Selecting Active Survelliance based on GG1 and small GG2 in biopsy?

@palli58,
I to am active surveillance. 65,yrs old active life style.

Thanks for your comment! How long have you been doing AS? Did you get a 2nd opinion on initial pathology report and/or follow up with any particular genetic testing prior to deciding on AS?

I’ve had my second biopsy from a second doctor. I would like to know more about genetic testing.
It’s not aggressive. Been Active Surveillance since 2018.

I am 70. Run, bike and swim regularly and have for 45 years. Active surveillance since 2020. Gleeson 6, less than 15% in three cores. So, different on the scores. Had two biopsies with same doctor. Currently seeking another opinion from Mayo primarily for continued information gathering. Active lifestyle is significant component of my decision, but we're all trying to be smart and educated about it. I did not need to change much about diet to meet criteria often discussed that could theoretically help manage cancer growth---that's the good news. I guess the bad news is I've been eating this way my whole adult life and still have prostate cancer. PSA has remained 3.5 to 3.8 over the three years of AS. All in all I'm probably on the lucky side so far---and hope to stay there.

I am 72 I had 3+3=6 in less then 5% of one core psi my second biopsy did not show anything PSA running around 5 my doc wanted to operate I chose AS he is doing. He is doing PSA every 90 days biopsy yearly I went to Mayo they suggested yearly PSA and MRI and as long as nothing new shows up on MRI or PSI 10 biopsy every Three years I am now looking forward r a local doc that goes along with Mayo recommendation and does transperineal biopsies

I did active surveillance for 3 years. 3 biopsies over that period. When an MRI showed a lesion left side and biopsy 3 +4=7 from a previous Gleason 6 docs recommended treatment. I saw a surgeon, radiologist, and oncologist all at Dana Farber in Boston.
They said intermediate prostate cancer should be treated. I chose surgery at age 65, active life style. 2 years out psa < .1. It changed my life no doubt but the pathology post surgery report showed it had progressed outside of the prostate. No lymph node cancer cells and clean margins. Some may have suggested continue AS. I don’t know for sure. I’m glad I opted treatment. I could be facing worse now had I kept waiting.
My pathology stage was
pT3aNO. I would need an expert to explain exactly what this means. Anyone? Thanks

Sounds like you remained diligent and had three good years of AS before having to decide on a treatment. Glad you are happy with your treatment decision. All the best for your future!

According to the John Hopkins website, T3aN0 means: T3a = The tumor has developed outside the prostate; however it has not spread to the seminal vesicles and N0 = indicates that the tumor has not spread to nearby lymph nodes.

Thanks so much for clarifying this for me. I thought so but never had this explained. I am hopeful and grateful.

handera: I had somewhat similar numbers, 3+4, contained to prostate and 10.2 psa. I took the Decipher test to get a feel for aggressiveness and # of modes of treatments suggested. I was also given the same choices. I spoke with 5 radiation oncologists, 3 from centers of excellence.

I was asking the same question about AS. My feeling was that even with testing psa every 1-3 months it might catch something that moves beyond the prostate but I did not want to take that chance. No doctor was able to give stats or any information that helped me come to the conclusion that the cancer would be caught early before any spread. For me, it was not worth the risk. The treatments thereafter, for spreading, were too invasive, if one had the side effects. Anecdotally, those that are in the best shape physically seem to have better side effect results from hormone treatments. My brother was not as lucky and his spread and he had great doctor care in New York city. Everyone is different, of course, and it is a tough decision but whatever your decision, I hope you end up saying what many have said/insinuated on this web site, I would not have done anything different.

I had 5 hypo fractional treatments in February. All good for now. I found the prep work for the biopsy, the biopsy itself (though I was out for it) and the insertion of spaceoar (out for that too) more obtrusive than the 5 bouts of HIGHLY targeted radiation with narrow margins.

Just no way to know for sure. I'm 65, was on AS for 8 years. 3 biopsies and 3 MRIs in that time that all found Gleason 3+3 non aggressive cancer. Genetic test said very low risk. PSA was on steady rise and when it hit 15 we took it out. Pathology found Gleason 3+5 in the prostate. Worst kind of cancer was totally missed by all the testing. Glad we took it out, but the side effects are a concern. 9 months out the incontinence is way better but nowhere near going without a pad yet. Good luck.