Active Surveillance vs Treatment Now

I am 78 and if anyone is doing the observation and active surveillance for prostate cancer. And if so what was your gleason score and PSA. I was diagnosed a few months ago and meeting with a urologist this week. Not sure what my plan of action is. A lot of what I read that my age surgery is not a good option and radiation also has it's draw backs. So I'm really at odds of what I should do. Thanks for any feed back!

Welcome, @snbbeninato. Deciding when to change from active surveillance to a treatment therapy and what Gleason score indicates the need to opt for treatment is often discussed among the members here. For that reason I moved your post to this existing discussion:
- Active Surveillance vs Treatment Now: https://connect.mayoclinic.org/discussion/active-surveillance-vs-treatment-now/

I did this so you can read the previously posted comments and connect easily with members like @paulchen @jerryegge @artscaping @web265 @darlynn @philnob @jb2buckwater @pablo81 who can share their experiences and help answer your questions.

Good evening @snbbeninato, I have a memory book of this time in my life partner's battle with prostate cancer. He was 70 and his worrisome scores were beginning to make a decision more urgently necessary. He just welcomed year 76 last week with a celebratory dinner with friends.

There are a few more factors to be placed into consideration. Most important was that the cancer was restricted to the prostate gland. An MRI revealed no evidence of cancer anywhere else. That makes surgery a better option when the cancer is contained. He even waited several months to be able to have the surgeon he felt was the best for his situation. They chose the wait time as perfect for the 3 months of hormone treatment to reduce testosterone development.

The surgery was robotic and they only ran into one problem. The margin at the connection to the urinary tract took several hours to eliminate all affected tissue.

Recovery was as expected and two years went by very quickly. Then his PSA began to rise. Come to find out, a small section of cancerous tissue at the margin had fallen into the prostate bed. That presented another decision. He chose 30 days of radiation and we spent the Holidays in Rochester at Mayo Clinic. That was 4 years ago and his sample submissions have stayed non-existant......no evidence of cancer. In fact....his checkups are now every two years and his PSA checks have moved to twice a year.

Every patient has to make these types of decisions with the expert help and experience of clinicians and providers. We are eternally grateful for the watchful and helpful folks at Mayo Clinic.

There is no perfect or guaranteed option. It is better when you trust the help provided by your medical support team. Good luck!

May you be free of suffering and the causes of suffering.
Chris

Hi, I’d suggest to follow your doctor’s advice. You don’t have cancer. Cancer is based upon a Gleason score of 7. I think it’s good to look ahead; however, you don’t need to jump into any treatment right now. Hopefully, you won’t ever. Good luck.

I, of course, don’t know what you decided. I just joined this forum so didn’t see your post of 9/22. From what I’ve read and studied, Gleason 3+3 would almost never call for treatment. AS is usually appropriate, from the sources I’ve seen. In fact, most 3+3 may call for “watchful waiting,” which has a lesser surveillance protocol going forward, than that of AS. Hope you are doing well. I’d be interested in what decision you made. I’m 3+4 and after CT, MRI and biopsy, my urologist and I have opted for AS (I’m 74), especially based on a genomic/genetic test (Prolaris), which indicated that in my particular case, I could go on AS.