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Choosing Active Surveillance over any further treatment at this time
Prostate Cancer | Last Active: 4 hours ago | Replies (52)Comment receiving replies
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
Replies to "My prebiopsy PSA level was 7.8, taken 4 months before the first mpMRI. I'm currently 68..."
Alan ; Thanks again ! That is really interesting - I'm 68 also .... after my first 2 PSA tests ( Jan 2024 ) came back at 10.9 and 11.0 I did what you did , I started exercising , running about 8 miles a week and going to the gym 3-4 times a week and I stopped eating food that tasted good ( unhealthy ) and switched to 80% meals of avocado toast , broccoli , fruits lower fat & sodium stuff and quit coffee etc. When I took my next PSA test 6 months later it came back at 8.6 . During the holidays I fell off the healthier eating wagon - shortly after that I was involved in a minor skiing tragedy and could barely walk for a few weeks I went about 2 months before I started exercising again - my last PSA test was right before I started exercising ( 2 weeks ago ) and it came back at 10.3 .
After reading your story I'm again inspired to start on a healthier diet again .... it sounds like it could actually make a difference . I guess I'll find out after my next PSA test in 6 months .
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I have heard that a restrictive diet can have noticeable effects on PC. I’ve heard of one other report of similar results to yours, where the cancer subsided.
The thing is, you had a high number of cores with cancer. That implies you are likely to have something that needs to be treated in the next five years, if you do AS.
Hopefully what you are doing will make it way past that timeframe.