What option to choose

Hi Dave 

When I was first diagnosed my PSA was about 6, Gleeson 6, small tumours contained, I went on active surveillance for 4 years , it was just monitored.

You don't say what your stats are but I presume lowish.

Don't forget treatments can come with side effects so do much research to see what you're up against, see what others say.

Steve 

Grundo, thank for your reply . 

My stats are low and the cancer is contained in a small area of the prostate . Can I ask , how often were you monitored and is the monitoring scans and regular PSA tests ?

Ok, so had PSA every 3 months but also 6 months may be ok.

MRI yearly, only had 1 biopsy 

Steve 

Hi Dave

When I was diagnosed with Gleason 6 back in 2017 I was in shock and my immediate reaction was get rid of it. My consultant was a surgeon and he was willing to operate. However, I found this site and I read hundreds of posts about people's experiences. I chose active surveillance and I have been doing that for 6 years. I have a PSA test every 3 months or so, and it has risen gradually. I have an MRI once a year.

Best wishes for your decision.

David 

Thanks , David . It's clear I need to do a lot more research before I make a decision 

Dave Mc,

A lot of us have been on Active Surveillance.  I was on it for 4 years, getting my PSA levels done every 6 months.  Then after 2 readings of over 12, they had me in, biopsied, 9/29 had Cancer (Gleason 3+2 (7), T2, Intermediate Risk.

I was unsuitable for surgery so I had the Hormones and Radiotherapy option.  This worked well for me.

Now I have just celebrated a full year in Remission.

You could be on Active Surveillance for years, with the Prostate Cancer being a slow growing Cancer.

Let us know what you decide.

Best of luck.

Hi Dave

I totally get why your family want rid - that was my initial thoughts. Unfortunately I wasn't suitable for the operation.

However, as others have said, all treatments have side effects, and unless you have to, why put yourself through them, until there is no choice. If I had the choice, and knowing what I know now, I would have gone down the AS route.

Hope this helps.

Regards

Stuart

Hi Dave, my husband has a very high incidence of prostate and breast cancer in his family and started having his PSA monitored annually about 12 years ago. He was referred to urology when his PSA rose to 6 and, at that point, they would not scan before biopsy and the older way of doing a biopsy was more likely to miss small tumours so it was agreed to keep watching. About 5 years ago the PSA was 8 and he went on to 6 monthly monitoring until and unless PSA rose above 10 which it did last summer. So, we had about 12 years of  monitoring before treatment has been needed. He is now receiving radiotherapy and hormone therapy for stage T3a, N0.M0 Gleason 4+3 = 7 with the ‘intention to cure. ‘. The waiting has meant that he has had 10 years of no intervention and treatments and diagnostics which have become ever more sophisticated. Treatment, too, is being introduced at the time when we know, for sure, that it is definitely needed as, without it, the cancer would have spread beyond possibility of cure. We were told right at the start that prostate cancer is often slow growing and more men die with it than of it. 

on the other hand , 10 years ago he would have been, obviously, younger and more able to withstand the rigours of the treatment!

I am no prostate cancer specialist and my own take is not evidence based and, obviously, very much based on our own circumstances, but, I look on this all as buying time. No treatment guarantees 100% that the cancer won’t return. Not all prostate cancers are highly aggressive and will cause death ( although , sadly, many do) . It’s a matter of doing what is necessary when it is necessary to buy the longevity to which we all aspire! We’ve had 10 good years with no treatment side effects. We hope to have more years of remission and, possibly, cure. If the cancer rears its ugly head again we will then have to resort to the next line of defence.

In the meantime, more and better therapies might come to the market? For example, my father in law was diagnosed with prostate cancer over 25 years ago. The only treatment he was offered was the hormone therapy which the cancer learns to evade and radiotherapy for bone pain when it became unbearable. He died after about 4 years of receiving that diagnosis. The methods of doing biopsies have become more accurate. Scans are routinely done before biopsy ( my father in law never had a scan as far as we know). If testosterone blocking drugs fail, there are other drugs now.  

I would recommend having all the diagnostics that are available now and that were not 10 years ago. Then you will have a better idea about potential spread of the cancer, the aggressiveness of the cancer and, so, the element of risk. I would then weigh up the risks of no treatment now versus the risks of treatment side effects which, currently, are unpleasant. You should be guided on this by your medical team. I also did a lot of research for my husband and there are many people in this forum who are far more knowledgeable than me!  I also think you need to take your age, family history, medical history etc into account. The younger you are the more aggressive the cancer is likely to be, I think?

I think, too, that this is a decision that really is yours to make once you have all the info at your finger tips. Yes, listen to what your family, friends and the medical profession say but only you know how you would feel about whichever course you chose. Hopefully, everyone around you will respect your ultimate decision but remember that no decision is , in effect, a decision to do nothing!

best of luck 

Thank you , given me much food for thought

Thak you for your comments