Active Surveillance versus Treatment

I think that whether to treat immediately or to go with active surveillance is such a personal decision that none of us can really advise. The same goes for whether to go for surgery or radiotherapy. I think that, knowing what I now know, with low risk results there is every benefit in going for AS. Equally, there is every reason to go for intervention for higher risk/ cancer with spread outside the prostate . The big difficulty is what to do if you fall into the intermediate category. But  it is always a balance of quantity versus quality of life and how much you can accept potential side effects of treatment versus risk of the cancer moving from curable to manageable. 

my husband was 76 when diagnosed and treatment (Rt +ht) started with the intention to cure (t3a n0m0 ) . He had been ‘watched’ for about 10 years. It’s made my heart ache watching him age as a result of the treatment. We don’t know how he would have been had he been treated earlier , whether the treatment has been successful or not, whether he has gained extra years or not ( something else might ‘get him’!)

It seemed an easy choice then but, with all the variables I now understand, it seems a minefield! 

good luck to everyone faced with this decision!

Thank you for your reply 

I have attached a summary of the ProtecT trial which Cumbrialady is referring to.

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https://www.urotoday.com/conference-highlights/eau-annual-congress-2023/eau-2023-prostate-cancer/143059-eau-2023-15-year-update-protect-trial-part-i-oncology-freddie-hamdy.html#:~:text=The%20PROstate%20TEsting%20for%20Cancer%20and%20Treatment%20(ProtecT)%20trial%20evaluated,Radical%20prostatectomy%3A%20553

Thank you .

Not sure how to attach the link but you can google 

Thank yoi

There is a caveat to this trial. It was based on the therapies available before 2009. Since then techniques in prostatectomy, radiotherapy and hormone therapy have come on in leaps and bounds which means that side effects from some invasive treatments are reduced. Also for low and intermediate risk patients they are usually on hormone therapy for a limited time period, just enough time to try and ensure that the cancer cells are killed.

Thank you 

I’m also t3a 3+4=7 5.7psa never opted for any treatment told I would have ht and rt I’m also 60 years old perhaps they took my age into account 

How are you? Big decision not to have treatment . Are you on active surveillance or watchful waiting?