Connect
← Return to Where are all the people on Active Surveillance (AS)?
Discussion
Where are all the people on Active Surveillance (AS)?
Prostate Cancer | Last Active: Jul 24 11:42am | Replies (61)Comment receiving replies
After 4 years on active surveillance for Gleason 3+4, with low risk Oncotype score, my PSA jumped from 8.5 - 15.1 ng/ml between 12/2024 and 5/2025 in spite of unchanged MRI. Subsequent biopsy showed evolution to Gleason 4+5 with PSMA Pet Scan continued focal disease. AS does not mean "do nothing" and does not mean things won't progress, but statistically the outcome with delayed treatment is no different than the chance of recurrence or metastases even with earlier intervention. A decision to treat early does not guarantee a perfect outcome either (both due to treatment risks, side effects, and still possible recurrence). That being said, the perspective looking backward is also different than the perspective looking forward. Still, I have no regrets about choosing active surveillance; nothing wrong with believing in the science and proceeding accordingly.
Replies to "After 4 years on active surveillance for Gleason 3+4, with low risk Oncotype score, my PSA..."
Connect
@rbtsch1951
How low was that oncotype score? Well, under 25 is low but 11-25 Is considered intermediate risk. A 3+4 should be treated unless it shows a very low percentage of four as well as a low percentage of cancer. Was AS really appropriate for you?
Research says
A low-risk score generally means that hormone therapy alone is likely sufficient after surgery, and chemotherapy may not provide enough benefit to outweigh its side effects.
That implies that something should be done right away about it no matter what the score, maybe Unless it is extremely low like 1 or 2.
I’m not saying the doctors are wrong. I would just want more information about what they found once they saw that score. How high was it.