Some questions nine months after Dx

Hi Dutch,

Welcome the the group of Pca survivors.  Before I had my first biopsy an MRI was done to guide my Urologist on where to take his samples which from what I know is pretty routine.  With AS you will need to have biopsies done every so often to check on your cancer growth.  If you choose you can stay on AS until your cancer gets more aggressive be it months or years.  If you do decide to kill your cancer you can choose surgery or some form of radiation.  Both work well if the cancer is within the Prostate. In my opinion you need to make sure the cancer does not grow outside the Prostate which gives you the best chance for a cure. Once the cancer gets outside the Prostate it can spread to other areas of your body which is not good.  Just make sure you study all the side effects of what you intend to do so you know what to expect.  Pick the best doctors and hospitals to-get the best results even if it means travel.  Davinchi robotic surgery and external beam radiation(Cyberknife or Proton) seems to be the treatments of choice for most and each have there own side effects so choose wisely if you want to go down that route.  Links below to help you decide:

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

https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq

Dave 3+4

I have been on AS for 2 1/2 years.  Urologists generally order an MRI for patients on AS.  Sometimes it can pinpoint suspicious areas where the Dr. might want to take additional biopsy samples.  However, your MRI may show NO suspicious lesions if the cancer cells are diffuse and in small areas.  I have had two 3T MRI's ( last one 3 weeks ago) which showed no lesions of concern.  The MRI is just another way of obtaining the maximum amount of information necessary to make an informed decison about what type of treatment would be best for you.  I would also strongly recommend genomic testing of the BX samples.  I have had this done for 2 or the 4 BX's I've had (my test was Oncotype DX) and both showed very low risk PCas with very low probabitly of metastastes or dying from PCa.  Other than regular BXs (which should be relataively painless if the urologist is a good one) and PSA's there are no side effects from AS. That can't be universally said for surgery or radiation.  

Dutchman,

I wonder why you are nervous for doing a pre-biopsy MRI. This test is similar to the CT scan, that I believe you have done during the diagnosis process, but with higher capability in identifying suspicious areas, which will be targeted in the next biopsy. The main goal is to detect malignancy. Those samples will then be analyzed by the pathologist under the microscope.

Above survivors have given you good opinions. I also think that AS is the best choice if one can opt for that choice by standing within the parameters required in AS, and surely if he has the courage in sleeping with the bandit on the same bed.

Looking into your PSA histology; I see it as absolutely normal for a guy of your age. Gleason rate 3 (low aggressive type) produces loads of PSA serum. Yours are acceptable for a regimen of AS. You should do what gives you the most comfort but in your shoes and in view of the above status, I would stay away from radical therapies for the time being. PCa takes years to grow and affect the patient. Therapies prejudice the quality of life we are used to.

Regarding the TULSA Pro treatment, I think that it is still immature. Why choose a TURP (Transurethral resection of the prostate) style therapy if traditional surgeries can achieve the same benefits as claimed by the TULSA corporation. TULSA is still a pilot therapy and has not enough number of results to be compared with other effective treatments.

Best wishes and luck in your journey.

VGama