Active surveillance: A friend of mine... - Prostate Cancer N...

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Active surveillance

Nomiskneh profile image
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A friend of mine is on active surveillance (Gleason 4 + 3; N0 M0). Diagnosed 2022. In 2023 he had a TURP-operation. PSA at diagnose 6.3. PSA-check twice a year. Previous PSA 1.6, Now it jumped to 2.2. Is there reason to worry? Friday he sees his urologist. Are there any questions he might ask? Thanks for your comments.

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Nomiskneh
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ulfhbg profile image
ulfhbg

Hi !

Is he on active survelliance with a diagnos of Gleason 4+3 ? I’ve heard of Gleason 3+4 with a very low percentage of Gleason 4 being on AS but if he is 4+3 then Gleason 4 prostate cancer cells have a higher percentage then 3 and if so perhaps it’s time to look at treatment options to take care of the cancer.

Best wishes - Ulf

Nomiskneh profile image
Nomiskneh in reply toulfhbg

Thanks. See my reply to Tall_Allen.

Tall_Allen profile image
Tall_Allen

No one with GS4+3 is on "active surveillance." Predominant pattern 4 is a trigger to end AS.

If he is elderly or ill, he might be on "watchful waiting." "Watchful Waiting" means there is no treatment until pain occurs, and then treatment is palliative.

Nomiskneh profile image
Nomiskneh in reply toTall_Allen

Sorry, my mistake. He has GL 3 + 4. He s is on active surveillance and is 78 year.

Tall_Allen profile image
Tall_Allen in reply toNomiskneh

What percent pattern 4? He should get an mpMRI and a targeted biopsy.

Nomiskneh profile image
Nomiskneh in reply toTall_Allen

Tall_Allen, see:

MRI of august 25 2021: sector 1) Gl 3 + 3 and sector 2. Gl 3+4; % 4 is 20; vol. tumor 7%. It ads: "Small Pirads 4-lease left, diameter 8 mm.

MRI july 4 2022: "The T2 hyperintense area has grown and is now 14 mm." Conclusion: Suspicion of tumor progression (...) P-Rads 4)."

As said, his PSA has gone down tot 1.6, until this week, when it came out at 2.2.

Thanks for your interest,

Nomiskneh

Tall_Allen profile image
Tall_Allen in reply toNomiskneh

Time for an mpMRI-targeted biopsy. Decipher, if it's available.

Nomiskneh profile image
Nomiskneh in reply toTall_Allen

Many thanks Allen for your advice. I will accompany him friday.

Best wishes,

Nomiskneh

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