New patient

Iamfuzzy

I am 71 years old living in Houston Texas and It's been 3 years since I was diagnosed. I feel good and in great health.

I have been on active surveillance. It started with my PSA level going above 4.0 since 2018 to 6.5 currently. My doctor recommended a urologist and he recommended a biopsy--which we did in December 2019. Fortunately only 2 sections (RLB and LLM) had cancer and both had a Gleason score of 3+3=6 so we decided to monitor it. In April 2021 we had another biopsy as my PSA went to 6.0. The results of the second biopsy showed that RLB had gone up to 3+4=7 and LLM benign, but there was a new section RMB 3+4=7. Again we decided to monitor it. In April 2022 my urologist said we should do another biopsy. This is when I decided to go to M.D. Andersen for a second opinion.

In June 2022 they did an MRI and a couple weeks ago we did another biopsy. If I'm reading the results correctly then the LLM is now 3+4=7 with less than 5% gleason pattern 4. The RLB is the same 3+4=7 with 5% gleason of pattern 4. The RMB now shows no tumor.

The 3rd biopsy also shows 3 regions of interest which probably came from the MRI test. the Right Medial Apex anterior, the Left medial apex anterior and the left lateral apex. All 3 show 3+4=7 with 5% Gleason pattern 4. I think the first 2 biopsies were 'posterior' so i wasn't sure about the "anterior".

Based on these results, I'm inclined to continue active surveillance. I will be visiting the doctor soon to go over the test results but i thought I would reach out to this forum for suggestions on what to do and what questions I should ask my doctor?

Thanks in advance!

VascodaGama

Hi,

If I understood your description correctly, the 3rd biopsy was done directional using 3 cores to the zones of interest. That means that you got 3 plus 2 positive cores (in the base, mid and apex regions).

That would classify your case as voluminous intermediate risk which requires you to think in starting a treatment.

It seems to be contained so you can expect success no matter which modality you choose. Surely you should research the details of treatments (RP and RT) particularly their attached risks and side effects, before deciding.

Best wishes in this journey.

VGama

Old Salt

It would be instructive to see all the PSA data on a time line.

Iamfuzzy

https://csn.cancer.org/discussion/comment/1702283#Comment_1702283

Below are the various PAS test dates that I have as they are not extremely high?

10/10/2018 4.4

10/13/2019 4.8

04/06/2020 4.3

8/5/2020 4.3

2/29/2021 6.15

3/10/2021 5.24 Free 1.068 ratio .20

2/3/22 6.46 free 1.141 ratio .18

Iamfuzzy

https://csn.cancer.org/discussion/comment/1702280#Comment_1702280

Thanks, seems like all treatments have some serious side affects that I don't like but will discuss with the doctor.