Question about biopsy results

hopeful and optimistic said:

VG
Thanks for your post, and the excellent information that you shared.

In response to your comment about laughing because you keep a couple of DNA samples.......I am not laughing....instead I am impressed with your brilliance and ability to follow up.

I am still interested in investigating various tests to be used in an Active Surveillance protocol for delayed treatment.

I hope to post various investigative technique to determine how effective each one is , and determine which combination of tests is "best" in an active surveillance program.

I wonder if you, or others can post any combination of protocols that you find that are used at various institutions.

Hopeful; AS is not an homogeneous principle
Ira

The best practice for AS in my opinion is the recommendations from NCCN.
These guys lead and establish the protocols followed by the majority of institutions and individuals around the world. The new NCCN Guidelines (check in their site) recommends “actively monitoring the course of the disease with the expectation to intervene if the cancer progresses”. Monitoring is taken as scheduled prostate examinations (MRI, CT, DRE, etc.), PSA tests, and repeated biopsies.

However, their principal aspect in recommending AS comes from a common consensus that more and more patients are diagnosed at very early stages due to the “popularity” of PSA diagnosis. In a study it was estimated that newly diagnosed patients “gained” ten years of survival in comparison with diagnosis pre to 1997.
Earlier diagnosis leads to earlier interventions that may lead to over treatment to a series of cases.

Surely this fact should be reflected in those statistic nomograms for survival that have been based or include cases before 1997. But AS just like WW needs to be addressed not as a homogeneous principle for delayied treatment because all cases may be similar but not equal.
You are therefore one of the examples with your own particularities.
Constant follow ups are required and the best result from this approach will depend in what you most believe. In your shoes, my layman's opinion points to a decision in a series of markers set in a mile-stone plan that would give me peace of mind. Surely that would not only include a biopsy program.

Do not let anxiety to drive you away from balanced decisions. Allow the time to reveal if in fact “negatives” are to become “positives”. That would be the right timing for any action.

I wish you the best along your journey.

Vgama