Gleason 6 diagnosis last week. 67 y/o my PSA went from 3.5 to 5.5 which prompted bx.

Commander

I had two of 12 biopsies return positive. At 15% and 18% of the core biopsy. Location was left and right lateral and one biopsy showed a high grade intraepithelial neoplasia. I don’t meet with the urologist until the end of April to go over treatment options. I suspect he may recommend active surveillance. Has anyone gone ahead and had surgery completed with a 3+3 score? Any thoughts would be greatly appreciated.

JJO

I had a similar biopsy several years ago, just two cores of Gleason 6, with a fairly small amount in each core. As top expert I went to for a second opinion told me I was " the poster child for active surveillance."

Commander

Thanks.. how often are you getting repeat PSA and or biopsy?

ASAdvocate

You have very low risk prostate cancer, from what you have posted.

All the major medical associations that issue guidelines for the treatment of prostate cancer recommend active surveillance as the default treatment for low risk men. Every one of them.

I have been on active surveillance since 2009, with no progression of my pathology. No need to chance the often life-altering side effects of treatment if you don’t need it.

But, surveillance must be active, and you need to be following regular testing protocol. The initial biopsy can miss up to 30 percent of higher grade cancers, so you would need an MRI and a targeted confirmatory biopsy within about six months to minimize the chances of having higher risk.

Commander

Thanks for the response. Nice to hear from others going thru this.

Rob.Ski

I had surgery with 3+3 but, had high volumes in 2 cores 70% & 100%. Pathology after surgery was 3+4. I'd probably still be on AS if I had your numbers. Think some AS plans do biopsies at 18 months but, other things like MRI or jumps in PSA might trigger sooner. I did get a second confirmatory biopsy < year later when I changed facilities. My first biopsy didn't have the high volumes.