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

Posted by arizobound @arizobound, Dec 27, 2024

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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@tuckerp
I don't see where you offended anyone. Surely did not offend me.

I just saw a poster giving your Gleason score. We all type in numbers all the time with mistakes.

If I was going to make a post reference your Gleason score knowing if it was a total 7 or total 6 would really help me post my experience.

I think you are right on with panic mode. That is why many of us suggest doing second and third opinions. That gives you different voices and time to decide what is best for you. Doing research is good but does not replace the professional advice from different urologist and R/Os.

May I asked what was your Gleason score? Did you have your prostate removed?

My Gleason was 3+4=7. And was told intermediate risk and recommendation radiation with hormone treatments. R/O suggested Decipher (I had not idea at time what that was) and I concurred. It came back low risk and changed my treatment plan to no hormone just radiation.

A decision to do A/S or to treat with radiation and or surgery is a personal decision and should not be based on what others did. It is your body, your cancer, your available treatments, insurance, etc.

I was overwhelmed when I was diagnosed but had an excellent PCP, urologist, and two different R/Os guiding me.

I wish you good luck in your journey and really you did not offend anyone that I can see.

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@jc76

@tuckerp
I don't see where you offended anyone. Surely did not offend me.

I just saw a poster giving your Gleason score. We all type in numbers all the time with mistakes.

If I was going to make a post reference your Gleason score knowing if it was a total 7 or total 6 would really help me post my experience.

I think you are right on with panic mode. That is why many of us suggest doing second and third opinions. That gives you different voices and time to decide what is best for you. Doing research is good but does not replace the professional advice from different urologist and R/Os.

May I asked what was your Gleason score? Did you have your prostate removed?

My Gleason was 3+4=7. And was told intermediate risk and recommendation radiation with hormone treatments. R/O suggested Decipher (I had not idea at time what that was) and I concurred. It came back low risk and changed my treatment plan to no hormone just radiation.

A decision to do A/S or to treat with radiation and or surgery is a personal decision and should not be based on what others did. It is your body, your cancer, your available treatments, insurance, etc.

I was overwhelmed when I was diagnosed but had an excellent PCP, urologist, and two different R/Os guiding me.

I wish you good luck in your journey and really you did not offend anyone that I can see.

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good. Thank you. mine was a gleason 6. 1 out 12 samples with cancer. clear margins. PSA was 1.1 or normal. Post op confirmed gleason 6 with clear margins. I did 3 month PSA's for 3 years and last 2 years every 6 months. All less than < .01. I had a PMSA scan done at 2 years. Nothing active. I admit I am not familiar with all the treatments and options available. Or all the abbreviations. I have both incontinence and ED. That has been my goal while on this site to understand where to go next. But those are a new thread. 🙂

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@tuckerp

good. Thank you. mine was a gleason 6. 1 out 12 samples with cancer. clear margins. PSA was 1.1 or normal. Post op confirmed gleason 6 with clear margins. I did 3 month PSA's for 3 years and last 2 years every 6 months. All less than < .01. I had a PMSA scan done at 2 years. Nothing active. I admit I am not familiar with all the treatments and options available. Or all the abbreviations. I have both incontinence and ED. That has been my goal while on this site to understand where to go next. But those are a new thread. 🙂

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@tuckerp
Looks like you are doing everything to keep track. I think but not sure as not medical professional is that they don't give Gleason score below 6.

The only thing I could even further suggest is a second opinion to help you understand what to do next. Has your urologist explained and looked into your incontinence cause?

Trust me you are not alone. There are so many different treatment options out there. I have posted several times that I have been on MCC now for 2 years and have seen even in that time new and different treatments being offered and available.

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@jerryegge

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!

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Hi im interested the same situation. 6 months ago psa went to .20 so did a psma scan and it's in one lymph node. Every 3 months blood work and another psma scan.psa went down slightly once now back up slightly to .36 doc recommend active servalance. Going for my 3rd scan Feb 21.not sure how to feel about this situation. It's in my pelvic area.anyone with this experience I'd appreciate feed back ty.

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@handera

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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For those interested in finding out why VO2 Max is the most important longevity indicator and how one goes about increasing their own VO2 Max....two short videos:


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Be careful with Medicare advantage plans. Many men on here complain about pre-approval issues and denials of procedures...not to mention limitations of where you can be treated. We have original medicare and a supplement and they cover everything once deductable is met.

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@mariopetrozza

Hi im interested the same situation. 6 months ago psa went to .20 so did a psma scan and it's in one lymph node. Every 3 months blood work and another psma scan.psa went down slightly once now back up slightly to .36 doc recommend active servalance. Going for my 3rd scan Feb 21.not sure how to feel about this situation. It's in my pelvic area.anyone with this experience I'd appreciate feed back ty.

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My experience is similar. Gleason 3+4 in 1 of 12 lymph nodes. PSA level tested every three months for past three years. My PSA has been < 0.1. I’m grateful.

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@mariopetrozza

Hi im interested the same situation. 6 months ago psa went to .20 so did a psma scan and it's in one lymph node. Every 3 months blood work and another psma scan.psa went down slightly once now back up slightly to .36 doc recommend active servalance. Going for my 3rd scan Feb 21.not sure how to feel about this situation. It's in my pelvic area.anyone with this experience I'd appreciate feed back ty.

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I guess your PSA says you’ve got something growing. I think you’d be a candidate for salvage radiation or at least SBRT to the node with something showing in a scan, right?
My feeling on this - and please understand that I am a very pro-active/prevention minded person - is that if something is actually large enough to show in a scan, how much more “might” be there that’s not showing?
Not trying to cause you alarm….but you did ask….

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