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Advanced Prostate Cancer
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Diagnosed with Gleason 6

I’m 65. My PSA has steadily climbed this past two years and just a month ago my doctor recommended a biopsy. My core samples were 12. 3 were positive.

My doctor recommends active surveillance. However, there have been 5 men in the family who had PC. Three are dead (most recently this past May was my older brother). Two that died because it spread to the bone. Under the circumstances, the doctor is doing genetic test and I’ll know results soon. I had heard that CBD oil can lower PSA levels and even stop the cancer. I’ve been taking the CBD oil for about a month. I’m also changing my diet to eat healthier (no red meat, plenty of veggies, fruit and grains). I’d like to hear from other men who have gotten a Gleason 6 and tried active surveillance. The family is urging me to have my prostate removed. I am also considering proton radiation therapy but will likely do the proton treatment after I’m healed from surgery.

I’d also like to know if laprascopic surgery was easier recovery. I have heard that recovery is easier but side effects are about the same.

I would appreciate any opinion and recommendation based on other men’s experiences.


18 Replies

I wouldn't do surgery.( complications are not good) With the low G, I would do SBRT (Cyber knife). I also wouldn't do active surveillance. If you have CA, get on it from the start.


Thanks for the reply! I appreciate your input.


Please join this new community too. More Gleason 6s there. healthunlocked.com/active-s...




You also might want to check out transurethral hyperthermia. No surgery or radiation.



I’m actually searching for someone who does the hyperthermia in my area. Did you have this procedure?


No- it wasn't available when I was diagnosed. Don't know of anyone who has had it, but it sounds viable. It is a popular technique in the German as well as the TJ clinics.


It is too soon for you to be making any kind of decision. Decide not to decide for now. Men with GS6 who wait a year before deciding have no worse outcomes than men who do it sooner. I can see why your family history troubles you, but the inherited component is estimated to be only about 20%.

Men who follow their family's recommendation sometimes suffer later from a kind of decisional regret called "role regret." Your family loves you and is well meaning, but only you are capable of deciding this for yourself. i recommend you join a local prostate cancer support group and attend meetings.

Active surveillance should be your #1 consideration. If your mpMRI-targeted confirmatory biopsy within a year finds higher grade prostate cancer, you can decide for treatment then. But for more than half of men, they can go 20 or more years without any sign of progression.

Any radical therapy is curative for men with your diagnosis. That means surgery (robotic, laparoscopic, or open doesn't matter - surgeon experience does), SBRT, brachytherapy (either kind as monotherapy) or hypofractionated IMRT are acceptable choices (don't worry if you don't yet know what they are - you have plenty of time to learn). Conventionally fractionated IMRT or protons are inferior because of cost and patient inconvenience.


If yours was random biopsy I do an mri guided biopsy to be sure. My random was 0-14. My mri guided one hit 3-3 Gleason 8.



Thanks for the info! No one has mentioned MRI guided biopay!


it's a fact if in the family then most men will get it. what i have found on this site how most of these maintenance oncologist i call them reacted slow slowly to do treatment. mine was biopsy first then lupron shot then radiation within 9 months and was aggressive all the way now 10 years i've had it pretty controlled until ran out of getting zytiga.


If truly a G6, then active surveillance is a good option, I would double check with an MRI guided biopsy.

I have a strong family history, had rising PSA. Had 2 random biopsies. First biopsy was negative, second was G6. Rising PSA was attributed to BPH. On the third (MRI Guided), they found G7 (3+4), had surgery and 18 months later a reoccurrence, just finished salvage radiation.

Bottom line is on a true G6, there are a ton of wait an see options. Just make sure that is all you have and nothing more.

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Have been on active surveillance for three years. First diagnosed in Oct '15-----2 of the 12 samples cores taken came back postive with a Gleason score of 6 (psa of 5.5). Second opinion agreed with my Urologist. Changed my eating habits, exercised a lot more often, and got on a # of supplements. I go every six months for tests and exam by Urologist. Got my psa down to 4.2 until last November when it rose to 8.2....Had another biospy; had to wait 17 days for the results. The original pathologist had to get a consult/2nd opinion form another pathologist in Los Angeles...Diagnosis came back ASPN (Atypical Small Acinar Proliferation)....Urologist again recomended active surveillance.....last psa came at 5.0....(I did consider having a TURP or a variation of the procedure earlier this year but cancelled)....I go back in January for more tests....Can't give you any advice except to say do a lot of research, get second opinions, keep thinking positive thoughts....Wishing you the very best......MAX


Thanks Max. Good info. Thanks for support. Best to you!


Tall Allen is right. I was recommended this book by a member of this group, The Key To Prostate Cancer, by Mark Scholz, MD. I found it very helpful in making my decisions as it educated me on all aspects of the disease and ramifications of treatment. It is available from Amazon and is as up to date as it can be.




Don't let anyone scare you into a biopsy!

I, too, am a Gleason 6 (3+3). Biopsy was in 2002. Hey, it's 16 years later and I'm just as grumpy but still here enjoying my wine, bourbon, and sometimes rum. My PSA goes up, then down, then up, then down -- depending on diet. More meat and cheese = up. Less meat and cheese = down.

I now limit myself to one slice of ham and one of cheese in luncheon sandwiches daily, plus steak only once every two weeks. Long enough to look forward to doing it again, short enough to still remember how good "real food" is. Learn to love steelhead trout which really is better than salmon! I have also cut pasta to once monthly.

Three months ago, my radiation oncologist said I urgently had to have a new biopsy. One week ago, my PCP said no biopsy is needed. No one really knows the answer. My goal is to live an enjoyable lifestyle (without overdoing it) and slash stress. Those last two words are the key. Here they are again: SLASH STRESS!


Great info and insight. Thanks a lot. Best of luck to you.


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