Active Surveillance or Radical Prostatectomy?

bob4894 said:

Still weighing on me

So much information on treatment options.  I struggle daily on what to do.  Because of the randomness of the biopsy process, I keep thinking that there may be some GS 4 somewhere as 20% change on re-biopsy or RP. 

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PSA

Jan 2013 - 2.76

Mar 2014 - 3.12

May 2014 - 3.4

Jul 2014 - 3.5

1/30/2015- 3.46

Color Doppler Biopsy 2/12/15 - 12 cores.  1 core Gleason 3+3 <10

Bob,

I understand the agony of deciding on this. As we have discussed, my case was very similiar to yours, except that my Doubling Rate was significantly faster than yours, but at around 1.0/year, even mine was not cause for imediate action.  You are actually experiencing virtually no increase presently.

If you retrace my decision-making at my threads, you will see that I actually had resolved for radiation, and changed to RP only later, for a few technical reasons (urinary obstruction mostly).   At five weeks since surgery, I have few regrets. My urinary control is doing well (I wear only "liners").  I was fortunate and the doctor said he spared the erectile nerves, but recovery in that arena reportedly takes a good bit longer than urinary control.  Even radiation can cause some symptoms of ED, however.

Go slow, read a lot,  and realize that all of the best doctors say that there is in fact no such thing in most cases as a "best" decision regarding which treatment to go with.    The most recent IGRT and CK results are virtually identical to surgical removal today for long term cure rates. In general, radiation is becoming better and better, while surgery, obviously, is essentially static in its results.

max

Max Former Hodgkins Stage 3 said:

Thanks

Thank you for the link, Hopeful.  I Guess G-6 is possibly similiar to PIN-cells; pre-cancerous or proto-cancerous.

Bob,

When we are diagnosed virtually all of us go through all of those negative feelings. This lasts about two or three months. During this time,  we , the patients are faced with making a decision from a choice of treatments, all of them negative, that can severely impact our lives. To complicate this, there are sharks out there who are touting their treatment type, sometimes at your expense, so you need to develop knowledge so you will not be a victim.

There are strategies to help with your emotions; surround yourself witrh positve people. If you attend religious services have an upbeat clergyman, if not switch, even if it's to a different religion..."upbeat" is the key. Attend support group(s). Keep on posting here.

Generally when a person is diagnosed , the first inclination is to get the "cancer" out. This can have serious side effects. This was my first thought, but instead, I did a lot of research, and am in an Active Surveillance program for the last six years, where I have had no side effects, and believe that I can seek active treatment if necessary, using my initial treatment choice with equal amount of success as I would have done. In fact since i have been successfully on Active Surveillance(with no side effects) for the last 6 years, I have investigated "newer and better" treatments which I will probably pursue if necessary (which may never be)

Please feel free to click my name to the left to follow what I have done, and information that I listed about Active Surveillance.

Bob,

First off, my regrets for your diagnosis. Secondly...PROCEED SLOWLY!!

One of the great aspects of this forum is the wide variety of opinions and experiences of everyone here. I don't know that I can add much to the conversation that hasn't already been said, but if you care to follow my story, here is the link: http://csn.cancer.org/node/264905.

Ultimately, the decision is a very personal one, and there is no "one size fits all" answer. Take your time...do your study...make the decision that works best for you.

Best wishes - CC