Can an 81-year-old with prostate cancer undergo surgery?

Whether an 81-year-old patient with prostate cancer is suitable for surgical treatment depends on the patient's specific health status, tumor stage, and doctor's evaluation. Age is not an absolute contraindication, but a comprehensive assessment of surgical risks and benefits is required. Treatment methods include surgery, radiotherapy, endocrine therapy, etc., and the specific choice needs to be individualized.

1. Surgical treatment. Radical prostatectomy is a common method for treating localized prostate cancer. It is suitable for patients whose tumors have not spread and whose life expectancy is long. Minimally invasive surgeries such as laparoscopy or robot-assisted surgery are less invasive and have faster recovery. For elderly patients, a comprehensive assessment of cardiopulmonary function, comorbidities, and anesthesia risks is required before surgery to ensure the safety of the surgery.

2. Radiotherapy. External beam radiotherapy (EBRT) and brachytherapy such as seed implantation are alternatives to surgery, especially for patients who cannot tolerate surgery or whose tumors have locally progressed. Radiotherapy can effectively control tumor growth and reduce surgery-related complications, but it may cause side effects such as frequent urination and urgency.

3. Endocrine therapy. Inhibiting androgen secretion through drugs or surgery to delay tumor progression is suitable for patients with advanced or recurrent disease. Commonly used drugs include luteinizing hormone-releasing hormone (LHRH) agonists and anti-androgen drugs. Endocrine therapy can be used alone or in combination with radiotherapy, but long-term use may lead to osteoporosis and increased cardiovascular risks.

The treatment of prostate cancer needs to take into account the patient's age, tumor stage and physical condition. Surgery is not the only option. Radiotherapy and endocrine therapy are equally effective and are more suitable for patients who are older or have more comorbidities. The treatment plan should be jointly formulated by a multidisciplinary team to ensure that patients get the best treatment effect and quality of life. Regular follow-up and monitoring are important components of treatment, which help to detect and deal with recurrence or metastasis in a timely manner.