newly disgnosed prostate cancer in family member...bad family history

Neighbour had same history Did robotic surgery and all out Now its off his mind and hes young to enjoy life

It's a tough call, but, I'm all about doing what the patient is most comfortable with as long as it's not unnecessarily damaging to the patient. Any treatment is going to have some side effects. Having said that, I was most comfortable with aggressive treatment as well.

If the PSA is low, what caused him to have a biopsy? If you don't mind sharing, how low? Were other symptoms present? Abnormal digital exam?

I have a friend similar to @melcanada , my friend ( I found out after I told him my diagnosis) had similar test results to your relative. He had standard radiation treatment about 8 years ago now and the cancer is still in check.

It may be a good idea to find a second opinion from a urologist/radiation oncologist that has a good track record/reputation to see if there's agreement here. The good news here is that this type of cancer is generally pretty slow going. Which gives us a little time for some decision making.

If your relative does go with surveillance at this point, if I were him, I'd push to get the PSA tests close together at first, say every three months so you can be sure his PSA is not climbing quickly. Maybe not necessarily medically necessary but I'd insist on it for peace of mind.

Another non invasive test which might help is an MRI of the prostate with contrast. It might help locate the cancer itself and give the docs a better picture of what is going on. Just a thought, I'm no doctor!

Best of Luck to him!

I would agree with web265. My PSA took off over a 4 month period from 3.8 to 6.1, but cancer was more advanced. At 3+3 I think he has options that are less adverse. When I had my treatment for 4+4 cancer, the treatment included proton therapy with ADT. Other men were there with 3+3 who only had radiation. That's a big difference in side effects.
Also, since there appears to be a family issue, you might consider DNA test. If the cancer is caused by mutations of certain genes, they may be able to repair the gene without invasive treatment. It would also be good to know if younger males in the family may be susceptible.

A PSMA Per/CT might provide some reassurance that it hasn't spread.
The active surveillance would then be easier to endure knowing that the disease is contained.
Getting the DIAGNOSIS is shocking but the treatment options are the good news. It's extremely disconcerting (as you know) at first but it can improve dramatically.
I had PSA 80+ and a Gleason 7 (4+3) w 4 cores involved w Lymph Node (2) mets. Radiation and lupron did a great job followed by Zytiga. 10 mos later PSA is undetectable . We have great treatment options thanks to our researchers .
Enjoy the holidays and know that the outcome can be successful .
MERRY CHRISTMAS.

When my PSA jumped in 3 mos from 1.2 to 4 to 6.6 I had bone scan and CT scam My left hip showed some uptake for first time My L2 that was nuked has lots of bone destroyed. My T 10 and 11 have some minor uptake Hence in Jan after my cruise to Aruba going on Enzalutamide 4 pills a day oral chemo in a pill to control and staying on Zolodex 3 mos injections Looks like going from castrate sensitive to resistant slowly

The family history is scary but his Gleason is low thankfully. I'm no doctor but checking the PSA every 3 months seems reasonable. My friend who had surgery is getting his PSA checked monthly after the surgery. I'm having mine checked every 3 months after surgery which is standard i believe.

Based on all the research I have done and my personal experience, I would highly recommend going with the most aggressive treatment possible to minimize likelihood of prostate cancer reoccurrence. With Gleason Score 6 (3/3), a radical prostatectomy can almost provide a "cure". As others have stated, the treatment chosen must align with personal goals. For me, I was 56 years old and wanted the highest likelihood of survival and no BCR. I could not even imagine letting a cancer to continue growing within me, possibly getting out of the prostate and infecting other parts of my body.

Best of luck for your family member in this decision.

I’m having my PSA checked every three months as a follow up to my surgery. I’m doing this for two years. I think it’s reasonable for you to wait and get your PSA checked every three months and hold off on any treatment. There isn’t a free lunch with the treatments.

I hear if you get a covid shot it can affect psa readings so wait 3 months

They started robotic on me 2017 but stopped as it would have made me incontinent requiring another operation In 2018 did 40 radiations and on Zolodex

Metastasis to L2 lumbar bone in 2021 so did intense radiation on it and back on Zolodex

Now some uptake in L1 so going on Enzalutamide and another radiation hit

Yes, I had similar numbers and was on active surveillance for 3 years with no symptoms. My psa hung around 5 to 8 and fluctuated up and down. In year 3 MRI showed a lesion and biopsy moved me to the intermediate class with Gleason3+4=7.
Treatment was recommended. I elected prostatectomy as my discussions with radiologists worried me more than I was comfortable with however The surgery is also not without risk and consequences.
I’m 14 months past surgery now and am testing psa undetectable. I wish I could say it’s clear to decide but so many variables make the treatment choices unique to each person
Advice is to talk to multiple docs and others, pray for guidance. Wishing you well.