Active Surveillance - When to call it a day?
Posted , 6 users are following.
Hi fellow Prostate friends. I've had some great advice and reassurance from people on this site over the past year so I would appreciate your thoughts on my current situation after the latest Psa result today.
Background - 53 year old man - fit as a fiddle with no symptoms.
Had a PSA 5.7 then 2 weeks later 7 - in Dec 12.
Through 2013, 14 and 15 Psa came down to between 1.7 and 2.2 until 6 months ago when it went to 3.3 then 3 months later 3.4.
I have had two biopsies the first had 1 core out of 12 gleason 3 + 3 T2 and contained within the Prostate. A year later another biopsy which found no cores with Pca out of the 12 samples taken.
I've had 1 MRI 6 months ago which found a small focus of suspected PCa contained.
So today I have been for the three month check and the blood result was 5.7 up from 3.4 twelve weeks ago. I know it's a personal decision but what do people think? I asked the Consultant for advice but they are so non-comital. I have a rising PSa but the MRI was quite positive and the two biposies only found one core out of the 24 they have taken.
I'm thinking of waiting another three months, see what the next Psa resul is, then perhaps another biopsy? and when the time comes Brachytherapy.
A bit confused - again at the moment so I would really like to hear your views?
Is there anyone else in a similar situation with a rasied PSa? How long do you leave it? When do you call it a day? or how long did some of you leave it before having treatment? What factors did you take into consideration because surely a high PSa is only one indication?
many thanks,
Sailor Sam
1 like, 15 replies
philip1950 Sailor_Sam
Posted
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.
Sailor_Sam philip1950
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stewarta philip1950
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cocoroton Sailor_Sam
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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.
Sailor_Sam cocoroton
Posted
thank you for that, it's very interesting, especially to hear how you are approaching it. Can I ask how old you are?
cocoroton Sailor_Sam
Posted
I am 63 and as I've told you in very good health. No prostate symptoms at all.
stewarta Sailor_Sam
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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.
Soloco Sailor_Sam
Posted
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
stewarta Soloco
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Soloco stewarta
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cocoroton Soloco
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Congratulations.
So , the result from Pathology on your removed prostate came positive? What was the exact and detailed result from pathology please? Would you please explain “However tiny positive margin [sad] (I am still reading up on this for T2 PCa!). Thank you.
Soloco cocoroton
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"Very small positive margin. I am not sure at the moment further treatment is in his best interest."
As said I am still reading uo on 'margin' result. Maybe somebody on here can read this and make sense of it! Are they saying surgeon error, in my case or?
http://myprostatedoc.blogspot.co.uk/2011/05/positive-margins-after-prostatectomy.html?m=1
Soloco cocoroton
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Soloco
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mark17736 Soloco
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