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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jeff Marchi | @jeffmarc | Dec 27, 2024

The fact that half of your cores, that they sampled, had a 3+4 means you need to do something. Active surveillance is not for you when you have that many positives. You could go a couple of months on active surveillance, but your cancer will almost definitely get worse, waiting frequently results in a higher Gleason scores and a more aggressive cancer.

You want to get a decipher score? Talk to your doctor and tell him that’s what you’d like to get. That will give you another idea about how aggressive your cancer could be and how quickly it could metastasize. That would be a major factor in any decision to go on active surveillance.

Get a second opinion on that PSMA pet scan. You don’t want to just have one doctor’s opinion saying there may be something on the test that the other doctor didn’t see. PSMA pet tests are hard to read so you want an Expert looking at your pet scan.

The treatments the doctor recommended could be good options, You need to speak to a radiation oncologist about those choices, There are other treatments that don’t require radiation, the other options to look into are HIFU, cryotherapy, and TULSA-PRO, they are three non-radiation options.

survivor5280 | @survivor5280 | Dec 27, 2024

Biopsies are only partial results. They may hit all cancerous spots during it or they may miss a bad spot somewhere. You might ask for a Decipher test, which analyzes the tissue samples to see if it's worse than the biopsy is revealing.

I was also 3+4 and recommended for active surveillance util the Decipher said it was 0.68 - meaning high risk, then I immediately went from active surveillance to treatment. And I had fewer 3+4 cores than you.