What questions should I ask my spouse's urologist

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My spouse is 89 and his health has been failing in the past year.  He has to use a cane or walker as his legs are very weak.  He has fallen 3 times in last few months.  He does not have any heart problems.  Our Dr. performed a PSA test and it was 55.8.  He has an appointment with an urologist 19 Jul.

Could we get some advise on what questions to ask the urologist.  

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  • Posted

    The important question to ask is the liklihood at 89, whether something else will get him before his prostate does, if he has prostate cancer (he may not, there are lots of things that can spike a PSA test that aren't anything to worry about). 

    My guess is that at 89, they wouldn't perform any surgery anyway, not matter what the results of further testing. If he has no symptoms, he should probably concentrate on enjoying the time he has left and perhaps some resistance training for his legs, if he's capable of it.

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  • Posted

    Mary so happen that your taking care of your husband.  The PSA may be that your husbands prostate is enlarged.  It could also be something he is eating or a med he is taking.  When you see the urologist THey will do some test on him and you will have to go from there.  Does your husband have trouble going to the bathroom  Maybe all he need is a  pill.  Good luck  Ken
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    • Posted

      Thank you for replying.  I failed to relay that he has had a biopsy years ago.  He has to pee very often and wears a depends pad.  He has been taking pills, but doesn't help much.  I am sure he has had an enlarged prostate for a long time.  He does not remember what his PSA was when he had the biopsy and hasn't had a PSA test until now.  He did not have cancer.  His father had his prostate removed successfully and lived until he was in his 70's.

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    • Posted

      In the past, has he has been offered some sort of surgery or procedure for his enlarged prostate? Depending on his diagnosis, there are ways to help. Another option is self catherization if he is having problems emptying the bladder completely. A lot of men here do that for various reasons.

      Jim

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    • Posted

      No he hasn't been offered any surgery or procedure in the past.  He does not have trouble emptying his bladder, but has to pee often and wears a pad because it comes on so fast he may not make it to the bathroom.  I am thankful there is a place to talk to people that are knowledgeable in prostate problems.  I will be glad when we get to the urologist on the 19th.

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  • Posted

    Hi Mary,

    Your doctor probably suspects prostate cancer, which can be very slow growing. So given your spouse's age, active surveillance or hormonal therapy is often preferred over more agressive treatments such as radiation or surgery.

    So listen to what the doctor says, but personally I wouldn't even let him have a biopsy or start any sort of agressive treatment like radiation or surgery, without speaking to at least one or two other uros who specialize in prostate cancer. 

    Jim

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  • Posted

    Mary,

    I agree with the previous posts about watchful waiting.   I am 78, and if I were  89, and was receiving my first high PSA, I would try hard to avoid any invasive procedures such as needle bioposy, which I hear is very painful and can be debilitating for some time.  It can also be a source of infection.  If he is not having other urinary issues, such as slow flow or blockage, I would do nothing if I were 89 and had failing health.  There are some advanced imaging that you might think about, but I say no cutting, sticking and no transurethral procedures.

    I am not an MD, but a bad outcome for me from some "routine" procedures to address my BPH has seriously decreased my quality of life, and caused me to learn more about male urinary issues and procedures than I would have liked.

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  • Posted

    Hi Mary

    If he is having problems with peeing he may want try meds .

    If already on meds Urolift is good for years and not to hard on body.

    I would find out if the doctor does Urolift if that's what he needs, I went to several doing test .and having to repeat for next one until I found out that. My family has longevity and live into 90s so I think Urolift would have good results for him

    Good luck and God bless

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    • Posted

      Paul,

      Her husband has high PSA which suggest possible prostate cancer. Not sure where Urolift fits into this unless he's complaining of bph/luts. First step is a good talk with a knowlegeable urologist schooled or specializing in prostate cancer. Glenn77, said it best regarding "watchful waiting" and the higher risks of invasive procedures versus probably low rewards.

      Jim

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    • Posted

      Yes.....Watchful waiting would be good for him.  At his age major surgery would not be good.  To much becaus of his age. She did not say if he is having a problem going to the bathroom.  Hope all goes well at the appointment  Ken   
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  • Posted

    First off....God bless him. Ask the doctor about the risk reward of a procedure for his enlarged prostate, especially for his age. You might wan't to get opinions from a number of doctors. Actually, you did great by asking the question on this site, because I see very good advice on here.

    God bless you!

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