Bevana00007:

I was diagnosed with the same pathological stage (favorable intermediate risk), after my mpMRI fusion TRUS biopsy in October 2023 (see details in my profile).

I selected (and my urologist agreed) to pursue Active Surveillance, after receiving a Decipher Score on my 3+4 cores of 0.22 (low risk).

Getting a Decipher score is a MUST (IMO) if one is considering AS with this stage (F-IR) of PCa. “High Risk” Decipher Score would have changed my treatment decision.

AS is not the same as “watchful waiting”. If one selects this approach IMHO a program of vigorous exercise and modified diet to reach and maintain an “optimal BMI” (22-23) should be a high priority.

One must also be prepared to pursue other forms of treatment if follow up PSA and biopsies indicate progression.

In my case, my PSA dropped from 7.8 (pre-biopsy) to 5.9 (3 months after biopsy). I lost 25 lbs, during that time period, due to my exercise/diet problem which may have helped??? I’ll know more after my 6 month PSA and a follow up biopsy at 12-18 months after my initial biopsy.

In any case, others will select immediate treatment with this F-IR diagnosis, so every man must decide for themselves, hopefully with the help of a supportive and informative doctor.

All the best as you consider your treatment options.

Alan

Hi I’m 67 and have been on active surveillance for 4 years. My biopsies were always 3+3=6 one core over the years psa went from 4 to 5 with no major jumps. My last biopsy in November 2023 things changed they came back 3 of 14 were 3+4=7 and psa jumped to 6.01. I sent my biopsies to John’s Hopkins for a second opinion they rated all three as 3+3=6. After talking to my oncologist he ordered a Decipher test it came back as high. So I have decided to go ahead with 28 sessions of IMRT. It’s a tough decision but the Decipher score was really the tie breaker for me. If it had come back low I would have stayed on active surveillance. I know what you’re going through. You’re doing the right thing by asking questions. Good luck.