Darryl, thanks for bootstrapping the group. Going through this with my father 20 years ago, there was fantastic listserv that unfortunately no longer exists. I'm 59, hoping this medium fills the gap and can age with me.
Given family history, I monitored my PSA, which gradually increased (log scale) from 1.0 to 3.1 over 14 years. But a one-year jump from 2.3 to 3.1 met the criteria for a biopsy, which found Gleason 3+3 in 2 of 12 regions, left and right, "involving 10%..." and "discontinuously involving 50% of the specimen," respectively. Urologist considers DRE palpable on a 25cc prostate, though primary physician didn't feel anything. A year later, PSA is down to 2.3, and I have 3+3 in each of 4 of 12 regions at "2%, 4%, 2%, and 4% of total biopsy lengths" as evaluated by an entirely different pathology lab. Urologist recommends brachytherapy based on increased number of positive biopsy regions as "growth". Oddly, radiation oncologist, if forced to choose, recommends further Active Surveillance (AS). I'll be getting MRI and both germline and Decipher biopsy genotyping.
Absent any troubling results on MRI and genetics, I'm inclined toward waiting another year, doing a biopsy, and ensuring it goes to that second lab for consistency of observation approach. It's not clear to me that the path results are using comparable methods, or that biopsy region increase from 2 to 4 is likely to be anything more than sampling variation.
Any thoughts from the group?
Any other information I should include with my history?
