Checking out options

sherwinmoscow

I had a prostate biopsy last Wednesday. My PSA levels had been going up, with my most recent one reading 5.59. Results came back yesterday, and I will speak to my urologist about 'where do we go from here?' on 3/13. Re: the biopsy, 5 samples were negative. 3 were positive, each with a Gleason score of 6, with less than 5% involvement. I am a 69 year old white male, in relatively good health. Like most here, I suppose, I want to find the right balance between surveillance and action. If it makes any difference, I have a very healthy diet and work out one hour per day, alternating between aerobic and resistance training. I have heard that although good health habits like these do not prevent prostate cancer, they can slow the advancement of the tumors. Thank you for your wisdom.

Clevelandguy

Hi,

At 3+3 you have time to evaluate the two major forms of treatment, surgery or one of the various forms of radiation therapy. Some other folks will probably chime in but for now if it was me I would just monitor with future biopsy’s. You can live a long time with 3+3 as long as you monitor the aggressiveness and know where the cancer is growing with a PET scan. The thing I would be cautious about is the position of the cancer, deep within the body of the Prostate is better than close to the edge. You do not want the cancer the leave the Prostate capsule and spread to other areas. I have included a link to get you up to speed on the various treatment protocols.

https://www.cancer.org/cancer/prostate-cancer/treating.html

Dave 3+4

sherwinmoscow

https://csn.cancer.org/discussion/comment/1704418#Comment_1704418

Thank you for this input. I agree that the biggest fear is whether the cancer is or will metastasize to other parts of the body. Good luck with your journey!

Rob.Ski

Based on the info you currently have, AS will probably be at the top of the options list. Really depends on your mindset of how well you can tolerate knowing you have PCa. For me, that changed as I got more information and past the initial shock. AS became more tolerable with more info. Some people want it out right away others want to avoid treatment and possible side effects as long as possible. With Gleason 6, < 5% you have time to do lots of research and get more than one opinion. Talk to someone that specializes in AS, Surgery and Radiation. Biopsy gives you very good information but, they aren't perfect. Sometimes the Gleason goes up or down after surgery and pathology is performed on the whole prostate. You may find yourself in information overload at first, just try to learn as much as you can to make the most informed decisions.

sherwinmoscow

https://csn.cancer.org/discussion/comment/1704422#Comment_1704422

Thank you for your input. You are correct in stating that the diagnosis can be startling and oppressive, and that, with more time and info and consultation, some of the anxiety can be reduced. I hope your journey goes well for you!

centralPA

@sherwinmoscow , was your biology a guided biopsy, preceded by an MRI? If so, what were the results from that?

If you didn’t have an MRI first, you should have. I would question staying with your current docs.

sherwinmoscow

Hi, centralPA.

I had a MRI about 8 weeks prior to biopsy. Impressions then were moderate BPH and no clinically significant cancer.

Sherwin

centralPA

Ok, that’s good. The last piece of easy info to get is to have your biopsy tested for genomics, via Decipher or other. It can help predict (not guarantee) the probability of your cancer progressing.

And think about a second opinion on reviewing your biopsy. John Hopkins does them, among others. They raised mine from a 3+3 to a 3+4 with less than 5% type 4, which has influenced my decision making.

Im on Active Surveillance right now, with a plan for if things progress in the wrong direction.

sherwinmoscow

https://csn.cancer.org/discussion/comment/1704430#Comment_1704430

Thank you for the info, and best of luck with whatever awaits you!