Connect
← Return to Not Good News after prostate biospy when MRI didn't look too bad
Discussion
Not Good News after prostate biospy when MRI didn't look too bad
Prostate Cancer | Last Active: 1 hour ago | Replies (376)Comment receiving replies
@brianjarvis
Okay so if I understand I am not Watchful Waiting or Active Surveillance? We are simply testing and monitoring our respective PSAs post-treatment for the rest of our lives. Anyway that is what I want to do. Also, that is what surgeon and oncologist want to do. Then I got the RO in Topeka that wants to do IMRT and ADT in 8 months when I get over or if I get over incontinence. So I am going to talk to a RO at a center of excellence at KUMC tomorrow and see what she says. She also specializes in genitourinary procedures. Seems these new studies say nothing wrong with watching PSA and avoiding radiation.
Then I guess it's in the end up to me as they can't force me into anything.
Thanks for your patience with me, I am a confused mess, which is not normal for me. I just have had too many things hit me at once with other family illness.
Replies to "@brianjarvis Okay so if I understand I am not Watchful Waiting or Active Surveillance? We are..."
Connect
@diverjer You mentioned this earlier, but if your “…PSA doubles or gets above 0.1….” then you want to get a PSMA PET scan first to try to see where the recurrence is. (At that low of a PSA, PSMA PET scans are only about 30% effective at seeing active prostate cancers so, it might even miss it; maybe, maybe not.)
You also previously mentioned, “…. If even gets close to 0.2 start radiation.” You would still need the PSMA PET scan results to know where to target the radiation (rather than just guessing). Dr. Kwon (of Mayo Clinic) indicates that only 1/3 of men who have recurrence following prostatectomy have recurrence only in the prostate bed, and that they should not get salvage radiation there unless they’re absolutely certain of the location of recurrence. He says to first confirm where the recurrence is. (See Dr. Kwon’s presentation about recurrence: https://youtu.be/Q2joD360_pI)
The amount of salvage treatment (radiation, ADT, & possibly ARPI) you get all depends on the extent and characteristics of the recurrence. The PSMA PET scan will determine that.
> Have you had an ArteraAI prostate test yet?
Getting multiple medical opinions is a great idea. That gives you the opportunity to compare them all — ultimately it’s you that has to make the final decision.
As for “….watching PSA and avoiding radiation,” that depends on the characteristics of the recurrence; again, the PSMA PET scan will determine that.