Active surveillance advice

[peterman]

I am 56, 3+3 Gleason 6, 3 cores out of 12 with a PSA hanging around 5-6. I'm a good candidate for AS. The routine my doc wants me to follow is quarterly PSA checks and an annual biopsy. I'm not crazy about the biopsy. (pain, blood, risk of infection, etc.) I've been reading about HD MRIs being used more and more in place of biopsies. For those of you on the AS route, what kind of routine are your doctor's recommending?

Also, anyone out there taking supplements for prostate health? Is it helping? What kind/brand seems to be working? (I was just recommended to use Prostate 2.4)

[Darryl Partner]

Hi Peterman. From what you wrote, should we infer that you did not have an MRI before your biopsy? Regarding an annual biopsy, you might ask your doctor what s/he information will be derived from an annual biopsy if your PSA (and free PSA) numbers stay (more or less) the same throughout the previous year?

[peterman in reply to Darryl]

I had a biopsy (that told me I had PC) and then an MRI to get a more thorough assessment. 12 cores is such a small sampling of the prostate on a % basis, the doc wanted an MRI too. That's why I am a little surprised that he is focused on biopsies going forward as opposed to MRIs. He feels that an MRI will pick up aggressive/high grade cancer but not low grade. Without a biopsy, he feels we could miss the spread of low grade (3+3) or even advancement to 3+4. (or worse) I have a relatively small prostate so I think he is afraid that my PSA will stay down (the converse of PSA being higher with an enlarged prostate) even if the PC starts to grow.

[billy1950]

Hi Peterman, have you considered having a more organic based diet with more vegetables, etc. while on AS. There are some interesting YouTube videos about diet and PSA. Billy

[ng27868168]

Hi Peterman, the one thing I want to impress upon you is......, if you are considering "Active Surveillance" make DAMN sure you are REALLY doing it! As a 25 year PCa survivor and a facilitator in our local PCa Support Group, I have seen more than one person who started out like you not wanting to really tackle the issue until the cancer was out of the prostate and then it becomes a whole new and more serious game. Your cancer will NOT go away and it is best to deal with it. As you can see, I tend to be a little to the point, but experience has shown "watchful waiting" and casual "Active surveillance' only works IF it is done right. Good luck.

[Jeff85705]

Hi, Peterman. It sounds as though your doctor (urologist I hope) is doing the approved approached to your situation. Gleason 6 is considered non-aggressive, but, along with a slightly high PSA, annual biopsy is indicated, along with the PSA tests. I'm not sure of the need for quarterly (vs. 6 month), but this sounds reasonable if not inconvenient. It is worth the inconvenience and discomfort of an annual biopsy when compared to the risk of malignancy that becomes aggressive and spreads outside the prostate. But that is my opinion. If you are not comfortable with the biopsy route, consider a second opinion or two. Good luck!

[Phoenician]

You should definitely consider supplements. You want to get healthy. Build up your immune system. Eliminate bacteria and heavy metals, etc. You want to avoid cancer, or at the very least you do not want to feed it. Good luck.

[Steve507]

My first biopsy reading was same as yours 3+3. 2nd one was 3+4. 3 cores cancerous under 15 percent involvement on avg. Had RP now 0.04 after 20 months post. RP. I don't regret surgery within 5 months of diagnosis.