I think that active surveliance is a very good option no matter what the age. Sure there is a small risk, but side affects are 100% guarenteed in any treatment and in a large percentage of men they are permenant.
There are a number of ways to reduce the risks, a color doppler can set a base line and any changes can be easily seen. If PSA starts accellerating or if a biopsy shows an increse in gleason or # of cores positive treatment can begin.
I know that is a psycological factor for some guys, but some like myself wouldn't mind knowing PC is in my body, I just have to know that it is controled. I've probably had PC for 12 to 15 years without knowing it and never felt the affects.
Having 5 to 8 years of good life before having to live with the consequences of a treatment is a good option for many.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.
2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.
Scheduled for 5 weeks IMRT in July