Did you choose active surveillance? Why was it a good choice?

Posted by arizobound @arizobound, Dec 27, 2024

Biopsy showed 3 + 4 MRI showed pirad 2 bone scan CAT scan no metastasism nothing found. psma pet scan radiologists said nothing found. but oncologist says he saw a very small spot. Only concern was half of the cores showed 3 + 4 out of 12 but he said it does not show the percentage of four?? Not sure I understand this part. Told me I could do active surveillance or cyber knife or brachytherapy. I think I am going to go with active surveillance my Medicare plan I can change next year to an advantage will cover more of the cost I have original Medicare now. Can I get some opinions on active surveillance being a good choice? Thank you in advance

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arizobound | @arizobound | Dec 31, 2024

In reply to @arizobound "Were they able to see the cancer in the MRI or the psma pet" + (show)

jc76 | @jc76 | Dec 31, 2024

@arizobound
I see you asked a question for me.
My MRI does show a determination of prostate cancer.
My MRI done with a contrast showed suspicous areas and thus the urologist ordered biopsies. A MRI can give the radiologist and urologist a good image of prostate and suspicious areas. I asked my urologist after I go the suspicious areas diagnosis what the chance it was cancer and he said 70%. Mine biopsy Gleason Score came back 3+4=7 and was diagnosed with intermediate prostate cancer per pathologist.

PMSA is a very excellent test. It uses a type of radioactive injection and then scan to look for prostate cancer that has spread outside of prostate. Mine was negative. I also had a bone scan that was also negative.

I was asked if wanted Decipher test and advised would give a more specific determination of risk level. I asked for it and my diagnosis of intermediate risk was changed to low risk and changed my treatment recommendations were also changed. A very good test that uses the same biopsies already taken.
I hope I answered your questions!

arizobound | @arizobound | Dec 30, 2024

In reply to @jc76 "@arizobound @survivor5280 @arizobound, Good information from @survivor5280 A biopsy report cannot show that cancer is not..." + (show)

Were they able to see the cancer in the MRI or the psma pet

clandeboye1 | @clandeboye1 | Dec 29, 2024

My primary suggestion was to get a 2nd and 3rd opinion of your pathology results as assurance that your 1st Gleason Score is correct .
If you have read Dr. Patrick Walsh's book : " Guide to Surviving Prostate Cancer " , this is highly recommended as do other International Tier # 1 Urologists .
Good luck .

arizobound | @arizobound | Dec 28, 2024

In reply to @clandeboye1 "No mentioon anywhere about a 2nd or 3rd opinion of your biopsy pathology results . I..." + (show)

No I would not I haven't even started active ssurveillance I just started. no way I would just ignore it.

clandeboye1 | @clandeboye1 | Dec 28, 2024

In reply to @arizobound "Yes I appreciate that I am in good health beside my prostate cancer. But I would..." + (show)

No mentioon anywhere about a 2nd or 3rd opinion of your biopsy pathology results .
I am on Active Surveillance -- Year over year MRI showed no growth change . My Bone & CT Scan were clear . I have a PSA Test every 3 months for the 1st 12 months , then every 6 months .
I am considering as my eventual options : # 1 Focal Therapy , NanoKnife which is gaining international success ( slower acceptance in thhe USA , as with many international treatments )
HIFU , Cryotherapy or TULSA PRO which was invented by Dr. Chopra at the Sunnybrook Hospital in Toronto , or others e.g. Immunotherapy . There are others .
Considering Radiation , I hope to avoid like the plague , ADTT 9 Hormone Therapy and it's side effects , both short term and long term . I am lookiing at the 5 Session Mon, Wed Fri and Mon Wed the following week . SBRT MONOTHERAPY . No hospital stay , no catheter , no anestetiic , Very low risk of incontinence or erectile disfunction . This is the current " International GO TO Treatment for your situation .
I would not make a knee jerk decision and go off AS at this juncture .

jeff Marchi | @jeffmarc | Dec 28, 2024

In reply to @arizobound "My decipher score is 0.41 I had that done already which I believe is low not..." + (show)

Sorry, I forgot you had your decipher score listed. So many messages it’s hard to keep track with everything going on with so many people. Just make sure to get quarterly PSA tests. You know you have a chance to be on active surveillance for a while, but you want to make sure you’re covering all your bases. If the PSA starts to rise, maybe you should go on monthly tests.

It is possible you could go a year or two without doing anything, To have a chance at the longest life you want to get treatment as soon as your numbers rise significantly.

arizobound | @arizobound | Dec 28, 2024

Thank you for your response

arizobound | @arizobound | Dec 28, 2024

In reply to @jeffmarc "Your MRI showed a single PIRAD 2 “tumor”. That is not considered cancer. Your results are..." + (show)

My decipher score is 0.41 I had that done already which I believe is low not super low but considered low that should make it even better correct? I have gotten doctors opinions actually three of them of course they all would rather do treatment but they seem to at least the last two I've been to agree that I could go on active surveillance. But they're saying I'll have to use treatment at some point. Thanks

jeff Marchi | @jeffmarc | Dec 28, 2024

Your MRI showed a single PIRAD 2 “tumor”. That is not considered cancer.

Your results are pretty good, but, as everyone mentioned, six out of 12, not great.

I don’t think you really need another biopsy, Though it may not hurt, If you did it, they should get other areas of your prostate to see what they show. Ask your doctor what he thinks.

Try to get a decipher score. That can tell you more than another biopsy about your future risks.