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Is "active surveillance for delayed treatment" a better choice of treatment for a young man with a Gleason 3+3=6

hopeful and opt...
Posts: 1364
Joined: Apr 2009

Dr. "Snuffy Myers" says yes in his current video

http://askdrmyers.wordpress.com/?mkt_tok=3RkMMJWWfF9wsRonuKrMZKXonjHpfsX67eQpWLHr08Yy0EZ5VunJEUWy2YIHSNQhcOuuEwcWGog80B5XCfSUaIVG9edIBg%3D%3D

VascodaGama's picture
VascodaGama
Posts: 1598
Joined: Nov 2010

The story repeats by itself over and over again.
Over-diagnosis and over-treatment in guys whose cancer would never be a problem.
I totally agree with the comments of Myers.

However, the difficult part is that doctors got their hands tied to the guidelines and norms of their institutions/associations who may recommend aggressive treatment approaches to young patients.

The "driver" of the case must be educated and wise enough when "choosing".

Thanks for posting the link.

VG

djbuk
Posts: 24
Joined: Dec 2011

I was 56 when diagnosed gleason 3+3=6 T1c psa 3.5 and was offered active surveillance. However, I chose RP. Final pathology report showed positive margin and gleason 3+4=7. Thankyou very much but I say take no chances with this unless you can be assured of the numbers.

hopeful and opt...
Posts: 1364
Joined: Apr 2009

Active Surveilance for delayed treatment is a very viable treatment decision for low risk prostate cancer, since 97 percent of men with LRPC are likely to die of something other than prostate cancer. The pathologic stage of patients who are closely monitored, is similar to initally treated patients with LRPC, so the treatment decisions will be very similar. I've been doing Active Surveilance for the past three and a half years . I plan to continue with this treatment option for the rest of my life if I can. If not I feel that I will still be able to seek any necessary treatment.

Samsungtech1
Posts: 350
Joined: Jan 2011

I think that the testing available now is awesome. They can do enough tests to show where the cancer is, and if it is confined. If it is confined then I would recommend watchful waiting. Seeds and radiation seem a great option, RP is getting a bad rap. I had it and I know that with everything going on it was my only option. I started with a Gleason 6, VA diag, after operation I went to 9. Plus had metastis to lung. This was known to urologist, but he was a firm believer that Agent Orange was overstated. Read VA docs and they tell you it metasticized as soon as it starts. If you are a vet do not trust any urologist read VA pubs, which are hard to find, and then make decision.

After rant statement; I would make sure you get the proper tests, mentioned all over this site, and then make your decision. It is a gamble, but just blindly having procedures is alot worse. Most of mine cause awesome side effects.

Mike

VascodaGama's picture
VascodaGama
Posts: 1598
Joined: Nov 2010

I agree with you Mike.

Explore fully all sources to assure a proper diagnosis; once satisfied follow your instincts, but never let fear to take the "pole position" in the tracks to decision.
I would follow AS as far as my stats would permit and reasoning would allow me.

VG

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

If a person can do AS then go for it. As was mentioned above by VG and Mike, Just take it easy and make certain that you are a canidate for this. I think that this would require a second opinion. Also a close examanition of the numbers are needed. When I was informed that I had Prostate cancer for the first my mind went blank. Only after visiting with the doctor and researching all of the treatment options. I opted for surgery as I felt that this was the best treatment for myself, but If considering surgery Then by all means do research. Surgery is rough. If you can do AS be thankful. But follow a program of close monitoring.

Kurt

mrspjd
Posts: 693
Joined: Apr 2010

More info:

http://www.ncbi.nlm.nih.gov/m/pubmed/20800964/
"Careful selection and close monitoring of low-risk prostate cancer patients on active surveillance minimizes the need for treatment."

"BACKGROUND: With the advent of prostate-specific antigen (PSA) screening and the increase in the number of transrectal ultrasound-guided biopsy cores, there has been a dramatic rise in the incidence of low-risk prostate cancer (LRPC). Because > 97% of men with LRPC are likely to die of something other than prostate cancer, it is critical that patients give thought to whether early curative treatment is the only option at diagnosis."

"CONCLUSIONS: If guidelines for AS are narrowly defined to include only patients with Gleason 6, tumor volume ≤ 20% in one or two biopsy cores, and PSA levels ≤ 10, few patients are likely to require treatment. Progression-free survival of those treated is likely to be equivalent to patients with similar clinical findings treated at diagnosis."

Add'l reading:
http://www.health.harvard.edu/newsweek/When-to-consider-active-surveillance.htm
http://www.nih.gov/news/health/dec2011/od-07.htm

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