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Treatment advice for prostate cancer

Posted by kune @kune, Jun 27, 2023

Hi folks. I am 68 years old and was recently diagnosed with grade 3 prostate cancer. PSA is 6, Gleason score 6(3+4), and just got genomic(gps?) test result of 29. I am at the low end of the intermediate risk range of 25-60. My plan is to go on active surveillance and see where PSA is in six months. My doctor is ok with this. Does this strategy seem reasonably safe at this point? My other choice would be radiation. Thanks for your input.

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hbp | @hbp | Jun 27, 2023

I agree with AS for you and I would do likewise. I had RP and I think that this was the right choice as my doctors told me that if I had radiation and the PSA went up ( cancer returned) then the option for a RP would not be offered and would be much less effective, perhaps even harmful. So RP preserved an important treatment option for me. Good luck!

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2 replies
mmacaulay | @mmacaulay | Jun 27, 2023

Be sure to get a PSMA PET scan. Mine detected tiny hits in my chest, later confirmed by separate biopsy. Wouldn’t have been detected via other scan methods. Led to chemo and radiation with Lupron and Nubeqa.

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melcanada | @melcanada | Jun 27, 2023

What is the average effectiveness of Enzalutamide or Xtanda? Anyone on it for 3 or more years? What is next if it stops? Stage 4 is in my L2 , i inch T10 T 11 small cm of spine Had L1 radiated 1 inch last year and just scar now
My PSA was 9.8 in Jan then once on Xtandi dropped to 1.7 in March Today its up to 2.3
Do I worry? or what do I do 78 and all clinical aspects are fine feel great even on Xgeva shot given today

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kune | @kune | Jun 27, 2023
In reply to @hbp "I agree with AS for you and I would do likewise. I had RP and I..." + (show)
@hbp

I agree with AS for you and I would do likewise. I had RP and I think that this was the right choice as my doctors told me that if I had radiation and the PSA went up ( cancer returned) then the option for a RP would not be offered and would be much less effective, perhaps even harmful. So RP preserved an important treatment option for me. Good luck!

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Thanks for the support!

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kune | @kune | Jun 28, 2023

Correction to my original post. My Gleason is 6, (3+3), not 3+4.

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mperloe | @mperloe | Jun 28, 2023

This is very appropriate. Just know that Active is an important part of active surveillance.

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kune | @kune | Jul 2, 2023

I was actually looking for advice with the more conventional treatments, am I a good candidate for AS.
Somehow this discussion went off the rails. Thank you

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1 reply
michaelcharles | @michaelcharles | Jul 2, 2023
In reply to @kune "I was actually looking for advice with the more conventional treatments, am I a good candidate..." + (show)
@kune

I was actually looking for advice with the more conventional treatments, am I a good candidate for AS.
Somehow this discussion went off the rails. Thank you

Jump to this post

Well, yes. AS as suggested by your MD is appropriate for G 6.
The PSA in 6 mos will help guide the future.
Curious: Why are you considered Stage 3?

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kune | @kune | Jul 2, 2023

My mistake. Actually grade 1.

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