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Did you choose active surveillance? Why was it a good choice?
Biopsy showed 3 + 4 MRI showed pirad 2 bone scan CAT scan no metastasism nothing found. psma pet scan radiologists said nothing found. but oncologist says he saw a very small spot. Only concern was half of the cores showed 3 + 4 out of 12 but he said it does not show the percentage of four?? Not sure I understand this part. Told me I could do active surveillance or cyber knife or brachytherapy. I think I am going to go with active surveillance my Medicare plan I can change next year to an advantage will cover more of the cost I have original Medicare now. Can I get some opinions on active surveillance being a good choice? Thank you in advance
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@arizobound
I see you asked a question for me.
My MRI does show a determination of prostate cancer.
My MRI done with a contrast showed suspicous areas and thus the urologist ordered biopsies. A MRI can give the radiologist and urologist a good image of prostate and suspicious areas. I asked my urologist after I go the suspicious areas diagnosis what the chance it was cancer and he said 70%. Mine biopsy Gleason Score came back 3+4=7 and was diagnosed with intermediate prostate cancer per pathologist.
PMSA is a very excellent test. It uses a type of radioactive injection and then scan to look for prostate cancer that has spread outside of prostate. Mine was negative. I also had a bone scan that was also negative.
I was asked if wanted Decipher test and advised would give a more specific determination of risk level. I asked for it and my diagnosis of intermediate risk was changed to low risk and changed my treatment recommendations were also changed. A very good test that uses the same biopsies already taken.
I hope I answered your questions!
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3 ReactionsNo
No
Pirad 2
As recommended in Dr. Patrick Walsh's Book 5th Edition " Guide to Surviving Prostate Cancer "
Everyone should get a 2nd or 3rd opinion of their Biopsy Pathology results .
Take my case : Biopsy # 1 A 5 core Transperineal MRI Fusion Biopsy - ALL NEGATIVE . This was in clear conflict with my MRI PI- RADS 5 Score . Biopsy # 2 , at my request not my Urologist was a 16 core with 6 cores in the same target area as # 1 .
All 6 cores came back Gleason 3 +3 = 6 . A 2nd opinion 4 cores Gleason 6 , with 2 cores Gleason 3 + 4 = 7 . TAKE YOUR PICK .
I would have a 2nd or 3rd opinion of my biopsy slides . I have been on active surveilllance for a year , and currently reviewing my other options . My recent year-over- year MRI ( My 3rd )
showed no change . My recent Bone and CT Scans were negative - No metastasis detected . I plan on a PSMA PET SCAN -- My call .
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4 ReactionsThe 1st thing I suggest , Get a 2nd or 3rd opinion of your biopsy results Confirm you have Gleason 3 + 4 = 7
Active surveillance MAY bbe a good option with regular PSA ( EVERY 3 MONTHS ) FOR THE 1ST YEAR . Followed by a followup MRI to determine any growth of the liason .
I have a question about active surveillance. I was given that option. But as jeffmarc has pointed out my 3+3 gleason 6 should be AS. But why would you wait on a 3+4. What are we waiting on. To get worse? Reduce the inevitable side effects? Would there be any likelihood its not going to get worse.
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2 ReactionsSome people do AS for 3+4. Yes it can get worse. It can also not change for a while, giving a break before treatment. Unlikely to not get worse over time.
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1 ReactionFollow your medical experts . Your Urologist should follow you closely on AS . I have a friend currently on active surveillance , for 7 years , with G6 and Gleason 3 + 4 = 7 . He just turned 60 last June . He has keept abreast of the emerging new advances over the years -- He has options today he did not have 7 years ago . He is currently considering NanoKnife should he decide , in concert with his Urologist , to discontinue his AS . He is also not opposed to other Focal Therapies as they advance .
You not have read my thread on my biopsy experience . Biopsy 1 A Transperineal MRI Fusion Biopsy 5 Cores - ALL Negative . Clearly in conflict with my MRI RADS 5 Score . My 2nd Biopsy a 16 Core with 6 cores in the same target area as Biopsy 1 . The 6 cores in the same target area as Biopsy 1 came back Gleason 3 + 3 = 6 .
A 2nd opinion on my G6 came back : ALL 6 CORES Gleason 3 + 4 = 7
A 3rd opinion : 4 Cores G6 2 Cores Gleason 3 + 4 = 7 . All other other cores of the 16 came back negative .
I hope this reinforces my advice . Get a 2nd or 3rd opinion of your biopsy slides .
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1 ReactionI can say that I've had a radical prostatectomy, 11 years later my cancer came back and I've had 36 treatments of proton radiation therapy. Right now, I'm one active surveillance with a PSAof 5.25 and rising. Not sure what or when the cancer will show a metastasis somewhere. So far 4 PET scans have not showed anything. The thing is, you have to have a great outlook for tomorrow and educate yourself. Patrick Walsh's book will definitely help.
I believe however, that you should take a really good look at Medicare Advantage because it isn't a great insurance option and many doctors won't accept it. My Medicare and my supplemental insurance so far, have covered all of my expenses.