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Multiparametric MRI (mpMRI) over diagnosis?
Prostate Cancer | Last Active: Dec 14, 2023 | Replies (32)Comment receiving replies
Thank you for relating your AS experience.
What was your Gleason score when you started AS in your early 40’s?
I’m also curious as to how you made that initial AS decision versus selecting some kind of treatment.
It is my understanding that the PCa community was much more reluctant to recommend AS twenty years ago.
I have a friend who was diagnosed with Gleason 6 twenty years ago and went with RP. He is now in his early 70’s and doing fine.
I think the most important decision any man diagnosed with PCa, no matter what plan or treatment he ultimately chooses, is what he plans to do about his WEIGHT, his DIET and his level of vigorous AEROBIC exercise. These last three items are totally within the control of the individual.
How we got ourselves into a position where PCa is diagnosed is history.
Once the stage of one’s PCa is absolutely confirmed (no small matter, btw); then IMHO the most important decision is what one plans to do about their Weight, Diet and Exercise.
This decision should be made BEFORE considering the AS, surgery, radiation and/or ADT options.
Again, from my research the former decision will guide the later.
IMHO the less one plans (and commits to do) to change their weight, diet and level of exercise, the more radical the level of treatment selected should be, with the full acceptance of the higher risks of the negative side effects that come with ALL forms of treatment.
Replies to "Thank you for relating your AS experience. What was your Gleason score when you started AS..."
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1) In my 40s I had PSA's in the 4's and was not referred for biopsy by the urologist--just digital rectal exams and PSA's back then. 25 years ago there were less tools. At first he monitored PSA yearly, then tapered off after several years without progression. No one had advised me not to bike and I was biking quite a lot starting sometime around then.
2) My uncle 12 years older was a pioneer in exploring alternative treatments, near Stanford, CA, and followed at UCSF hospital. He oriented me to the options. The literature was also much spottier and less accessible back then. The support group he was a part of was face to face. He traveled an hour or two to get to the meetings.
3) In a broad sense, active surveillance has been around forever. Any time you are not taking medical action but monitoring concerns about PC in my mind is active surveillance, before or after RALP, radiation, ADT, or whatever. It used to be called watchful waiting, but the term was modified to emphasize that this was itself an active choice, not just a passive numbing. My active surveillance though over the years without progression of the PSA became passive. I did not become more active even when my cousin on the same side, two years older, was diagnosed and had RP. He has been very disappointed in his treatment plan, btw.
Question back at you: While I know that weight control, healthy eating and vigorous exercise are all good things, I am unaware of how that might impact PC. Can you point me to any research or evidence-based care standards in this regard? What has influenced you in this direction?