Active surveillance?: I'm not sure yet... - Active Surveillan...

Active Surveillance - Prostate Cancer

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Active surveillance?


I'm not sure yet what the consultant will suggest, appt on 9 October. But biopsy was Gleason 7 (3+4) Group grade 2 Intermediate favourable. 2 from 7 samples positive on right, 6 on left benign. No perineural invasion identified, or extraprostatic tissue. Tissue involved 10%.

I'm wondering what others think about possible treatment. Maybe active surveillance or perhaps radiation. A few nervous days ahead!

I've lost over half my bowel from cancer just on 5 years ago, so nearly clear.

13 Replies

Hello Thetoad,

Can you tell me what perineural invasion means? Thanks!

Thetoad in reply to Fox2018

Spreading to a space surrounding a nerve. Cheers.

Fox2018 in reply to Thetoad

OK - thanks and I look forward to learning more from you.

I had the same Gleason score with a PSA of 23 and my doctor recommended 42 radiations. My PSA went to 2.5. Then I was in active surveillance for 4 years and my PSA went up.I had a bone scan and they found metastases so they put me on Lupron injections for 6 and 1/2 years and 30 more radiations. In June of this year they told me I was cancer free. Lupron has about 15 side effects which I had to endure, but I am alive and grateful. So I am back on active surveillance, my PSA is 0.00.

Thetoad in reply to JimVanHorn

My last PSA was 7.4 three months ago. Probably need it checked. Might have been better before the consultation in 2 hours 35 minutes!

dbrooks_h in reply to JimVanHorn

I read that you had radiation in 2006 and 2011, what type of radiation and did your psa go undetectable soon after the 2011 treatment. I had pelvic radiation in 2006 but no follow up radiation after that. My psa started slowly rising in 2013 from undetectable to 1.3 and back to .8. My MO just want to keep watching psa levels, says there is nothing that can be done right now.

dbrooks_h in reply to JimVanHorn

Forgot to add ADT treatments 2007, 2008 and 2015 to present.

JimVanHorn in reply to dbrooks_h

I had 42 pelvic radiations in 2007 and my PSA was under 2.0. I was on active surveillance. Then my PSA went to 23 in 2011 and I had a bone scan. The bone scan showed metastases, so I had 30 more pelvic radiations and started Lupron injections (Eligard - generic). I took Casodex for 2 weeks because of testosterone spikes. After 2 years I needed Xgeva injections (3 total) one every 6 months. I was on Eligard until June, 2018 and now I am cancer free, but on active surveillance. I was on Eligard for 6 and 1/2 years.

dbrooks_h in reply to JimVanHorn

Thanks for all the information.

Follow up consultation in 6 hours and 40 minutes! Not that I'm worried of course. (Lol, as we young ones say.) I've had advice to push for surgery to active surveillance from various contacts on a few sites, so will leave it to the man who should know best I suppose. But also I'm told it's up to me and there is no great hurry to decide. I'll update in about 9 hours hopefully.

You may want to consider a second pathology opinion. I did and it changed my decision from surgery to AS.

Yes, after yesterday's consultation I'm leaning towards AS. He ruled out surgery but will refer me to an oncologist/radiographer. So more waiting but there's no panic. He also said that nothing is likely to change for at least 5 years, by which time I'll be a young 78. Surgery would be complicated by a dinner sized piece of mesh sewn in to fix a large incisional hernia from the incision made by emergency bowel cancer surgery 5 years ago next month. As I wrote in another post somewhere, it's sad that this pc arrives just as the all clear for bowel cancer arrives. Must not feel sorry for myself!

It sounds like you have been through the mill. I am 73 yrs and I have diabetes, heart disease, and kidney failure. I no longer am positive for PCa, but now I start on Kidney dialysis. Before you try Lupron read all the side effects (15 of them). I didn't get them all and they mostly went away after two years. There are newer medicines to try, but check with your insurance before you start one of them. They can be costly. Try to fine a doctor at a cancer clinic who is keeping up with all of the newer medications and treatments.

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