Prostate cancer

Hi !

To be on active survelinace you must be a Gleason 3+3 and maximum a Gleason 3+4 with max one biposy core only showing Gleason 4. Every other combinations is not subject to AS. Gleason 3+3 is of course also cancer but you can normally be on AS until the cancer evolves to higher Gleason grades

Hi, I was gleason 3+4 with initial psa 5.4, mri showing only quarter infected, 12 months on mri is showing the same but psa has shot up to 9.4 and surgeon has recommended surgery but after a few days deliberating I'm thinking about holding off for a few motths and seeing how things settle 

Hi !

Normally it”s the Gleason grade that decides AS or not by looking at the biopsy and the core taken. If you for example have 10 cores taken and 9 of them shows 3+3 and the last is 3+4 then one of standard ’treatments’ is the active survilliance. If a new biopsy shows more cores with 4 (or higher) then it’s not standard anymore offering AS. MRI don’t gleason grade the cancer, it only shows that there is cancer present

You have a PSA doubling time of a little more than 12 months which is ok so far but you really need have it under control now and if possible more frequent PSA test and why not try have PSMA Pet Scan added to get a more better overview

Thanks for that as I was thinking the same, go for psa then if stedy rise consider my options

You mention spelling to a surgeon. 

Have you spoken to an oncologist?

Given that your cancer is low grade and contained you should at least have all the possible options available explained to you..

You should also perhaps consider, if you have the resources or can get on a trial, one of the newer focal therapies, as the cancer is located in one area. 

You have the benefit of having all the options. You also have the confusion of having all the options.

Good Morning Psmike 

Another warm welcome to the Macmillan Online Prostate Community, although I am so sorry to find you joining us. I am Brian one of the Community Champions here at Macmillan and am 4 years into my personal Prostate Cancer journey.

My opinion is as a Gleason 7 with a rising PSA  it's time for some action. At the moment you will be under Urology and the surgery department will be looking for business and with your Gleason, PSA and MRI results you could enter a "curative pathway" with Hormone Therapy - Radiotherapy - Surgery or Brachytherapy.

I agree with Steve mstev2 above, you need to speak to the oncology department and do some research as to your choices. Stick to trusted sources for your research, Prostate Cancer UK, Cancer Research UK and Macmillan (Not Dr Google!). Feel free to ask any questions, however trivial - we are all happy to help.

Best wishes - Brian.

Hi Millibob, 

Thanks for the reply.. I will speak to oncology as after looking at the options I think Brachtherapy may be my favourite option as it seems more focused and less evasive but I know it's quite new so not sure I can even offered it but l ask

Hi Mstev2,

No I've only spoken to tg surgeon so far but after looking at possible options Brachtherapy is looking my favoured option as seems newer, more focused and less evasive with less possible side effect Will ask this wwwk for possible alternatives to surgery as the side effects are scaring me as I'm still relatively young at 54 and have no other side effects apart from raised psa

Good Morning Psmike 

It's not offered or available everywhere BUT you are entitled to it if it's suitable. We have a Community member who has had it and know all about it and I will "tag" him into this post - it's Alpine Wanderer, 

Feel free to ask him anything - he's "been there - got the T shirt"

Best wishes - Brian.

Hi Brian, 

Brilliant and many thanks. Would be good to speak to someone who's actually had the Brachtherapy