I agree it's a tough call. His health, apart from CABG (quadruple bypass) and a series of Stent's is pretty good. Could probably use a knee replace in one, but he gets Cortisone shots every 6 mos or so which help out.
I guess I would lean towards doing the biopsy. If Gleason 7 or above, then maybe seeds. From JAMA 1998; 280 and article called "Competing Risk Analysis of Men Aged 55 to 74 Years at Diagnosis Managed Conservatively for Clinically Localized Prostate Cancer", the 15 year mortality risk for 70-74 yo's, specific to PCa, was about
40%, and about
equal to the risk from all other causes. That's still a lot of area under the curve.
"Managed Conservatively" meant no surgery or radiation of any form, but harmone therapies for some of the patients at some point in the progression.
One nerve spared
Gleason 7 - T1c
Pre op PSA 8.2 -- first PSA ever taken at age 50 physical
Most recent PSA 0.02 (12/10)
Post Edited (Rolerbe) : 2/17/2011 11:02:39 AM (GMT-7)