Active Surveillance As A Choice?

Posted by desertfalcon1954 @desertfalcon1954, Mar 11, 2024

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

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desertfalcon1954 | @desertfalcon1954 | Mar 12, 2024

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

mn281 | @mn281 | Mar 12, 2024

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.

brianjarvis | @brianjarvis | Mar 12, 2024

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.