Monday, September 25, 2017
Removal of Testicles or Hormone Therapy
My dad is nearly 85 years old. He was diagnosed with prostate cancer through a cell biopsy 10 years ago. At that time, he opted to have his prostate gland removed. His PSA count never went down to normal. He has had consistent 6-12 month check-ups by a urologist over the past 10 years and his PSA level has gradually increased. It is now 27.
He has had many total body bone scans and other tests and all have been negative in spotting cancer. He chose not to have any "just in case" chemo/radiation treatments. Because Dad is very healthy at his age, his urologist says he feels Dad has a great chance to live many more years. He said he felt Dad was "playing with fire" regarding not taking any action to control or stop production of testosterone which the cancer cells feed on. Dad has opted to have an orchiectomy for simplicity sake versus ongoing injections/patches.
My concern is (1) at his age should he put himself through this and (2) would the hormone treatments cause fewer side effects and easier to control such? Thanks for your help.
An orchiectomy offers the advantage of being cheaper and certainly no need for continued injections every few months. However, he may want to try the hormone injections first to make sure he is able to tolerate the side effects as the orchiectomy is not reversible. The procedure itself is relatively straight forward and well tolerated. Usually patients can go home the same day and do very well even at his age.
Lee E Ponsky, MD
Associate Professor of Urology
School of Medicine
Case Western Reserve University