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active surveillance

1005tanner
Posts: 29
Joined: Dec 2017

 

Diagnosed in October 2017, Gleason 6 Have had pathology slides read again at Vanderbilt for second opinion

and was told they were consistent with original . Oncotype dx was 23 , psa 2 years ago 2.57 one year ago 2.97

then last week was 4.7. Have MRI scheduled May 11,  First Biospy was left mid 2 of 2 cores measuring 5 mm and 3.5mm

comprising 60% and 35% .  Peripheral Zone 61 years old good health ,   also scheduled was fusion biospy within a year.

Also have started 3 month psa testing. Hope all is well with you and appreciate all your valuable input and information.

Thanks Frank

hopeful and opt...
Posts: 2218
Joined: Apr 2009

Recommend that  the 5/11 MRI is a T3 MRI for best results.

When will the fusion biopsy occur?

Have you had a FREE PSA? Incorporate the FREE PSA with the PSA.

Other factors can raise the PSA, sex before, bike riding, infection , even a hard stool....quite often the PSA jumps a lot at one time.

 

1005tanner
Posts: 29
Joined: Dec 2017

Yes it is with T 3 MRI and I have not had a free psa yet. Will ask at next appointment in 2 weeks and also about

my fusion MRI . Thanks for your input . I see you have been on active a long time, wishing u the best. Im going 

to stay this route and stay on top of it for as long as I can. 

Thanks for your input and good luck.

 

hopeful and opt...
Posts: 2218
Joined: Apr 2009

Fusion biosy.....when you say a fusion biopsy, first a t3 MRI that locates and ranks suspicious lesions, then the results are locked into a three dimension biopsy machine, and the urologists can target the lesions with the highest pi-rad scores, usually 5, 4 or 3, using a three dimensional biopsy machine.  In my case the biopsy machine was manufactured by Artemis.

Feel free to click my name to the left to see my medical history and other pertinent information about Active Surveillance.

 

Please feel free to ask any questions

1005tanner
Posts: 29
Joined: Dec 2017

Yes sir, I am on track with all your information. You have been through alot over the years

and all the test and Doctor visits.  After my May 11, T3 MRI , I have all the questions wrote down

that you have giving me. Free PSA Test with my next PSA Test. plus when he wants to do my Fusion MRI 

biospy.  Thank You so much and continued success in your journey. Ill be in touch. I know Vanderbilt Hospitail

has that machine and im finding out if they do here in my hometown at my next Doctors appointment.

hopeful and opt...
Posts: 2218
Joined: Apr 2009

Frank, 

Please be aware that you want the the facility that is most experienced; there is a difference among radiologists interpreting the results of the MRI and and the skill of the urologists who take the biopsy.

I wonder, as long as you are having an MRI now, if it can be followed up with a biopsy.... a follow up, I think within three weeks is best.

SantaZia
Posts: 64
Joined: Apr 2018

1500taner looks like you are a great candidate to continue AS.  I have only been on it for 3 months what helped me was to have a doctor or two who agree you should do it.  I have complicating issues that treatment will make worse. However, if it was life threating I would start treatment immediately. I had a couple of genetic PTEN test and Prolaris test, MRI, Bone Scan and a new PSA. I am mid intermediate on the Prolaris test 5% chance of death from PC in the next 10 years with no treatment, 2.1% with treatment. I am waiting for results on the PTEN. There are a lot of individual factors you will need to consider my PSA is high 13.78 and 13.20 but there are reasons it is higher than most. My 3T MRI revealed a small lesion on the right side of prostate which confirmed the biopsy of 3+4 but only 15%.  Someone like Hopeful and Optimistic can really help you. There are others out there that went 10-30 years with AS and they had worrisome issues, but they didn't die of PC. You have to be brave to accept treatment or continue AS it is just part of the deal.  Good Luck!

ASAdvocate
Posts: 113
Joined: Apr 2017

So, just keep following your specialists' advice. You don't appear to need treatment, from what we know now. just keep up with the testing regimen. At Johns Hopkins, we switched to using the PHI test a few years ago. That combines PSA, free PSA, and a PCa biomarker, plus an algorithm to produce a score of possible aggressiveness. More accurate than PSA alone, and costs about $115. You may want to request that next time.

I have been in the world's oldest, strictest, and most suceessful AS program for nine years now, and every day I am thankful that I was not cut up and overtreated by some greedy urologist.

 

 

hopeful and opt...
Posts: 2218
Joined: Apr 2009

When you first switched to the PHI test, did you also have a PSA and FREE PSA for trending purposes, or did Johns Hopkins simply start the PHI test ( does the PHI test also indicate the PSA and FREE PSA scores, as well as the PHI score).

ASAdvocate
Posts: 113
Joined: Apr 2017

A PHI test will generate both PSA and Free PSA results, as a part of its assessment.

hopeful and opt...
Posts: 2218
Joined: Apr 2009

Thanks 

 

1005tanner
Posts: 29
Joined: Dec 2017

Thanks so much for the  information . I will be asking about the PHI test next week. Thanks for 

being there guys it is greatly  appreciated.  Hope all is well.

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