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Did you choose active surveillance? Why was it a good choice?
Prostate Cancer | Last Active: 18 hours ago | Replies (42)Comment receiving replies
That was there only concern was the amount of cores. That was one urologist and two oncologist told me. I got quite a few opinions actually yesterday I was at the oncologist. He has 30 years experience in prostate cancer he said that I should eventually get it treated like no later than end of year. but he was comfortable with me waiting for a while. The amount of cores the only negative he said.you're correct but he also said everything else all the scans decipher and PSA are all low. My main problem that I don't understand is how can every scan be negative including decipher 0.41 which is low but they found it on a biopsy. To me the concerning part is why can't four different types of scams not pick up anything. They're supposedly MRI pet scanner 90 something percent accurate if we think one of these will pick it up something that there is something there to pick up that was of any size??
Replies to "That was there only concern was the amount of cores. That was one urologist and two..."
If your cancer is completely inside the prostate, then all the other tests will find nothing, Except a PSMA pet Test would which find it in the prostate, They just didn’t mention that since that was a known problem, If you ask them, they could tell you that the Prostate did light up on the PSMA pet test.
There is a difference between a medical oncologist and a Genito urinary oncologist. Do you know if your oncologist is a GU oncologist?
If you Decide to do nothing get quarterly PSA tests
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For background: I'm 68 y/o and have been on active surveillance (AS) for the last 14 months.
I received my initial mpMRI and targeted TRUS biopsy in October 2023. The mpMRI showed 3 PIRADS lesions, one 5, one 4 and one 3. The biopsy took 21 cores from 15 areas and 7 of the 15 were positive. Two of the PIRADS lesions were low volume (5-10%) 3+3 and one was benign. They also found three additional 3+3 cores (5-10%) and two 3+4 cores (10-20%) in the "random" portion of the biopsy. My Decipher score was 0.22.
One of the main reasons I opted for AS was because my Decipher GRID Clinical Genomic Model (see attachment) dropped my clinical "Favorable Intermediate Risk" stage to “Low Risk" (based on the clinical/genomic model) and recommended AS. My post-biopsy PSA's (I get them every three months) have averaged ~20% lower than my pre-biopsy PSA.
I had my yearly follow-up mpMRI in October 2024 and it showed largest lesion shrinkage and the other two lesions were not visible. The so-called "T2 & DWI/ADC" lesion signals were also reduced from “moderate” to “mild”. In my latest December appointment my urologist said I can postpone getting another biopsy. I continue to closely monitor my situation.
The reason I'm going into all this detail is that each of the things I mentioned above are important pieces of information for men with a 3+4 PCa diagnosis who are considering AS.
You should definitely find out what your cancer volume percentages were in all your biopsy cores AND the percentage of type 4 Gleason (in your 3+4 cores). This is very important information, especially when multiple cores are involved.
If your radiologist did not provide cancer volume percentage information you should seek a second opinion of your biopsy pathology to get that information.