Most patients in their 70s will probably not be surgurized for prostate
ca unless they are suffering from urinary retention.
    Furthermore, a patient with Parkinsons and dementia will need
significant postop help, since it will be difficult for him to follow
postop instructions on his own.
    This doesn't mean treatment is ineffective.  He will probably be put on
hormone therapy that often drastically cuts tumor activity.  If he has
spread to his bones he will likely be given bisphosphonate drugs to help
prevent fractures and further debility.

Steve

I take it to mean that prostate surgery is not appropriate, taking into
account ALL the circumstances in a particular case, and other forms of
treatment are more appropriate. Only the patient's urologist can decide.

"not a candidate" can mean that there is no effective surgical treatment for
a particular condition, or the patient is too ill to undergo the procedure,
or there is too much disease to be effectively treated with a limited
operation.  It depends upon:

-- what kind of "prostate surgery" is being considered

-- what the diagnosis is (probably the most important information -- does
the patient have prostate cancer?  does he just have benign enlargment of
the prostate?  if he does have cancer, has it spread?)

-- more medical history than what is provided here (or could be provided
here).  It may have nothing to do with whether the patient superficially
just looks "good ", it may have more to do with whether there is any
surgical treatment for the patient's problems --- whether there are specific
urological contraindications to a surgical procedure -- whether the patient
has indicated that he personally doesn't want treatment (something an
acquaintance might not have commented on) -- whether the patient's primary
physician doesn't feel he should have it -- and whether  as someone else has
already pointed out, whether the patient's dementia (and lack of social
support) might make a complex surgical procedure difficult to perform
successfully at the present time...