Active Surveillance As A Choice?

Posted by desertfalcon1954 @desertfalcon1954, Mar 11 8:13pm

This is very good news. Most men with localised prostate cancer are likely to live for a long time, whether or not they receive invasive treatment and whether or not their disease has spread, so a quick decision for treatment is not necessary and could cause harm.
https://www.ox.ac.uk/news/2023-03-13-study-shows-delaying-treatment-localised-prostate-cancer-does-not-increase-mortality

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Initially diagnosed with a 6(3+3) and PSA of 4.2, I was on active surveillance for 9 years (2012-2021), giving me time to calmly evaluate all treatment options and take advantage of treatment advances, until it was medically-necessary to be treated.
Eventually my PSA rose to 7.9, and my Gleason to 7(3+4) - with a 2nd opinion upgrading that to a 7(4+3). I chose to have 28 sessions of proton beam radiation (during April-May 2021), with SpaceOAR Vue, and 6 months (two 3-month injections) of Eligard. PSA now varies between 0.3-0.5; most recently was 0.43. So far, so good.

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I'm always skeptical about data like these when they indicate that around 75% of the men on active surveillance had some type of treatment within the 15 year study period. Was it that treatment that influenced the success rate to a higher degree? Hard to tell when only "around 15%" of the men stayed on AS the whole time. I agree a quick decision is not always needed, but IMO a decision at some point is necessary.

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I think if you are above 70 years old it is advisable not to take any invasive treatment and stay on active surveillance.

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Since the cause of prostate cancer has not yet been clarified with certainty, it is not possible to prevent the development of the disease in many cases. However, recent studies indicate that by making changes in diet and lifestyle, the risk of prostate cancer can be reduced.

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Thanks for attaching the photo. It’s basically what I’ve followed since my prostate surgery, two years ago. I feel healthy and my residual lymph node cancer has remained in remission. (Note, I’m on a Mediterranean Diet.)
Enjoy your day.

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Active surveilance is GREAT!!! as long as you assume PSA etc will drop...otherwise, research your options and get treatment. Use an oncologist, not a urologist.

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Before he created TheActiveSurveillor.com, Howard Wolinsky was a medical writer for the Chicago Sun-Times for nearly thirty years and a regular contributor to MedPage Today and Medscape. When he was diagnosed with Gleason 6 (now also called GG1) prostate he said no thanks as he was being rushed to take on a radical treatment option. Thirteen years down the road from his cancer diagnosis he is one of the country’s most passionate advocates for active surveillance as a first (and possibly forever) step to indolent/favorable diagnoses of prostate cancer.

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Have your doctors recommended bicalutamide pill orally to go with Active Surveillance? I am 62 recently diagnosed with gleason 3+3 and found cancer in one of 12 biopsies at 10% in the one core. PSA was 7.1

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Exactly, very good news and hopefully folks are paying attention.

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