Newly Disgnosed in Scotland

[SBoardman]

Diagnosed shortly before Christmas last year PSA 7.5 Gleason 6 (3+3), now Awaiting a Template Biopsy to map the tumour. As it stands, Active Surveillance is the suggested measure. Age 55, and happy to avoid surgery if possible, though LDR Brachytherapy sounds OK.

[AlanMeyer]

Here is a web page with the recommendations of the Johns Hopkins University Brady Urological Institute in Baltimore, Maryland, USA on Active Surveillance (AS). Some of the most well respected research on AS was done there.

urology.jhu.edu/prostate/ac...

I recommend working through all of the links on the left side of the page. The Hopkins docs use PSA density and number of biopsy cores with cancer (maximum 2, I think that's out of a 12 core bipsy) along with PSA and Gleason to determine suitability. Note too that they "prefer" men to have a life expectancy of less than 20 years if choosing AS - but that's probably pretty conservative. See "Risks".

If you do decide on treatment, I think that LDR brachytherapy is indeed effective and easier to take than most other treatments. However, be as sure as possible that the radiation oncologist who performs the procedure really knows what he's doing. It's just as easy to screw up a radiation procedure as a surgery and the consequences can be equally bad.

If you decide to stick with AS, be sure to emphasize the "active" part. Don't just go for a PSA test once every year or so. A lot can happen in one year. Personally, I think I'd want a test at least every 3 months.

Best of luck.

Alan

[Neal-Snyder in reply to AlanMeyer]

Great advice, Alan!

Neal

[S103462]

Mine was similar to yours - in 2012: 57y/o, PSA 5.9, Gleason 6(3+3), biopsy showed tumors. 2nd opinion verified. Also, did OncotypeDX - indicated as non-aggressive. Opted for active surveillance - PSA/DREs every 3 months for 1st 2 years; another biopsy in 2014 - no change; then PSA/DREs every 4 months for next 2 years; PSAs have remained in the 4.x range ever since; another biopsy in 2016 - no cores showed cancer (not sure why, but continuing active surveillance). Now PSA/DREs every 6 months; will have another biopsy in late 2018.

Active surveillance is very "active." Stay on top of it.

[Hidden]

Welcome to the club. You are somewhat lucky in having a non-aggressive gleason score. I had HIFU surgery recently. It is touted as being least invasive and having a lower risk of quality of life after effects. Good luck with whatever treatment course you select. Educating yourself on sites like this one is a great way to start.