Is prostate cancer a "slow-growing" cancer?/If so, what if one leaves it untreated?

Sorry to read about your problem and hope all goes well. I too have asked pin down questions and while appreciating practitioners will do best treatment plan there is not always a clear answer they can provide. 

Hi Dee. 
I was diagnosed the same time and low level 6. I’ve gone for Active observation with blood tests every 3 months and a MRI and Biopsy every 12 months. 

have you discussed this option yet?

Hi T

The simple answer is that some people have slow growing PC that means they can avoid treatment for many years, I've read 8 or more.

I had a slow growing cancer which was 3mm in size initially and grew to about 13mm at which point I went for RT.   AS lasted 4 years

Slow growing can suddenly speed up at some stage but obviously not always,  so that is why important to keep testing.

Steve

Thank you Dane1. I have not discussed it, but the idea of enduring another biopsy is unimaginable to me. But I certainly wouldn't mind blood tests every 3 months. The thing is, I clocked in at Gleason 7. An MRI was taken in December 2021 indicating "something suspicious." I will certainly ask my doctor if watchful waiting is still an option or if I'm beyond that. I really appreciate your response, thank you. 

Thank you, Grundo. I will ask what the size of the lesion (tumor?) is. I'm getting the feeling they are being very proactive, which I appreciate, but I also do not want to subject myself to hell at this moment unless it is my only option. 

I'd be ecstatic with AS for 4 years. I'll find out soon. Thank you. 

Yes Prostate Cancer is generally slow growing so if diagnosed with low PSA, low gleason of 6 or even 7 (3+4) not necessarily 7 (4+3) maybe. Staging of  T0M0N0 or even T1 N0M0 and scans and tests show it to be totally contained in the prostate and not pushing out to one side or others - where microscopic cancer cells may have already escaped and not be seen and are already causing spread of the cancer  then Active Surveillance can be useful for maybe up to 5 years possibly longer.  However, Active Surveillance  (AS) must be just that with quarterly PSA and yearly biopsies and scans so that any change in size -and shape and cancer cells can easily be seen and be seen quickly enough to start treatment to "cure" the cancer where possible with effective treatment. This does give you the chance to research your treatment options and discuss this treatment with various specialists before making a decision which can only be good.  My cancer was diagnosed with PSA 13 Gleason 7 (3+4) and T2N0M0 but at MRI T3 staging could not be ruled out as the tumour could be seen to be pressing onto the back of the prostate into the rectum and microscopic spread - which would not be seen on scans could not be ruled out and so treatment started within 2 months with 9 months of Hormone Treatment (HT) and 6 months later when the HT had time to act on the cancer cells (the HT acts to bring down the PSA and testosterone which feeds the cancer and it also weakens the cancer cells so that when RT is given it is more effective) An operation to remove the prostate at that stage when microscopic spread could not be ruled out would not have been as effective as HT and RT as any microscopic spread would have been "mopped up" by the RT.  Of course, there is no way to know whether there was microscopic spread but if there was any it was successfully mopped up as I am now 6 years post treatment and still undetectable PSA. 

All the best with your decision. 

I can't thank you enough for this. This answers questions I didn't even know I had yet. 

Yes, my Gleason score is 3+4, but my PSA was, at last reading 5.62, as opposed to 4. 51 just two weeks prior. I'm not sure yet what the staging is, because my doctor inexplicably didn't tell me (but he will tomorrow), but he did say it's contained in the prostate. There was nothing seen in other organs or in my bones. 

If you had a PSA of 13 and Gleason 7, and, if I understand, you went through HT, then RT (I assume it was external beam and not brachytherapy, though I should not assume--brachy is what has been offered to me here in Japan), and you have survived it for 6 years... you are a hero in my book. 

Have any side effects all faded away? Or are you still dealing with their "after math"? 

Thank you again; much appreciated! :)

Hello again. Since I cannot edit my initial response, may I ask how the side effects were of the HT? And did those go away once  you stopped it? 

Have you had to take any other specific medication once you completed RT (and if you did external beam, for how long and how often did you have to do it)?

Thank you again. 

Yes couldn't have brachytherapy as it would have had too much effect on my rectum and bowel with the position of the tumour.  Also I had already had a TURP procedure about 12 years previously so at that time it was thought that that meant brachytherapy could not be used but I believe these beliefs have changed now.  So, for me it was 9 months of HT and 1 month of HT.  Minimal side effects during RT with only one night half way through RT where I was weeing for Great Britain.  I think I actually must have got up about a dozen times that night but it felt like 30 times.  Unbelievably I had no bowel or rectal side effects when going through RT considering the position of the tumour I thought I would have some but got none.  Then 4 months post RT had to have a colonoscopy for another problem and should have realised I should have waited another couple of months until the inflamed areas from the RT had healed better as it aggravated these areas and at 5 pm that very afternoon I started having some problems.  The hospital - not the one I had had my cancer treatment at, should have given me a scan first so that they could concentrate on the areas where polyps could be seen but instead did the colonoscopy first and not with the consultant I first saw so he wasn't necessarily up to speed on my treatment for PCa.  The gastroenterologist I had seen that day prescribed some daily enemas to soothe these areas which he said may not work - they didn't really - and quite by chance I mentioned this to the Macmillan nurse and she suggested another treatment which worked within days.  None of these side effects were bad I must say just a little awkward and didn't stop me doing all the things I had always done.  All the way through HT and RT I continued to exercise at least 4 times a week at the gym, swimming and cycling on the other days when I could and I am sure this helped with the way I was able to get through HT  with few and light side effects - didn't notice the hot flushes until they were fading away over the months after HT had stopped and by about 3 months after I stopped HT they had pretty much gone or were not noticeable.  Very little fatigue if any, no mood swings, and I put on just a few pounds in weight with a small belly which with the exercise disappeared within a couple of months.  Keeping fit has been my life as I was a PT Instructor for 37 years so healthy diet and exercise has been my way of life.  I ate sensibly as I always have and still do too.  All of this helped.  Along with a positive attitude.  

I realise I didn't answer your question on what happens if you do not treat prostate cancer on diagnosis - well it will continue to grow, PSA will go up the tumour will grow - the speed at which it grows will be different for everyone and the more problems it may cause - such as urinary, bowel and pain problems in local area and back.  Eventually you will need treatment but you will have time to research and find the treatment most suitable for you.

My younger brother was diagnosed with a lower PSA and gleason 6 at about a year younger than I was when I was diagnosed and had brachytherapy only.  He had some minor urinary upsets for about 3 weeks and was fine afterwards and still is 4 years later.  He decided on treatment so early because our Granddad died with not of prostate cancer at 78 our Dad died at 89 with - not of prostate cancer and then I was diagnosed with PCa and he was so with the family history he decided he should have treatment earlier rather than later whilst he could still have  brachytherapy only and recover easily from it.

PS not dealing with any aftermath of any of my treatments that was all gone very early on,