Did you choose active surveillance? Why was it a good choice?

I am of the same opinion as you. I feel he should stay with Medicare and perhaps plan F or the new G plan. I haven't had to pay for anything since using the F plan and I'm very pleased that I can go where I need for treatment. Med Advantage is rejected in many places.

This is directly from my urologist about last week. They didn't find anything even on a psma PET scan. As you can see. So I take it it's that small? Since it showed on a biopsy of 3 + 4 I don't understand and even urologist seems a little confused. As to why It didn't show. ..................The only finding that is of concern is the number of biopsies positive isolated to 1 side of your prostate.

Again, CT scans, and MRI negative.

This is very perplexing as we would assume that both a PSMA PET and MRI should shows some clinically significant disease and in England there was a study demonstrating avoidance of biopsy in PSMA PET and MRI negative and they are even proceeding with radical prostatectomy without biopsy in patients with positive MRI and PSMA.

I actually think it may make more sense to repeat a standard transrectal ultrasound prostate needle biopsy and send pathology off for 2nd opinion to confirm that the actual tissue that was reviewed by other pathologist is actually correct before definitive therapy.

Please let me know how you would like to proceed.

Your MRI showed a single PIRAD 2 “tumor”. That is not considered cancer.

Your results are pretty good, but, as everyone mentioned, six out of 12, not great.

I don’t think you really need another biopsy, Though it may not hurt, If you did it, they should get other areas of your prostate to see what they show. Ask your doctor what he thinks.

Try to get a decipher score. That can tell you more than another biopsy about your future risks.

My decipher score is 0.41 I had that done already which I believe is low not super low but considered low that should make it even better correct? I have gotten doctors opinions actually three of them of course they all would rather do treatment but they seem to at least the last two I've been to agree that I could go on active surveillance. But they're saying I'll have to use treatment at some point. Thanks

Thank you for your response

Sorry, I forgot you had your decipher score listed. So many messages it’s hard to keep track with everything going on with so many people. Just make sure to get quarterly PSA tests. You know you have a chance to be on active surveillance for a while, but you want to make sure you’re covering all your bases. If the PSA starts to rise, maybe you should go on monthly tests.

It is possible you could go a year or two without doing anything, To have a chance at the longest life you want to get treatment as soon as your numbers rise significantly.

No mentioon anywhere about a 2nd or 3rd opinion of your biopsy pathology results .
I am on Active Surveillance -- Year over year MRI showed no growth change . My Bone & CT Scan were clear . I have a PSA Test every 3 months for the 1st 12 months , then every 6 months .
I am considering as my eventual options : # 1 Focal Therapy , NanoKnife which is gaining international success ( slower acceptance in thhe USA , as with many international treatments )
HIFU , Cryotherapy or TULSA PRO which was invented by Dr. Chopra at the Sunnybrook Hospital in Toronto , or others e.g. Immunotherapy . There are others .
Considering Radiation , I hope to avoid like the plague , ADTT 9 Hormone Therapy and it's side effects , both short term and long term . I am lookiing at the 5 Session Mon, Wed Fri and Mon Wed the following week . SBRT MONOTHERAPY . No hospital stay , no catheter , no anestetiic , Very low risk of incontinence or erectile disfunction . This is the current " International GO TO Treatment for your situation .
I would not make a knee jerk decision and go off AS at this juncture .

No I would not I haven't even started active ssurveillance I just started. no way I would just ignore it.

My primary suggestion was to get a 2nd and 3rd opinion of your pathology results as assurance that your 1st Gleason Score is correct .
If you have read Dr. Patrick Walsh's book : " Guide to Surviving Prostate Cancer " , this is highly recommended as do other International Tier # 1 Urologists .
Good luck .

Were they able to see the cancer in the MRI or the psma pet