Patient Question: Description:I am 78 years old. I have been in good health with no chronic diseases, my psa has been high and rising year by year, 9.91 in November last year, 8.30 the day before yesterday. recently, my urine has become thin and incomplete, recently I had a puncture, the report has been uploaded. Hope to help:Hello doctor! At an age like mine and with very few cancer cells, which is the best treatment option to use on the balance of pros and cons? Please analyze which option is better and less troublesome after surgery? Thank you! I am looking forward to your reply! Niu Yinong, Department of Urology, Chaoyang Hospital, Beijing, China, replied: Currently, prostate cancer is in the very low risk group, and the treatment options are active surveillance, particle implantation, external radiotherapy and radical surgery. If you are in good health and have a life expectancy of 20 years or more, you can undergo aggressive treatment such as radical surgery. If you are in poor health and have a life expectancy of 10-20 years or less, active surveillance, annual PSA and rectal examinations, and repeat punctures if necessary, at least one year apart, are sufficient. If the life expectancy is 10 years or less, observation is sufficient. Patient question: Dr. Niu: Thank you for your serious reply. 1. If the life expectancy is less than 10-20 years, active monitoring is sufficient. What are the items to be monitored? If the life expectancy is less than 10 years, observation is sufficient. What should be monitored? Can you tell me more about this? 2. Radical surgery means that the entire prostate is cut out, right? Is there any after-effects? The first thing you need to do is to take a look at the results. Are there any sequelae? The actual fact is that you can be a good deal more than just a little bit of a person. I’m 78 years old, in good health with no chronic diseases, weighing the pros and cons, what kind of treatment plan do you think I’m suitable for? I have wasted a lot of your time asking questions! Thank you again. Niu Yinong, Department of Urology, Beijing Chaoyang Hospital, replied: 1. Monitor PSA, rectal examination, and repeat puncture if necessary. The disease has progressed, that is, active treatment. 2. Radical surgery removes the prostate and seminal vesicles in their entirety, and also includes pelvic lymphatic fatty tissue. The possible sequelae include urinary incontinence, erectile dysfunction, etc. The actual adjuvant treatment can wait for the final pathology report and other comprehensive judgment. 3. Endocrine therapy, i.e. androgen deprivation plus anti-androgen therapy, is an injection and medication, not surgery, and you do not need it for the time being. According to your situation, local treatment such as radical surgery is feasible if you are more active, and active monitoring if you are more stable. You can come to our hospital for evaluation of surgical treatment. The echogenicity is uneven, and the middle lobe is protruding 19mm into the bladder. The actual fact is that you can take finasteride to shrink the rest of the product, benefit urination and control the tumor development to some extent.