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Pick a treatment or stick with AS

SantaZia
Posts: 64
Joined: Apr 2018

I am looking for some advice. I just received my Prolaris results 3.7 which is consistent (their rating) for intermediate PC. two cores less than 15% 3+4 with high PSA 13.7. (PSA may be high from long term and frequent cathing according to two urologists) Also received a clear Bone Scan and MRI results - (MRI prostate gland is relatively small, measures 3.1 cm cephalocaudal by 2.2 cm AP by 3.9 cm transversely for an estimated volume 14 mL. With diffusion-weighted imaging and ADC map a focal lesion within the mid gland extending to adjacent base and apex measures 1.8 cm largest transaxial plane. Lesion involves the peripheral zone of the mid gland anteriorly extending to adjacent apex and base and into the adjacent transition zone.) I have one more genetic test and will meet with a surgeon who is not recommending surgery for me due to my TURP in 2002 which caused scaring to the bladder neck. Following that visit on to MD Anderson Proton Center for a consult. So folks I would rather stick with AS as my surgeon is recommending due to my potential bladder neck complications from Radiation. I think I will need to make up my mind in the next month or so, as MD Anderson gives you 62 days to begin treatment. I appreciate your throughts on this. Thanks!

Grinder
Posts: 438
Joined: Mar 2017

Pardon my ignorance here.... but is the genetic test comparing the genetic makeup of your cancer cell DNA to that of cancer cells that remain dormant in lifelong AS patients, versus DNA in cancer cells that were aggressive in patients requiring immediate treatment or even succumbed to aggressive cancer?

If it is, I am guessing your genetic test will prompt your surgeon's confidence in AS, if your cancer cell DNA more closely resembles lifelong AS patients where the cancer cells remain dormant.

Genomic Health is developing that genetic test, I was just guessing that might be the test you are taking, since it is a "genetic test" that predicts whether you are a good candidate for AS. I didnt know if Genomic Health has gathered enough data yet to know which markers are which in a DNA profile.

I am hoping that is the genetic test you are referring to. If it is not, then forget everything I just said.

And kudos to your urologist for being honest, and not just cashing in on another procedure.

SantaZia
Posts: 64
Joined: Apr 2018

Hi Ginder there are quite a few genetic tests and you are correct the Prolaris test is similar to Genomic Health and used to determine if you are a candiate for AS. Of course a score of 0 or 1 would be more what they like. Over 2 is leaning to treatment.  However besides the sample from your Prostate Biospy they use your Gleason Score and your PSA Score. My PSA could be a little higher than it should be because of cathing 6 times a day.  My Prolaris test was consistent with my intermediate PC not low grade by any means but not more worrisome. The estimate likehood of me dying from PC is the next 10 years was 5%. Fortuunately no evidence of extraprostatic disease. Although I am 68 I am in great health a mathaton runner my dad is 93 and had radation for PC at 78 and my mom is 90. Although I will need to make a decision your advice helps.  Thank you!

Grinder
Posts: 438
Joined: Mar 2017

If its any consolation, my dad was diagnosed with PC around age 70, was untreated and died at 92 from organ failure unrelated to PC. And my neighbor who I mention repeatedly did not know he had aggressive PC until much too late to treat it. So he was telling everybody... "Get checked out!" You may not have PC, or most likely scenario, you have it but it is laying dormant and may stay that way, or its aggressive and needs treatment. With all the effort us guys put into other worldly pursuits, Its amazing how little attention PC gets.

I pray that AS works for you for a lifetime... 

SantaZia
Posts: 64
Joined: Apr 2018

Thanks Grinder!

 

hopeful and opt...
Posts: 2224
Joined: Apr 2009

I am attaching your previous thread for reference....suggest that it is best to stay with one thread

http://csn.cancer.org/node/315849

SantaZia
Posts: 64
Joined: Apr 2018

Thank Ginder I will go back to that threat.  I loved the diagram.  

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