jmvelezpr]

Try modified citrus pectin 3 times a day 4.8grams empty stomach and with 3 grams of turmeric with fat

[@KDean22]

ALL CANCER THERAPIES ARE KILLERS. TAKE INTERMITTENTLY AND STOP IF SYMPTOMS GET WORSE

[@KDean22]

DOCTORS GET RICH FEEDING YOU POISON WAY BEYOND NECESSITY

[@johnfowler6189]

Thanks for your comment. I'm practically in the same situation. After my last MRI, which was prescribed because my PSA HIT 4.9, The radiology report stated that I had four lesions. 3 were rated at a PIRADS of 2 and one at 4. The MRI also revealed my prostate had a volume of 58cc. Doing the math my PSA density was .085 . Given the current guidelines of 1.0-1.5 for PSAD for determining the need for an MRI, I'm thinking at 76 why is there the necessity of a biopsy?

[@Russ188]

I am 81 years old. During several years of watchful waiting, my PSA steadily climbed, but MRI scans with a 3T scanner showed nothing of significance. When my PSA finally reached 50, my urologist ordered a PET scan, which showed locally advanced prostate cancer, with seminal vesicle invasion. I started on ADT monotherapy with Eligard a little over one year ago, and my PSA has dropped to 0.31. Not only was it effective, I did not experience any side effects. I have maintained a regular exercise program, walking 3 1/2 miles each day, and working out with resistance bands three times a week. Each individual reacts differently to ADT, and all the warnings about awful side effects do not necessarily apply to everyone.

[@johnfowler6189]

Great video. I'm 76 and getting the feeling that I'm being put through a system. The radiology report indicated a lesion with a PIRADS of 4 . However there was no involvement of any other tissues (vesicles, urethra, etc.) and my urologist wants a TRUS biopsy with 16-20 cores. Should also mention my PSAD density (PSA 4.99, prostate volume 58cc) is .086. I just get the feeling I'm being put in the system. I wouldn't have any objections to a PSMA PET scan but not available under medicare without a biopsy which is insane.

[@jonmcphee9662]

In late 2020, I had SBRT radiation with HDR brachytherapy and 24 months of Lupron for Gleason 4+4, PSA 11.8. The Lupron got tougher as time went on. Hot flashes, no energy, impossible not to gain weight, and even with carrying on my weight training regime, I lost muscle, until I was unable to get my bodyweight up from a deep squat. I cut the Lupron short at 21 months. It's now been almost 2 years and I'm back. Almost as strong as before and active again, and my weight is under control. I won't do Lupron again. At 78, 2 years of Lupron would put me into a wheel chair. If there is any recurrence, then PSMA/PET with spot radiation would be my choice.

[@bglrj]

Thank you for science-based, commonsense approaches that exhibit compassion towards the patient.

[@rickcertano2767]

Thank you for your videos. I am a 77 year old very active person. Walk, hike, lift free weights 3 days a week in the summer ski over 100 days in the winter. Have had bph having to urinate at night 2-3 times. Still have a decent stream. Psa was 4 3 years ago, stopped talking saw palmento, 6.5, 7.2, 6.8, now 11. Free psa test showed low probability, over 25. Read somewhere that hard physical exercise could increase psa 40-50% and that ejaculation would also raise psa. I will not do hormone treatment. Cure is worse than the disease. But frankly rising psa does worry me. Try to eat right get plenty of sleep and of course exercise, but not sure what eating right is. Obviously with bph psa will rise just due to the increase in size. Lots of questions here I know, but very distrustful of drug and treatmesnt marketing. Thanks again for your videos. I feel im getting an unbiased answer! Please keep up the good work!

[@maxthemagition]

In August 2007 I got a private health check and my PSA was 5.64. Early this year 2023 I went ot the doctor for frequent visits to the toilet during the night and the doctor took a blood sample for a PSA test which was foun to be over 10 at 11.5. So my PSA went from 5.64 to 11.5 over a period of 15 to 16 years during which I have been very healthy other than the frequent visits to the toilet during the night for a wee. Anyway this was followed up from early this year ...scans, biopsy etc to find that I have Gleeson 4/3 and now I am on Hormone therapy for 6 months during which I will receive radiation therapy over 3 weeks. My testostorone level is going down and I feel aged, body sweats and fatigued. I read that my PSA should come down to near zero after Ratiation Therapy, but if it goes up slightly, I could be back to square one as it indictes that the cancer could still be present. Is there no escape for this nightmare? I will be 77 years old come December this year....

[@robwells230]

Best wishes.. I am in a similar situation..76 PSA was 42, had cystoscopy, then MRI that showed locally advanced cancer, then a fusion biopsy showing Gleason 3 plus 4 with three percent 4. Coerced into a six month shot of Eligard , then 25 fractions of 68 Grey IMRT. No problems from the RT and PSA dropped to 0.006. with T at 9. Severe side effects from ADT so I refused future Eligard, and remain well below castrate level even 9 months after the first shot expired. The fatigue, mood swings, and brain fog were the worst, could have suffered through the hot flashes, sweats, loss of libido, no ejaculation or orgasms. I feel like the ADT CASTRATION has aged me by at least ten years. Soon, I will self administer twice weekly testosterone cypionate intramuscular injections to try to reclaim some quality of life. I was never warned about the horrific side effects or told that testosterone recovery was uncertain, but coerced, deceived and extorted into this toxic shit without being given any statistical benefit. It's not a life suffering as just another ZOMBIE EUNUCHS. I have lost all faith and respect for my Alberta CROSS CANCER INSTITUTE. I need to sign a two page consent form just to get a freaking flu shot, but the bastards can just force ADT CASTRATION on me without any FREE AND FULLY INFORMED CONSENT. THEY treat us like concentration camp inmates at this hellhole named in honour of the fascist bastard W W CROSS who forced castration under his criminal Eugenics program. YES...I AM PISSED OFF

[@richsparkman9980]

I'm 73 and on hormone treatment and radiation and it is terrible I have no energy I tried to quickly it is life changing I thank you for all your useful information

[@KDean22]

YOU ARE BEING KILLED. I AM 75 AND REFUSED ALL THERAPY

[@kanelliscalcoyannis2692]

Thank you for your video & this awareness. My dad at 78 was told to have robotic surgery for his prostate cancer whilst he also had a aneurysm that they wanted to do surgery for, doctors suggested first to do robotics and two weeks later to do the aneurysm surgery. The robotic prostate surgery 3 days after developed post operative ileus, went back to ICU, then had a aneurysm in his leg, so more surgery, had to learn to walk and stand again so spent more time in rehab. Had little bladder control for a long time afterwards. Six months later had a stroke and a year after this procedure died. If he had just lived with the cancer probably would have lived longer. Invasive treatments are to be considered especially after a certain age and surely robotics was not for him as a history of high blood pressure etc.

[@fredcisneros]

I'm on hormon therapy for 7 months now and am experiencing severe cognitive problems with things am writing an hour or two been forgotten. Next month I will be 87 years old. Thanks for the shared observation.

[@robwells230]

The best, most honest video PCRI has produced because it , for the first time, acknowledged that the ADT CASTRATION effects can be horrific and quality of life destroying. .....If men at 80 should be spared the harms of these TOXIC drugs, certainly men mid or late seventies should give every consideration to avoid or minimize ADT results ... shorter duration ... milder drugs like Bicaludamide monotherapy .. perhaps NO ADT at all. You are so right that patients need to be assertive and consider their quality of life before doctors coerce or deceive them into ADT CASTRATION which results can be permanent in up to twenty percent of older men. Great job Alex

[@robertmonroe3678]

It amazing that we still have to see toxic drugs like Lupron utilized in the fight v Prostate Cancer. Your point regarding Bicaludamide monotherapy is very well taken. Perhaps short course or intermittant orgovyxx is another alternative.

[@hokkitt]

This channel is liffe-saving (mentally) Love you guys. Greetings from northern Sweden

[@TK-123]

God Bless you guys. You guys are a guiding light..

[@ForTheLoveOfMike]

Thank you so much for sharing 💙

[@barrie888]

well explained , tks always

[@rancancookcanoy9768]

Another great video. Thank you

[@likeariver2237]

Excellent advice Dr.and Alex. 👌

[@danielswenson5502]

Really good video and advice, thank you.

[@Giovan_Nino]

Such a good video..please continue to educate..👌

[@edwardbertorelli7358]

Great topic ....as a man who is 75 and undergoing treatment involving darolumide and radiation as part of the INTREPID study...so far going well

[@robwells230]

Has it dropped your testosterone level below CASTRATE LEVEL, and if so, how are you coping with side effects,???? My ADT was so insufferable that I refused to continue on it, and yet, I'm still well below castrate level eight months after that first shot expired. Some men don't seem to be bothered by no T, and others would sooner be dead than suffer from it. Always good to get other's experience

[@edwardbertorelli7358]

@@robwells230 darolumide does not drop the testosterone level ...it prevents the testosterone from connecting to cancer cells and weakens and kills them...psa is .17.......as for side effects...very little..no hot flashes..slight tiredness

[@jasminesharma5278]

Could you please mention the dose of chemotherapy for 82 for small multiple lung metastasis disease as CRPC . My dad had Gleason 8 and on hormone therapy but developed penile metastasis which is radiated recently and now PSMA pet showed lung metastasis. If he needs chemo then how much should the dose be? Doctor has put him on Abiraterone and zoldex. Please suggest

[@richelledejong4863]

Question: will dad need to be on hormones permanently? My dad is 80 and in Dec. 2022 was diagnosed with stage 4 with Mets to several bones and lymph nodes , Gleason 9 , PSA 78. Since February he has been on Valtran , Zoltan, Nubeca, 8 chemo treatments of Doxtel. Fast Forward to today: We just received his latest PET scan with is METS 79% gone and PSA .377 He exercises 4 days a week, 2 -3 days with a physical therapist. (We asked the doctor to write a script for this so it’s billed under insurance and it has made a big difference in my dad keeping his strength) This channel has helped me be more informed and gave me knowledge when talking to the doctors. Thank you ❤

[@salamawaad9460]

thanks a lot for both of you I am 64 years old l diagnosed recently with prostatic cancer Gleason 6 I am complaining of BPH symptoms since 7 years your opinion about robotic prostatectomy

[@hn5460]

I hope the doctor will answer your question, but IMO, you should not go for treatment. Your Gleason 6 is a dream case most of us here wish to have. It won't kill you at the end of your life, if that is a true Gleason 6 score.

[@robgerety]

I'm 72. Just had prostate mri and then biopsy. The MRI shows that I have a tumor that involves nearly my entire prostate. The gleason assigned is 7 (4+3). I am getting a second read of the slides. There are some details in the mri and pathology reports are concerning (at least to me) for possible existing spread. My most recent PSA is 16. It has been weeks and I have yet to have a conversation with a surgeon and/or an radiation oncologist and they are initially talking about scheduling these meetings in November. There is almost no communication unless I push hard. I am working on that and it looks like they may schedule appointments mid October. My mri and my biopsy were completed in August. My concern is that we won't even begin to discuss treatment options until mid October and I assume it will be a good long time after that before the treatment option we settle on is implemented. I feel somewhat like we are fiddling away while Rome is burning. Are these sorts of time frames typical? I know they are all terribly busy. But...

[@davidbuha9132]

Contact the PCRI for a recommendation for a good radiation oncologist in your area. They are a tremendous resource.

[@robwells230]

I know I had cancer for at least 15 years before symptoms final made me seek medical attention. But, those were good years, and if I had been diagnosed early, they would have had my balls in a bucket, surgically or chemically, and I would have had no quality of life over those years and suffered as a ZOMBIE EUNUCH. My point is... there's no big rush or panic. You are on the right track by educating yourself by getting ALL the facts so you can't be rushed or coerced into any treatment. Don't believe everything that your doctor says about how well tolerated the side effects of ADT CASTRATION are. They are horrific and quality of life destroying and life threatening and permanent to many. I am not for a moment suggesting that you should refuse ADT as it may be your best or only reasonable option. Just demand full and honest disclosure, not Big Pharma sales propaganda. Then, YOU make your own decision without being rushed or extorted into anything without your FREE AND FULLY INFORMED CONSENT. best wishes for a cure AND a good quality of life.

[@PMRA1285]

@PCRI, need help can u share about liver toxicity of Abiratone and what options for men who develop high toxicity and it is stopped .He is diagnosed metastatic

[@frankchi7704]

Hi, thanks for the video. I am 81, currently I am on Eligard and my PSA was 1.4 about a month ago. PSMA -PET was taken on 3/8/2023 indicating that cancel cells were only present in the prostate. What is the likelihood that the cancer will become castration resistant if ADT is not a part of the treatment? @FKC

[@user-hl4ke5js2y]

My husband is 85 .suffering with prostrate cancer with affected lymphnodeshe is on hormone therapy for last 3 years what do you suggest .thanks n regards

[@gshenaut]

Interesting. I had my prostate whacked at age 74 (Gleason 3+4), about a year ago. I've had a slow but nearly complete recovery from the urinary & erectile effects of surgery, and my PSA is still undetectable. In effect, I will be in watching and waiting mode the rest of my life, because of the chance of a recurrence. However, because there is now at most only a tiny bit of prostate tissue left in my body, the chances of a recurrence would appear to be much less now than they would have been without the RP. I am cautiously optimistic about prostate cancer in my 80s and beyond, if I should be lucky enough to make it there.

[@hn5460]

I am happy for you, but your reasoning was flawed. - In the "watching mode", you actually will quickly forget about it and get on with your life. The annual check will just be part of your total health check that you should do given your age, and those possible health issues are far more dangerous than your low grade PC. - When talking about chance, there are 2 important measurements we must think carefully: 1/ chance of death by PC. 2/ quality of life. With low grade PC, it seems there is no difference in mortality by all causes between having low grade PC treated and having it on "active watched". Unless we live past 100, other health issues will quickly take over the low grade PC issue and eventually kill us. Meanwhile, quality of life will reduce substantially with treatment, and you lost at least a year of quality life for it.

[@gshenaut]

@@hn5460 I don't think so. Based on the MRI, my cancer, although lowish grade and not huge, had already invaded the fibromuscular stroma and so I was worried about it growing outside the prostate. Also, my quality of life had already deteriorated due to prostate growth squeezing the urethra; now, I pee like a teenager, so on that scale, I have greatly improved my quality of life. Also, I'm one year out, but it would be unreasonable to count the majority of that year as a loss of quality of life. The only period of markedly reduced quality of life, in my opinion, was the first few months as urinary continence gradually resumed. Three months post surgery, I drove cross country CA to RI and back with various side trips to visit family and, except for wearing light pads for security, had a splendid time. I no longer need the pads at all, and haven't for a while. I've resumed my fitness program and even teach a Zumba-ish class from time to time. However, there is still some chance of a recurrence, and that's what I am watching for. Since I have no prostate, this is just a matter of having periodic PSA tests through the rest of my 70s, my 80s, and beyond, until I die, unless a recurrence is detected. Of course, every case is different and I could have had a worse outcome, no question about it. I kept that in mind when deciding about what to do after the initial testing had been done; that is, I knew there was a risk of a poor outcome quality-of-life wise, and I suppose one might say that I've been relatively lucky so far. My surgeon has a long record of producing good outcomes, and that was a factor in my decision.

[@paulchan568]

If you go to the gym, no matter what the age is..side effects is overcome. Diet too....

[@robgerety]

I need to get real about diet and exercise now.

[@irenesieu7312]

How about for 70 years old? Gleason score 10. Pet scan show tumor only locally. Should he go on hormone therapy? Thanks.

[@ThePCRI]

For specific questions and information, please reach out to our Helpline here: pcri.org/helpline

[@terranceolson9134]

That's a tough one. I'm 74, Gleason 4+3, with two tiny spots are on my lower left lymph nodes. I'm being treated with radiation and planned 2 years ADT. At 70 and if healthy, I'd hit it with everything available, especially with that high Gleason score. You may want to get a Decipher biopsy score as well. I believe it's more accurate than the Gleason score, Medicare will pay for it, and they just use tissue from the Gleason biopsy slides. I plan to consult with my urologist after a year to see if he still feels 2 years ADT is prudent with all the new information that is coming out since my cancer may be curative if they radiated everything that showed up on the PSMA Pet Scan. My feeling some ADT is good, but why wait two years to stop ADT and see if PSA rises? If it does rise, then get another scan to hit any new spots which were likely to be detected after 2 or more years on ADT as well? If the cancer is spreading after radiation, then ADT is likely be needed on an ongoing basis, but if not, why stay on ADT two years to find out?

[@edotero6331]

Can you address AOH 1999 pill. Is it effective? can it be a treatment pill for folks on active surveillance?

[@MoreChannelNoise]

My partner is 91 he has prostate cancer with spreading. They put him on hormne therapy. Before he could walk 1 mile easily and liked to walk every day. No most days he cannot walk at all and is in a wheelchair all day and sleeps most of the day. Zero quality of llife

[@hn5460]

This is the issue we most fear of: With reduced activity, comes the faster death by other causes.

[@MoreChannelNoise]

Well that's what I have been thinking. It is like living with someone not far from death now! he just sits and sleeps all day in a wheelchair and eats and drinks less.@@hn5460

[@KDean22]

TRAGIC INDEED. HE SHOULD HAVE ASKED THEM Y TO STOP WHEN DETERIORATION STARTED

[@MoreChannelNoise]

@@KDean22 He was dementing and we had to make hard choices. He passed away last September

[@KDean22]

@@MoreChannelNoise CANCER THERAPY IS ALL KILLERS. ASK ME

[@gvet47]

I am 75 and are taking hormone therapy and the side affects are terrible. No energy to even get out of bed. The sweats are more like I am drownding and always miserable. My prostate cancer is in my lymph nodes and lots of pain. I have never even been told anything about Gleason scores. I'd rather die at 80 and live better without these shots. These lupron shots are bad. Told my doctor about you video. Ask about the pill you say may not be as bad. He just looked at a chart saying my life will be longer and less tests on the pill. I just know my mind snd body are not as good.

[@georgerios7491]

Lipton stands for 7 days of Hell trust me this how painful it is sorry 🙏

[@RonWondga]

Wondering what research says about taking testosterone injections immediately after quitting hormone therapy due to unbearable side effects ( at age 78)?????

[@lectricmotors]

I don't want to prolong life at the expense of any loss of quality of of life, especially if loss of multiple functions such as muscle mass, urinary, erectile, ejaculation, bowel etc. Perhaps I'm an outlier, but my current age is completely irrelevant to my choice of action. If I'm eventually going to die of Mets, it's going to be even more painful if I'm older, no?

[@danwilliams4698]

I agree with you. I'll be 82 in a month. I was diagnosed with grade 4 cancer in 2021 (Gleason 9) and was put on Lupron with Zometa infusion to help with the bone loss that comes with taking Lupron. . Then Lupron and Zitiga plus Prednisone, then Erleada plus Lupron. None of these brought down my PSA significantly. After my last shot of Lupron I told my doctor that I would never take another Lupron shot because it quit working and I want quality of life over length of life. Initially the Erleada worked to bring down my PSA from 13.1 to 2.1, and then it quit working and my PSA is back up to 9.7. These ADT meds work until they don't as for me, with metastatic resistant cancer moving to a small spot on my hip bone. With the rise in PSA, I can do all the things that I previously just thought about doing, but did not have the energy or strength to do. I do have an appointment with a radiation oncologist to discuss radiating the spot on my hip to determine if we can kill the cancer there. I do not have any difficulty peeing, but do have to get up several times per night.

[@John-ro9tf]

Whàt ìf àll thàt has beèn applìed by our URÒLOGIST fpr seven yesrs isCAPHITA change