Questions about active surveillance

[Azbound]

Question about prostate cancer. Biopsy 3 + 4 Gleason. 6 out of 12 course positive couple 30%, the rest 10. Pirad 2 MRI which is low I believe 0.41 decipher low bone scan negative CAT scan negative. PSA went from 7.3 down to 4.5 over about 4 months. I'm considering cyber knife or active surveillance. Would like to get some opinions about active surveillance.

[pd63]

How many cores were 4

[Azbound in reply to pd63]

2 have 30% 1 have 20% 1 have 10% 2 have 5% Out of 12 core samples. These are the percentages of four with the rest of the percentage being grade 3 left side 6 cores is benign.

[Tall_Allen]

Good idea to get a second opinion from Johns Hopkins:

pathology.jhu.edu/patient-c...

Please answer these questions:

1. For each of the cores that have GS 3+4, what % of each of those cores had cancer?

2. For each of the cores that have GS 3+4, what % of the cancer was pattern 4?

The report from Johns Hopkins will tell you if your current report doesn't.

The decision on whether it is safe to stay on AS depends on it.

[Azbound in reply to Tall_Allen]

2 have 30% 1 have 20% 1 have 10% 2 have 5%

[Tall_Allen in reply to Azbound]

Question 2?

[Azbound in reply to Tall_Allen]

percentages above are the percentages of four in each core. The rest of the core is three in all of the above. The other side left shows benign. Out of a 12 core biopsy so half six are positive with the percentages stated above being 4. So six of the cores out of 12 two of them have 30% for two of them have 5%, one has 20% and one has 10%.

[addicted2cycling in reply to Azbound]

Your age would help.

1st - if me a 2nd opinion IS a must.

Be aware that imaging can still miss PCa and your post reads like you had a TRUS biopsy that can also miss higher Gleason PCa.

2nd - no Dr. here but I would be uneasy going with AS.

[Azbound in reply to addicted2cycling]

No it was not a trus went through the rectum for the biopsy. They got me down for a pet scan Thursday that's about the last test. Not sure I needed a pet a cat at MRI decipher. But I would think if the pet Scan is negative the only other thing I could do is get a second opinion on my biopsy

[addicted2cycling in reply to Azbound]

TRUS biopsy is via the rectum. Getting a 2nd opinion on biopsy is wise no matter what scan or other testing results are.