<s>[INST] Hi- I have had a rising PSA over the past 10 years. four biopsies during this period all negative...when PSA was 26 urologist recommended a endorectalcoil MRI which revealed susupicious area in the anterior of the prostate...a fifth biosey was conducted revealing cancer Tc1 (cancer nodes were never felt during digital exams througout the periiod) Gleason 3+4=7 with a PSA at present of 54.....bone scan, skeletal MRI all negative in terms of cancer spreading. I have been given the options of surgery (with no guarantee since the urologist who is chairman of the local cancer board does not understand why the PSA is so high.) or hormone/ radiation therapy ....my urologist has conducted over 600 robotic surgeries for prostate cancer and is willing to do surgery however he informs me that there is a chance that the cancer has spread in microscopic form outside of the gland ..he believes this due to the unexplainable nature of the evevated PSA. Therefore the surgery and the risks associated with it would have been in vain ..for the most part Given the crap shoot that I have been offered in terms of treatment options and the serious side effects of these treatments particularly as they cause my quality of life to decline I am seriously considering doing nothing...I am 65 will be 66 in October... I do have an appointment with a Oncologist (non radiation) to discuss other possibilites. Your thoughts..?? [/INST] Hi, At 66 with a Gleason 7 cancer without evident spread even with a high PSA needs to be given a chance for curative therapy. Robotic prostatectomy gives the best chance for cure with minimum complications. High chances of node positive disease though. Other option that you are considering of doing nothing will land up in Watchful waiting i.e. hormonal treatment when you develop extensive disease. That option is exercised in older patients or if you have some other diseases making you unfit for surgery. At your age, give yourself a chance Good luck </s>