Active Surveillance - When to call it a day?

Hi Sam, I dont have Pca but have had all the tests am regarded as high risk and have a six monthly check up.

Two of my friends age late 60s had possitive test results for Pca and both had ebert. 30 sessions. J is now clear after passing the 5 yr mark. T is clear after the 2 yr mark. Both recomended this treatment to me. They are both very active men who report that Ed has been the only problem after their treatment finished. Both canget help in that department if wanted.n This will be my treatment of choice if i need it in the future.

Hi Sam,

​1/ My PSA went up from 5.5 to 6.6 in one month. This was the point when the doctor decided Prostate Biopsy. He believed the PSA was elevated enough and the standard procedure in 2015 is to have biopsy. No symptoms at all. NOTHING.

Since 2012 my PSA went up from 3.8 to 6.6. But nothing else. After that 6.6 I went and I did 2 other PSA test  only two days later and they came 4.4  and 4.9 (this one 4 days later). I realized that 6.6 came after I had sex.

All this time, since 2012 my doctor prescribed antibiotic CIPRO ( 3 weeks ) and always my PSA went down to around 4-4.4.

This is about PSA.

2/ Now, regarding the prostate biopsy which it was done on 12/28/2015. The result came : PROSTATIC ADENOCARCINOMA, Gleason score 6 (3+3) , involving approximately 10% of the 16mm biopsy core , The doctor recommended Active Surveillance . His advice: You don’t have to do anything for now.  

​I am going to wait untill my PSA will go up very fast or I will have symptoms.

Sam: I can understand your confusion. I wouldn't rely on PSA for anything. Mine has been in the range of 2.5 to 3.5 for a decade. I am 69 years of age and live in Australia. Yet, during a pre-op for a PAE (by an interventional radiologist in Sdyney), the 3T MRI that was carried out came back with PI-RADS 4 from a lesion on the left lobe of the prostate. This indicated the likelihood of carcinoma. A subsequent Tranperineal Fusion Biopsy was carried out, where the MRI is used to guide the needles, and where there is no liklihood of infection as the entry point is between the scrotum and anus, and not the anus itself. This was only a few days ago.

The results gave a Gleason score 8 and you can guess that the first suggestion from the urologist was a radical prostatectomy. I could go on with the rest of the story but your question seems to be about PSA, and I have made my point.  

For anyone in a similar situation, I have been accepted for Proton Beam Therapy at the National Cancer Centre in Korea. The reason I want this is because while the entry dose is high, the exit dose from the prostate is almost zero. Yes, I have spoken with others who have had this treatment and are still alive a few years later.

Hi

I am 49 and reasonably fit and well.

I was on AS for since May 2014, PCa, Gleason 6: 3+3, PSA 4.6-5.6. June 2015 PSA went up to 7.6 so had MRI, this showed abnormalities. September 30th, Targeted biopsies revealed Gleason 7: 3+4. 3+3 still there!

30th Oct 2015 Robot Assisted Laparoscopic Radical Prostatectomy.

Dec 8th 2015 PSA undetectable so less than 0.1 However tiny positive margin (I am still reading up on this for T2 PCa!)

Jan 19th 2016 PSA still undetectable.

BTW. No impotence or incontinence