Do I Continue Active Surveillance or Consider Intervention?

We are the same age and I too have a heart condition, but no heart surgery. I can understand active surveillance. If you Gleason number goes up you can consider starting treatment. I would, however, discuss with your doctor a biopsy to confirm the state of the cancer and I would want the biopsy done and read at a very well respected cancer center and a second doctor’s concurrence on the biopsy reading and conclusion. Best of Luck and hopefully you have a very long journey.

I was 69 last year when I was diagnosed with similar results as yours. By the way, nccn.org, the doctors treatment guideline organization, recommends hormone treatment when a psa is over 10. I don't have a heart condition but I did not know, after the MRI confirmed there was something there, how long it would take to grow or whether I would die of something else before it became a problem. Doctors had no definitive answer or close enough to feel comfortable with monitoring. Although I had the Decipher test which used my biopsy material to judge aggressiveness and still indicated a single mode of treatment, I still wanted "it" out, so to speak. I spoke with 5 radiation oncologists including from two centers of excellence (only 1 recommended hormone treatment by the way). I did not want to take the chance that it grew outside the prostate creating treatment and quality of life issues that I did not want to have to deal with for potentially the rest of my life. I had the biopsy, spaceor to separate the rectum from the prostate and 5 treatments with the MRIdian Viewray at the Orlando Cancer center, which finished in February. All good for now.

A radical prostectomy survivor ten years ago with subsequent radiation treatments having been done five years ago, I would consult with a radiation oncologist and if he recommends radiation, do it at least for peace of mind.
This business of wait and see makes no sense to me.

I'm not in your age range so can not speak to any experience, but it is interesting that in 2018 you PSA was 10.57 and now in 2022 your PSA is 3.1, but it is of noteworthy concern that your biopsy in 2019 came back with Gleason 7 (3+4). I would concur with getting additional opinions about treatment options as you would like to stay on the team that deals with cancer that is confined to the organ. I'm on the team with no prostate and cancer outside the organ. Overall, you sound healthy and perhaps that is what is kicking &ss against the cancer. Keep the Faith.

You sound like your body and lifestyle is keeping things in check, I would put off doing anything as long as possible , So many clinical studies out there, I'm confident that better and more precise treatments could be around the corner. I feel that having a great immune system is half the battle and gives you the luxury of time. If you're not having any problems and the PSA is in a normal range. Maybe it will stay there. Keep in mind that I'm not a doctor, but I have an opinion.

My situation is similar to yours( 3+4 GG 2) except my Decipher score was much worse… I did have a PSMA Pet scan which confirmed that the cancer was contained within the prostate… You may want to consider getting this test if you haven’t had it already… I should mention that like you I have other medical conditions to seriously consider when/if choosing treatment for prostate cancer.. One of these requires me to take chemotherapy pills on a daily basis.. I asked my oncologist what she would do if she was I’m my position regarding treatment for my prostate cancer.. Her answer was “I don’t know”.. I just had a PSA test June 1st and miraculously, it dropped down.. In my case it’s still high but below the 10 threshold that seems to be one of the major measure in getting treatment.. For now, my body is strongly telling me to hold off on the prostate treatment as I am very active and feeling exceptionally good.. Am I rolling the dice for now??? Perhaps I am, but we each have to make our decision based on our unique circumstances and health conditions…

@anjalid30, what did you decide? What advice did you get from your oncology team?

I am about 20 years younger, but definitely agree with others that have recommended getting a biopsy to understand what you are dealing with. I had my biopsy done in the Mayo-Rochester office (no anesthesia, etc.). This procedure was very quick and quite comprehensive. I had 19 biopsy samples taken and 13 were cancerous (GS 4/3). This information gave me a better understanding of my situation and what path should be taken. Because of my age/health/GS/etc., I went with a RP. However, there are a lot of options out there, and given your circumstances, you and your medical team could use the biopsy results to pick the best treatment plan.

God bless and best of luck with your decision!!

Hello Colleen
Thanks for responding
Surgery is not a good option due to age, CABG, co-morbidity etc.
Radiation Oncologist and Urologist suggest MRI and repeat biopsy.
With supplements PSA has dropped to 3.1 from 6.5 prefer to repeat PSA and DRE (which has been normal). I am presently undecided but if PSA worsens or DRE is abnormal then may look into MRI first before repeat biopsy. I am not sure what other options are there now, or will be in available in future researches.
Thanks again

Surgery is not a good option due to age, CABG, co-morbidity etc.
Radiation Oncologist and Urologist suggest MRI and repeat biopsy.
With supplements PSA has dropped to 3.1 from 6.5 prefer to repeat PSA and DRE (which has been normal). I am presently undecided but if PSA worsens or DRE is abnormal then may look into MRI first before repeat biopsy. I am not sure what other options are there now, or will be in available in future researches.