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Choosing Active Surveillance over any further treatment at this time
Prostate Cancer | Last Active: 5 hours ago | Replies (52)Comment receiving replies
Hi , thanks for the info that was very helpful . One other question for you ..... what did your MRI show ? Mine was borderline Pi-Rad 3-4 and there is a 5mm lesion which is contained in in the prostate with no evidence of migration outside of the prostate. I'm only asking because your situation seems somewhat similar to where I'm at ...
Replies to "Hi , thanks for the info that was very helpful . One other question for you..."
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My prebiopsy PSA level was 7.8, taken 4 months before the first mpMRI. I'm currently 68 years old.
My initial (October 2023) mpMRI showed three lesions. Lesion 1 was 2.2 x 1.1 cm and considered a PI-RADS-5 lesion. Lesion 2 was 0.7 cm and considered PI-RADS-4. Lesion 3 was 0.9 cm considered PI-RADS 3.
I had a mpMRI fusion targeted transrectal biopsy in October 2023 indicating 5 cores with adenocarcinoma (Gleason Score 3 + 3 = 6) involving 5%-10% of the specimen and 2 cores with adenocarcinoma (Gleason Score 3 + 4 = 7) involving 20% of the specimen with Gleason Pattern 4 comprising 10 - 20% of the cancer. A total of 21 cores taken. As I indicated, my Decipher Score was 0.22. I started AS and significantly increased my aerobic running regiment and modified my diet.
The odd thing was the PIRADS 4 & 5 lesions were found to be low volume 3+3 and the PIRADS 3 lesion was found to be benign and the low volume 3+4 cores were found in the "random" 12 core portion of the biopsy...apparently too small to be detected by MRI.
As of March 2025, I've had 6 post-biopsy PSA tests, which have averaged ~6.6; below the initial 7.8 prebiopsy PSA.
My 12 month follow-up mpMRI (October 2024) showed that Lesion 1 had slightly shrunk (1.9 x 1.1 cm) and its T2 hypointense focus and DWI/ADC signals had dropped from "moderate" to "mild". The other two lesions (the PIRADS 3 & 4 ones) could not be seen in the 12 month followup MRI.
I've lost ~25 lbs, since I was diagnosed, which I'm sure is due to my aerobic exercise and modified diet.
My urologist indicated that since my 12 month mpMRI did not show lesion progression, I could forgo another biopsy for now.
I continue my AS regiment and I'm glad my numbers are moving in the right direction....my plan is to have another mpMRI in October 2025 to see where I stand.
Dr. Mark Emberton, Professor of Interventional oncology at University College London and Dean of its Faculty of Medical Sciences made a recent presentation about the meaning of low risk prostate cancer that is not seen in a mpMRI. I found it very helpful.
Best,
Alan