From what you described so far, key points of your 87 Y.O. dad’s case is that he is asymptomatic
(he is experiencing no symptoms today) and but prostate cancer was found yet apparently confined
to the prostate.
It would likely be meaningful to add information on why—at age 87—he was given a prostate biopsy. In other words, what history of prostate monitoring and/or PSA history does he have. (Typically, if a man has had normal PSA test results testing is discontinued at age 75; has he had past prostate issues?)
For newly diagnosed men, we typically suggest that they have their prostate biopsy slides read by a prostate pathology expert. This step is highly recommended because hospital pathologists read a lung cancer sample, then a breast cancer sample, then a prostate cancer sample, and they are expert in none. As a result, many prostate samples are “re-graded” when read by an expert…they could go up or down, but we often encourage men to get good data to start with. The cost is only a couple hundred dollars, and there are names/links in the “sticky” thread (“Newly diagnosed…”) at the top of the page for this well-known service.
He should be aware that all prostate cancer treatments have side effects detrimental to quality of life. All of them. He should also be aware of the term “watchful waiting.” Confined, asymptomatic prostate cancer in this age group is usually managed conservatively. The previously mentioned sticky thread has a great definition of “watchful waiting,” which is:
What is “WATCHFUL WAITING?”
Watchful Waiting (WW) is a strategy of using less intensive follow-up (fewer monitoring tests) and relying on changes in a man’s symptoms to decide if a treatment is needed. If symptoms appear, whether it is a lower urinary tract obstruction or bone pain from metastatic disease, treatment is introduced to relieve symptoms…so it is a palliative (not curative) therapy. This strategy is usually applied when the doctor & patient agree that he has fewer years of life expectancy and/or has other concomitant health problems, or because the patient believes strongly that he would prefer the risk of disease progression to the risks associated with aggressive treatments.
WW has been around a long time, but the fundamental basis for modern forms of this strategy is that one is trying to avoid receiving treatment of any type for as long as possible so that the patient may optimize his quality of life, while recognizing that it may be necessary in the long term to intervene so that he has minimal impact from the potential morbidity and mortality associated with prostate cancer.
WW may also be appropriate for a man who is suspected of having PC but for whom a biopsy is perhaps an unnecessary intrusion because of age or health. In such cases, even if a biopsy proved to be positive, curative therapy would not be recommended, which makes the biopsy somewhat futile.
Your dad may or may not be interested in watchful waiting, but the term should be added to his vocabulary…particularly if quality of life is paramount. Older patients may be more inclined to avoid risk and less willing to sacrifice quality of life for prolongation of life, but this is a very personal choice.
Hope this helps.