active survellance or robotic

After having second opinion at Vanderbilt Hospitail it confirmed gleason 6 from previous pathology . 2 out of 12 positive,

one 5mm and 3.5mm  cores, 60% and 35% of core length. Oncotype dx test was 23 very low  psa 2.97, considering active

survellance, Then psa checked in April and prostate fusion mri within a year . Both doctors were comfortable with this decision

which I have to decide. Was told in October of PC  and have being getting information and been for second opinion and lab results.

Any information is appreciated. 61 years old and good health. Was scheduled for surgery March 1. PC was discovered in Peripheral

zone that doctor said 75% is discovered there.

Thanks and hope all is well.















  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    edited January 2018 #2
    your previous thread

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    edited January 2018 #3

    From 100tanner:

    "Thanks for your input and information I see you have had many test and procedures done.

    I am going to have a fusion mri next and psa in april and go on active treatment .

    Thanks and hope you are doing okay."


    To monitor with an Active Surveillance protocol, it is very important to find the best doctors and facilities...there is a difference in skills and outcome.

    With reference tto your planned fusion biopsye; it's best to have a three dimensional biopsy machine versus a two dimensional found in most doctors offices. The results of a T3 MRI (uses the best magnet in clinical use) is locked into the biopsy machine. In my case, an Artemis brand machine is used

    Also a PSA and also a FREE PSA test is appropriate at various intervals; my doc does these tests at six months intervals. As recommended at this board by AS Advocate a PHI test is an improvement ( which I will talk to my doc about, next time we ).

    As a lay person, I think that you and your medical team are making a valid choice, and hopefully will eliminate unnecessary procedure if possible.


    I'm doing well; have a February appointment for a six month meeting with my doc...a PSA/Free PSA/ digital rectal exam is on the agenda...also will discuss the timing of my next biopsy



  • paulc59
    paulc59 Member Posts: 10
    robotic or survailance

    i choose robotic after being diagnosed with a gleason 7,6 of 7 slides positive- fully contained. i am 58 and did not want to go through hormone therapy followed by 9 weeks of radiation. Found a local surgeon who has performed thousands of procedures and everything has gone as expected--out of hospital in a day-back at work in 2 weeks albeit a desk job,could have returned sooner-,contineance getting better everyday,i have accepted the fact an erection might take a bit longer--but the cancer ,via a psa test is gone at the 6 week point---wasnt that the point!!!!!

  • ASAdvocate
    ASAdvocate Member Posts: 179 Member
    You are well advised

    With only two cores of G6, you are well advised to try AS. The current guidelines from the National Cancer Centers Network, the American Urological Association, and the American Society of Clinical Oncologists all prescribe active surveillance as the default choice for your pathology.

    But, as H & O stated, you need to have a structured protocol of confirmatory testing and regular follow-ups.

    Mutliple studies have shown that spending time in AS, and later needing treatment has no effect on life expectancy as compared with men who had immediate treatment. And, every day that you can safely defer treatment is another day living a normal life. Good luck.


  • Clevelandguy
    Clevelandguy Member Posts: 767 Member
    More time?


    With your diagnosis you should have the time to study the different treatments vs side effects to guide your path in the future.  I chose surgery and don't regret it but other people might choose radaiton.  I would not rush into it until you are ready, don't let the doctors push you for this or that until you feel comfortable with the treatment plan.  I would look at the MRI to see where the cancer is located(deep inside or close to the edge of the prostate) and go from there.  If it's close to the edge you might want to get more agressive treatment sooner.

    Dave 3+4

  • 1005tanner
    1005tanner Member Posts: 29
    Thanks for all your input it

    Thanks for all your input it is greatly appreciated with people that know what you are going through.

    It helps out to read your comments brothers and glad you are here for all of us.  I will let you know

    in the next few months of outcome and direction im going. I wish you all well and hope you all are

    doing okay God Bless 

  • Tech70
    Tech70 Member Posts: 70 Member
    Oncotype score

    With your Oncotype score of 23, you likely would have a less than 1% chance of dying of PCa or metastisis in the next 10 years.

  • Steve1961
    Steve1961 Member Posts: 301
    edited January 2018 #9
    what about other treatment

    i am in the same boat..stanford told me surgery is the only way...then i went to UCSF..their surgeon told me i was a candidate for brachytherapy and cyberknife as i am meeting with radiation dr at UCSF tommoroow to see what they say..i was told at my stage   stage 1 low intermeiate tahteither treatment whether it be radiation or RP would produse the same results......we shall your case u r better off than me..cant see why they would say active surveilance or RP   come on there are many other trratments that RP...many peopel on this great forum have said RP should be the last resort..