I was diagnosed last year in July had a biopsy - Gleason score 6 my PSA was 4.2. Just has another PSA was 4.4 going for another biopsy in August. Question is I know it slow growing but how long do people usually wait before choosing a treatment plan?
Thanks,
Rob
In the longest running active surveillance trial in North America, 55% of men have still not gotten treatment after 20 years.
very good response thanks for the knowledge .....
I am no expert but if on AS with a PSA above 4 and a Gleason at 6, I would prefer to have my PSA checked every 6 (possibly 3) months. I would do this for peace of mind, to catch any PSA level ramp-up that may occur. Oh yeah, and if you haven't had one, I'd be sure to obtain a digital rectal exam (DRE).
I had similar results to yourself following two separate biopsies. I was given an MRI scan which showed the cancer had spread to the seminal vesicle and this resulted in me being advised to have hormone treatment followed by radiotherapy straight away.
Following this treatment, I had PSA readings of below .03 for the next 5 years.
My advice would be to ask for an MRI scan to ensure the cancer has not spread anywhere else.
I am by no means an expert on this subject and am only relating my own personal experience.
Rob the nice thing about having low risk PC is that you don't necessarily have to seek treatment. However, even with low risk PC many men can't handle the diagnosis and seek treatment even though they only have a slow growing cancer. Active surveillance is not right for everyone. You will need to work with your doctors and regularly schedule PSA testing, biopsies, digital exams, perhaps an MRI and genetic testing to gage how aggressive the cancer is.
Active Surveillance – Recommended Plan
PSA every 3 months, at least every 6 months
Biopsy within 18 months, then periodically as determined by your doctor.
Digital rectal exam (DRE) visits at 6 or 12 months
Here is a cool Oncotype DX Eligibility Quiz myprostatecancertreatment.o...
There are other tests just as good I had Prolaris and found my cancer was intermediate. Also the PTEN is less expense with results of positive or negative to determine if the PC needs treatment. Hang in there AS is a good thing!
As the joke goes: it Depends.
How good a poker player are you?
How old are you?
Is there need to have a sense of great urgency?
Is twenty years (Tall_Allen's response above) too long?
no one can answer this for you but YOU.
Ten years so far for me. No progression seen on MRI or on biopsy.
2 years on AS for me. One day at a time.
About 10 years here. PSA every 6 months, Dr appointment same schedule. Been up and down with PSA, started at 3.0 10 - 12 years ago, went to ~6.5 over 10 years, recently dropped to about 4.9. Awaiting newest results. Been keeping up on treatments and thinking about what I may choose if I need to but no current plans to stop. Since I started about 10 years ago lots of advances in PCa diagnosis and treatment. Also have avoided and side effects/complications from treatment.
Started in and am currently in an AS study. As someone noted above, not for everyone. Depends on you state of mind and beliefs. Good luck going forward.
I'm six years in on AS; original diagnosis in 2013 was Gleason 6 - disease on both sides but "low grade/low volume". MRI's since 2014 have shown no change, and PSA results have only shown slight increases over the years. At my last Consultant Urologist appointment in April I was told my disease was, in his opinion, unlikely to ever cause me issues and that further biopsies were not clinically justified; I was therefore discharged from the formal AS programme and in future will have 12 monthly PSA tests at primary care (GP) level and only if significant rises occur will I be referred back to the hospital.
It seems the pressure on managing the AS programme is leading urologists to "cull" the cohort by removing "clinically insignificant" cases on the basis of at least 5 years stability - but ironically that course may lead many men to consider some form of radical treatment if the reassurance of AS is no longer provided.
all these are correct but at i would say tall_allen says it all.......
Many good responses above
How long is up to you and test results
2 advantages of deferin(assuming no progression) is quality of life and advances are ocurring every year. Should be getting psa or phi,mri,dre and biopsy on a regular basis
I like psa every 3 mo not only cause you can catch changes earlier but with more data you get better idea of ups and down
You should get confirmation biopsy zfter first year then maybe another on third year after that you may be able to don only evcery 2 to 5 years
Should get mri early on may not show g6 depending on volume but should show g7 or better. Give picture of whole prostate znd more. Lets you know if you got anything else going on
Neither biopsy or mris is perfect but together they work well
Lastly its you can you live with what you got. Will you continue o monitor diligently
Also a disadvantage is progression is possible so there is some risk
So continue to investigate and choose whats best for you. Whith AS you can choose treatment option at any time.
Been on AS for 2yr
Best of luck
Trying to decide Active Surveillance vs other options
Thinking of Active Surveillance with 3+4
Oncotype and active surveillance
