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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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Began AS in October 2023, after being diagnosed with low volume 3+4 and Decipher score of 0.22.
After an initial mpMRI showed PIRADS 3, 4 & 5 lesions, only one reduced T2 & DWI/ADC signal lesion (the original PIRADS 5) could be observed in my 12 month follow-up mpMRI.
So....yes...a 3+4 diagnosis (with low decipher score) can regress. I personally believe it may be due to my 90 minute/week vigorous aerobic exercise regiment, which I started upon PCa diagnosis...but who knows for sure...clinical studies & RCT's would suggest that could be the case.
https://jamanetwork.com/journals/jamaoncology/fullarticle/2783273#google_vignette
https://www.health.harvard.edu/mens-health/exercise-may-slow-prostate-cancer-growth
Recently, CoE institutions (UCSF & UCLA & John Hopkins) have all completed independent studies suggesting a healthy diet may also help slow PCa progression...but who knows for sure...
One thing I do know for sure is that my VO2 Max has increased from 40 to 47 and I have lost 25 lbs, since I was diagnosed.
- https://www.ucsf.edu/news/2024/05/427571/prostate-cancer-study-more-health-benefits-plant-based-diet
- https://www.uclahealth.org/news/release/low-omega-6-omega-3-rich-diet-and-fish-oil-may-slow-prostate
- https://www.hopkinsmedicine.org/news/newsroom/news-releases/2024/10/study-suggests-a-healthy-diet-may-help-keep-low-grade-prostate-cancer-from-progressing-to-more-dangerous-states-during-active-surveillance
You could be one of the people that does not produce much PSMA. Without producing PSMA a PSMA pet scan won’t show anything. I know at least one person that died of prostate cancer because it couldn’t be detected on the scan. He had no idea he had a lot of metastasis. When he finally discovered how severe it was he went as far as getting Pluvicto and Actinium in Austria, but neither worked because they require PSMA.
You might want to request an FDG PET scan, It can show cancer that can’t be seen in a PSMA pet scan when you don’t produce PSMA.
With a PSA at 5.25 something somewhere is producing PSA, That’s usually cancer if that’s what you’ve had in the past.
Definitely a strange case with a high PSA and no visible cancer.