Active Surveillance of Grade Group 1

Posted by kalidad @kalidad, Apr 2 1:56pm

I am so grateful for this group. The wealth of information and personal experiences prepared me in many ways for running the gauntlet of screening/diagnostic tests and to be a full participant in planning any required treatment.

My annual physicals revealed a slow upward progression of PSA from 4.0 to 6.0 over 3 years. I was otherwise asymptomatic for prostate cancer at age 72 and in very good health overall.

I am relieved that my present course of action is Active Surveillance, with another checkpoint in 6 months. This plan follows DRE, PSA, 4-Way, MRI and transperineal biopsy.

DRE was Normal. PSA was elevated at 6.0. PSA Density was abnormal at .30 as prostate volume was small at 20 mL. MRI was negative for prostate cancer. Transperineal biopsy revealed one core of 12 with adenocarcenoma, Gleason score 3+3=6. Grade Group 1; discontinuously involving 40% of core 1/1.

Next PSA in 6 months. Stay tuned.

I continue to watch this group and pray for the best possible outcomes for all of you. Thank you for being here for me.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

batsam10 | @batsam10 | Apr 2 5:08pm

Happy for you and wishing that you stay on AS for the rest of your long healthy life.

Take care.

proftom2 | @proftom2 | Apr 3 8:54am

Thank you. I speak ten years in DRE + Slightly Rising PSA treatment. Official watchful waiting every 3-6 months for 5 years after that. Lower back pain began year six, first sign of blood in urine years 7. Immediate Biopsy, but darn too late, Stage 4, aggressive. That was 4 years ago. Still going. Still learning hot to deal/live with it. Very proud of you for sharing and tracking your treatments/numbers.

brianjarvis | @brianjarvis | Apr 3 9:22am

While you’re on active surveillance, beyond just PSA and Gleason, also track your % Free PSA, PSA Doubling Time, PSA Velocity, and PSA Density, as well as getting biomarker (genomic) and genetic (germline and somatic) tests. All these will provide you more insight into monitoring the status of your prostate cancer.

I was on active surveillance starting in 2012 for almost 9 years with a localized, 3+3=6 (2nd opinion confirmed), PSA of 4.2; biomarker (OncotypDx) results were positive. I made a commitment that should my PSA ever reach 10, or Gleason reach 7, or have a negative biomarker (genomic) test, that I would seek active treatment.

PSA slowly increased during that time. But, those 9 years gave me more than enough time to comfortably and without pressure evaluate all treatment options, as well as benefit from advances in treatments and medicine.

After almost 9 years, my PSA was 7.976, but my Gleason did reach 7 and my biomarker (Prolaris) test indicated that I had “exceeded the threshold for active surveillance.”

By then I had already decided that proton beam radiation was my choice of treatments. At 65y, I had that treatment during April-May 2021. Today, nearly 3 years later, PSA remains low and life is back to the way it was prior to the PCa diagnosis.

Wishing you the best with your active surveillance. Keep it truly “active.”

kalidad | @kalidad | Apr 3 10:32am

In reply to @brianjarvis "While you’re on active surveillance, beyond just PSA and Gleason, also track your % Free PSA,..." + (show)

Thank you! I had prepared myself for results that demanded immediate treatment and so had become knowledgeable of proton beam therapy and centers of excellence. I am grateful for the time afforded me during Active Surveillance. Your experience and diligence are inspiring.

bens1 | @bens1 | Apr 4 6:55am

kalidad: you may want to ask that your biopsy material be used for a Decipher test. It is used by doctors to diagnose and decide on any treatment, if any.

airborn | @airborn | Jun 18 6:59pm

G7 3+4 here with less than 5% grade group 4, confirmed in 2nd opinion at John Hopkins. PSA 4.9 at diagnosis last June. AS ever since past 12 months, PSA rose to 6.7 in 12 months, now in June and also had another 3tMRI which showed no change, same size and stable. Staying the course on AS.