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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
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1 ReactionYou 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.
With Gleason 3 + 3 = 7 if you are uneasy about active surveillance . Discuss Monotherapy SBRT with your Radiation Oncologist .
Good luck .
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1 Reaction@clandeboye1 @tuckerp
How do you get a =7 from 3+3?
Active surveillance has to be a personal decision based on your basis for quality of life and what you want to go through for your life not others.
For me doing active surveillance and a diagnosis of prostate cancer was not an option. I wanted to treat the cancer and work to cure it not being mentally capable of not treating it. I was one of those told "you will not die of this prostate cancer" by my Mayo urologist. Just not for me personally. But many others do not want (at the time they make decision) RP, radiation, hormones, or other treatments, and for them active surviellance is their choice and it is a personal one to make.
We are all different. Many many treatments out there these days even new ones I am seeing since coming on MCC two years ago. I just read in a Mayo newsletter I get about a new treatment of attacking only the cancer cells only and not the normal cells by special program of stem cells or proteins that attach to cancer cells (don't have the article any more so hope I am close to what was stated). It is in clinical trial but sounds really promosing.
I dont think I mentioned 3+3 = 7. Mine was 3+3 6. biopsy showed 1 out 12 samples with cancer and my PSA 1.1. I went in for the urgency to pee. I have been on the site for some time now. Everyone has pretty much told me I was crazy for asking for NS RARP. AS would have been a much better choice. I had no other testing done. My question which has mostly been answered is why would you go on AS just to watch it get worse. But I think I have a pretty good answer to that. I would probably go on AS a second time since I still ended up incontinent and ED. 5 years now I appear to be cancer free. But you never know.
@tuckerp
It was a reply from clandeboye1 to you about your Gleason score of 3+3=7 and some comments about active surveillance. Should have sent to him but thought he was reflecting your post. I never saw your original post. clandeboye1 post to you is a couple of post above this.
It is great to see you are cancer free. That is the goal for all of us not matter what treatment we have.
After my surgery, I learned that I had cancer in a lymph node. I chose active surveillance to avoid radiation and hormone shots.
I change my diet and adopted the Mediterranean Diet. Plus, I’ve had my PSA checked every three months. I’ve done this for three years now. I’m grateful my cancer has remained in remission. Good luck with active surveillance; there is hope!
3 + 3 an Obvious Error .
I BET YOU NEVER MAKE MISTAKES OR HIT THE WRONG KEY ON THE KEYBOARD - I know your nit picking types . Always looking to criticize . Never an original idea or opinion , but always ready to crititize others proposals and opinions .
@Clandeboye .. MA.Sc. P.E. P.Mgr. MBA .
p.s. I will be looking for " YOUR " future typing errors . The body of my thread is the same
whether it is GLEASON 3 + 3 = 6 or Gleason 3 + 4 = 7 . Other less critical members on
this forum will understand my posting , and overlook a senior moment by an 85 year old .
Get a life .
I had a similar experience. I was told that the L4 on my spine probably had a metastasis on it. At that time I was going on Zytiga And for 2 1/2 years, it stopped that thing from growing at all. When I stopped Zytiga And moved on to Darolutamide I decided it was time to get the thing zapped. The radiation oncologist, of course agreed, And my oncologist also thought it was a good idea, though not essential. Had it zapped and since 2 months later I have gone on a 14 month undetectable streak.
Not Treating it at all wasn’t really a problem For me either. Over that time. I also changed my diet a lot.
yes. sorry if I offended anyone. I had thought I would just ask why anyone would choose AS. jeffmarc and several others responded appropriately. I should have done more research before just jumping into panic mode and telling the urologist to just remove mine. Yes it is my wish we all outlive this whether cancer free or not. Again no disrespect meant to anyone.