Most in here know my story. I have been on Active surveillance for the past 7 months.
I visited my Urolgist today 12-1-2016 for a re evaluation. I had a PSA test done prior to the visit, and my PSA had increased from 5.83 to 6.87. I was disapointed to say the least of the increase.The last PSA was taken 7 months ago. So that's an increase of 1.04. (not Good)
I discussed my options going forward and I have agreed to have a MRI-guided prostate biopsy After January 1 2017. My TRUSS biopsy as I indicated in other threads, and the results were.. 2 cores 4-3=7 and 3 +3 =6
I will meet with my Urologist again after the results of the MRI- guided biopsy and discuss my treatment. Whether or not I stay on AS or go for treatment. We did discuss another PSA test after 3 months, but I declined on that plan, My opinion, The MRI would give me a better indication of my PCa, and let me make a sensibile decision.
I would like some opinions from the group, I would be very appreciative!
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I have been on Active Surveillance at PSA levels of 10 for 15 years now, and am more worried about Sepis again after biopsies. Too many possible side effects when they are at your prostate with main risk of nerve damage. You do not mention your age as I am 73 so could die from natural causes before Cancer gets me. If it gets worse then action needs taken.
I had the same thing done with the MRI guided biopsy and my results was 3.3 so I am deciding to have surgery on December 7th good luck I think you're making the right decision whatever that may be
I had the same thing done with the MRI guided biopsy and my results was 3.3 so I am deciding to have surgery on December 7th good luck I think you're making the right decision whatever that may be
My Gleason score was 3+3 my PS PS I went from 4.9. To 5.7 to 6.3 and that's why I decide having surgery on December 7th good luck MRI biopsy picked up two legions at my other posts and you'll see why I should logically for good luck
Supertractorman,
I am 76 years old and considered healthy. What is your Gleason score? I do admire you for chosing Active Surveillance . I wouild like to stay on AS and keep what I have currently have, erections etc..But I fear my PSa will leave the Prostate and cause me hear ache at a later age.
Thanks greg for your info.
Roger, Gleason 3+4 if I remember correctly. One Professor I have seen says 10 is his boundary position and if their is rapid movement in PSA score then that requires attention. After my TURP in December last year my PSA went down to 6 but I lost E/D and still have incontinence plus Prostatitis which I put down to that procedure. Biopsies give you a big risk of Sepsis and anybody having one, please ask after that they have given you A/B's as Sepsis can be a killer and I was an hour away from the next world. He told me nerve damage can be a big risk with removal and that he never wanted to take out a Prostate which can easily be watched. Am seeing him in 2 weeks for next review so will see the position then. As always it is your choice but for me providing they are watching closely then I will leave it as long as I can. There is an old Scottish saying which is very apt for all of us " Lang may ye Pump & Pee and never need a Doctor".
Supertractorman...
Making decisions are difficult with this horrible disease, There are so many opinions out there , including the urologists, doctors, and professionals on PCa. So, it comes down to the patient to ake the right decision. I truly hope I do. I n your case I would say you made the right one, but you have many years left at age 73, and hopefully your PCa stys the same.
Hi Roger, The biopsy will help to determine if you have a PCa, where it was found and know its Gleason score. The MRI will answer the first two, but not the Gleason. It may help with staging, and the Radioloigist will give you a PIRAD score 1-5..1 being you are a teenager and 5 you got problems.
I am not sure about the MRI/biopsy, unless you know you have a lesion to see to biopsy.
My choice was to have the MRI first, then I went to the urologist, we looked at the images and radiologist report and my PSA history to decide if a biopsy was warranted. In my case it was not warranted. If it was warranted, then I would chose a perineal biopsy, which has virtually no infection risk, compared to a rectal version.
When you know you have a PCa, and you have its gleason, size, stage..you can make a better decision about AS or....
Geoff
Roger,
what ever you do, don't make it worse. Choose your options carefully. Still, does not look to bad and do not rush into making decision on treatment. At your age, you don't want to choose treatments with debilitating SE. IMHO, I would stay on AS as long as possible and enjoy life to the fullest.
i case, treatment is necessary, look for something with SE that you can tolerate and that won't affect quality of life. Look for something that is least invasive especially you mentioned that you paying out of your own pocket. It is there many choices available.
i just want to mention my case. Age 51, Gleason 7 4+3 and I had robotic assisted RP on November 2nd. Catheter came out on November 10th and ever since I am having severe incontinece using 2 pull ups and 5-6 heavy absorbency pads per day. I feel miserable. I used to lead very active life like I was in my mid thirties and know I did not leave the house ever since I was discharged from the hospital on November 4th. My only time out of house is when I take my dog to the park. Thanks Good, I am lucky to work from home.
I do not want to stear away anyone from surgery but for me that was big mistake and now I am suffering consequences of being incontinent and who knows for how long. At this point, I am not even thinking of ED and with the surgery that side effect is unavoidable. Here in USA men are very discriminated by insurance companies. Medications are not covered and they are very expensive so recovery from ED does not look bright for many men.
Good luck and happy holidays!
MK
Geoff,
I have already had a MRI, Pirad score etc; and. A TRUS biopsy. My biopsy remains were sent for Genetic testing and the results proved my PCA in the non aggressive range.That is why I chose AS. Now my PSA has elevated , I want to know exactly what my cancel is.. ie aggressiveness etc. So a guided biopsy perhaps will tell me. Your thoughts?
I am 58 and had mine out 10 months ago, 76? with a Gleason 6. I would let that PSA get to 11 before I removed it. By then something else will have killed you. In 2004 my PSA was 7.2 and it didn’t hit 11 thill last year. I would not have another biopsy till you hit 11.
Thanks MK for sharing your story.
Tybeeman' I am not even considering removing the prostate. However, I will consider radiation. I am just fearful that my PCa will leave the capsule in later years. I will not panic , I have time to make my decision.
Your PSA levels are close to what mine were. 4.1 on the first test, 6.9, 8 months later and 9.1, 7 months after that. 6 samples tested positive from the biopsy and were classed as 6 on the Gleason scale. (Later upgraded to 8 after testing).
I had my prostate removed Sept.21/16 and I am recovering now.
I am 62 so the decision to have the surgery was not hard to make.
With any type of cancer, the sooner it is taken care of, the better.
Any ED or urinary problems
Roger, my thoughts
What size did your original MRI report the lesion(s) to be and their proximity to the walls? Did they give you any staging? It is good you had your biopsy genetic tested for aggressiveness and it came back in the non aggressive range. To me, this means the lesion(s) will still grow, but slowly. The PSA increase shows the PCa is still growing, as to be expected, but, it will also be your BPH, and a bit of prostatitus adding to the PSA score. What size is your prostate?
The number of needle samples with a MRI guided biopsy will only require a few samples due to the targeted plan. This should help reduce the problem of infections. I guess you are you looking to see if the Gleason score has increased? You will then get it Genetic tested to see if is still in the non aggressive range?
Roger, on this and other forums, I have seen reports of guys in their 70's and 80's still AS with PSA at 70+. Sure, their PCa is growing slowly, but it was not aggressive, meaning, it is in no hurry to leave the prostate capsule and create havoc. At 76, I would not contemplate interventional treatment unless the PCa has turned aggressive. You might be in pretty good health now, but even robotic surgery will take its toll on you. Us oldies do not heal as well as the 'young' guys in their 50's.
If YOU decide to consider remedial action, consider all of them, but the less damaging types like radiation may better fit your age. Apparently, radiation with or without seeds are getting better and more targeted. While radiation may presently have 20 year later complications, you may not be here, and so not be a problem for you.
It is all about quality of remaining life.
Good move, I was 64 when I Hadith removed and so far doing great!
99.5 % drip free only under stress!
Back in the saddle special seat, hiking etc. To many people take to many chances thinking more of satisfactorily satisfying their sexual needs, Well to those who take inessential risk, think about it once it's spreads it's gets very difficult to treat,
So the little fella will recover too so don't get so worried about that side of it and anyway he will be of no use to you or your other half 6 ft under!
Think about it it's sometimes better out than in!!
Good move hope your recovery goes Well
Hello Roger.I was dianosed with Prostate cancer in 2012.My PSA was 8.5.After another 3 blood tests over the next few weeks,the PSA flucuated between 8 and 9.Then came the biopsy where i was told that out of the 12 samples taken 3 were positive for cancer.The Gleason score was 3+3.The specialist nurse told the good news out of the bad news was that the cancer was slow growing.So over the next 4 years i remained on active surveillance.Then during the latter part of 2015 the PSA reading started to rise.Reaching a peak of 13.7.So it was time for a decision,was it to be More AS.Radiation treatment or Prostatectomy,i could not have Brachia Therapy because my prostate was also enlarged.So we opted for The removal of the Prostate gland.Which was carried out on the 10th Aug 2016.The only thing i can say is that everyman is different.Some men can live a normal life with prostate cancer,If like in my case it was slowing growing,i opted for AS.Over the 4 years i had 3 biopsies,and 3 MRI scans.Good luck.