Vascular Dementia/Alzheimers

My father has vascular dementia and probably also has Alzheimers and as recently been diagnosed with prostate cancer.  He has been told he should have a radical prostectomy vs. seed implants.  He is 67 years old and has been an icon in our commnunity.  Will the surgery cause his dementia/Alzheimers to worsen?  I would almost rather loose him to cancer than to see his dignity and reputation destroyed by his mental disease.  His prostate cancer has not spread to other organs or to his bones but as explained to us, when they do the surgery, they will check his lymphh nodes prior to removing his prostate and if they are positive they will sew him up and try a different form of treatment.  He has lost 43 lbs. since last July but has not lost any in the past 2 months.  We feed him well so I wonder if the cancer has already spread to his lymph nodes.  I am struggling with whether to put him through the trauma of anesthesia and surgery if it will be for not.  It seems that they could know if it has spread tot he lymph nodes without invasive surgery.  It is so hard to know the right thing to do, I just want him to have the best quality of life for as long as possible. Thank you for your prompt answer.  He is scheduled for prostate surgery on July 17.

[Roger Gould, M.D.]

This is a difficult choice but there are some medical facts to help you.  The surgery itself should have no effect at all on the dementia or Alzheimers.

The question about surgery is much more difficult to respond to because it is urological problem rather than a psychological problem.  One thing you can do is ask for a second opinion from another urologist.

There several non-invasive alternatives, and one of them is hormone treatment, which may have( you will have to check out) some positive effect on the vascular system.