Question
I’m really worried about my elderly father. Last November we were told he has prostate cancer, which has spread to the bones. (He does not know about it). Yesterday he agreed to have a knee replacement carried out due to severe arthritis. Can you please tell me if having cancer may complicate his recovery and if there is any other way he could get pain relief without going under a general anaesthetic. Painkillers and injections into the knee joint in the past have failed to help. We were told that he may live up to two years with the cancer and I’m worried that having this operation may shorten his life. In general how well do older cope with such operations?
Answer
Carcinoma of the prostate can spread to bone and the usual site of spread is the spine. It is most unusual for it to spread to the knee but presumably that point has already been considered because a surgeon would hesitate before inserting a replacement joint into a bone that was affected by cancer. With regard to your father’s recovery his pre-operative state of health is the crucial determinant of outcome following surgery. In other words, if he is in good general health the fact that he has carcinoma of the prostate should not unduly affect his recovery. If on the other hand he was not a very fit candidate for a general anaesthetic due to heart or lung disease then he could be operated on using spinal anaesthesia. Either way his history of carcinoma of the prostate should not be a block to him undergoing joint replacement surgery. In my experience elderly people cope quite well following such surgery. The key issue in managing your father’s situation is quality of life. Since he no longer obtains relief from painkillers joint replacement surgery would appear to be the best course of action to take. As a general rule carcinoma of the prostate in elderly men tend to be slow growing and such men often die eventually for reasons other than the carcinoma.