About to have that "One Month after Biopsy" conversation with Doc.

[Louis75]

Urologist gave me a month to think about questions and concerns after my diagnosis of Favorable Intermediate Risk PC.

My Biopsy showed 1 core with Gleason 6, One core with Precancerous cells, and 10 good cores.

My PSA is 12.1 and My Select MDX test was 72% likely, 48% aggressive.

I'm 74.

Other data is in my profile.

Seems like a high PSA for a single core cancer. I am thinking of having a 2nd opinion on this.

My Urinary symptoms are moderate and very annoying.

What should I know going into this meeting with my doc. I, of course, want active Surveillance, but I don't want to be stupid and naive either.

[Tacker]

Louis75, I am facing a similar decision. I am 62, PSA numbers vary right around 10, biopsy showed several Gleason scores of 6. My symptoms are very mild and I could live with them the rest of my life. Only one core with cancer when you have a PSA of 12 is interesting. I am looking into genomic testing. It is supposed to help determine how aggressive the cancer is. You may want to look at that. Definitely get a second opinion. I have talked with 3 doctors, a urologist, a urology surgeon and an oncologist. I got the same opinion from my urologist and oncologist. That all 3 options are viable. They seem to both lean slightly towards active monitoring. The surgeon wants to remove it. I am still mulling it over, but am leaning towards active monitoring. Ask as many questions as you can. Read as much as you can. Take your time. Unless this is an aggressive cancer, take your time. Ask about likely outcomes, side affects (short term and long term), who would do the procedure, what is your doctor’s experience? Are you going to a doctor that practices in a cancer center? It sounds like you probably caught this early. Best of luck.

[Louis75 in reply to Tacker]

You are lucky to be near one of those major cancer centers. I live in a very small town in the desert of northern Arizona

. My doc is in Flagstaff (Urologist); there are several radiation oncologists, but no medical oncologist.

You mention a genomic test. Is the Select Mdx test referenced above, a genomic test? My score was not very encouraging. My High PSA and this poor score are balance by my low Gleason (6) and lack of cancerous cores (1).

In your case, is the doc who wants to remove it, talking about just the cancer or the entire prostate...which to me would seem a little excessive...although you are somewhat younger. At 75, I don't want the rest of my life to be just about cancer treatment, unless necessary. I think the age factor is what is going to make this decision tricky!

[Tacker in reply to Louis75]

Surgery would involve removal of the entire prostate. I am not sure about the MDx test. You may want to ask your doctor.