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Active Surveillance-How Long?

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User

Posted 12 Aug 2021 at 02:38

Hi Mel.

It would be helpful to know what prompted the removal of your husband's prostate after 8 years on AS.

Was it a rapid increase in PSA and or MRI report showing increase in size of lesion(s)?

Hope he is recovering well from the procedure.

Roger

User

Posted 13 Aug 2021 at 21:50

Hi Roger

His. MRI in January showed growth backed up by biopsy in April . Gleason went from 3+3 to 4+3 . Saw consultant in June and he was offered RT or surgery. He had no qualms about the robotic surgery . That was six weeks ago . Recovering well . I’m thinking the incontinence issues are improving day by day . He has a family history of PC so always thought it would catch up with us sometime. He is nearly 68 and is otherwise fit and healthy.

Edited by member 13 Aug 2021 at 21:53 | Reason: Not specified

User

Posted 06 Dec 2021 at 14:03

Hi Everyone,

Updating my 3 monthly results that I received from the specialist nurse a couple of weeks ago. A large increase of 20% from a PSA reading of 5.0 to 6.0.

The nurse said she wasn't concerned at this point and recommended another PSA test in 3 months, I did voice my concerns and she recommended I speak to my GP. I spoke to my Doctor regarding my concerns and I did a water test, that was clear.

I've suffered with lower back pain for a number of years, but have had a really bad episode of Sciatica for the last 2 months. I still believe that my back pain is not connected to my cancer. Can an enlarged prostate or prostatitis trigger sciatic pain and increase PSA? I'm currently under the care of the MSK team and they're recommending another MRI scan for the sciatic pain.

My plan is to enjoy Christmas and the New Year, wait to see what my next PSA test result is in February and then re-evaluate my options.

A bit early, but a Happy Christmas and all the best to everyone in the New Year.

Paulo

User

Posted 28 Mar 2022 at 20:21

Hi all, update on my latest PSA test taken on 10th February'22. Down slightly to 5.8 , so next test in 3 months.

The Sciatic pain i have been suffering with was confirmed by the MRI scan taken in December, showing a large left central L5-S1 disc extrusion compressing the S1 nerve.

Paulo

Edited by member 28 Mar 2022 at 20:26 | Reason: Not specified

User

Posted 21 Jun 2022 at 10:57

Hi all, update on my latest PSA test taken on 14th June'22. Down slightly again, from 5.8 to 5.5, so after todays conversation with the specialist nurse, we've agreed to the next test in 6 months. The conversation always ends with the question, If I'm happy to remain on Active Surveillance?

Paulo

User

Posted 21 Jun 2022 at 13:44

Hi Paul.

Like yourself I've had a fall in my PSA which has prompted me to stay on AS despite the PIRAD 4 lesion identified on the MRI I had at the beginning of the year.

I'm a bit nonplussed at the Uro's attitude to my case. A couple of months ago he'd scheduled a TP biopsy on the basis of the PIRAD 4 MRI report which I put on hold, then at a recent face to face consultation he said that a PIRAD 4 could be anything and I may as well stay on AS. My respect for him is slowly diminishing.

Roger

User

Posted 21 Jun 2022 at 13:49

I would be asking for a treatment plan things aren't going to improve sooner be treated now than waiting for a rise in psa just my opinion 👍

User

Posted 21 Jun 2022 at 15:04

My MRI report identified two PIRADS 4 lesions of 1cm each. At the time the consultant said it was inconclusive (50:50) for cancer. However my biopsy showed cancer in all 12 cores (4+3) with up to 66% of the tissue involved in one of them. Based on this I'm not sure I'd be hanging around with a PIRADS 4 lesion.

User

Posted 21 Jun 2022 at 15:48

The difference is that Rogcal has already been diagnosed with a G3+3 and his PSA has been something akin to a cycle ride across the Alps. In that context, his onco is rightly pointing out that the PIRADS 4 is most likely picking up cancer he already knows he has; PSA did rise which could have been the end of AS but has also fallen.

Rogcal- just tell them you want a TP biopsy as previously agreed.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Jun 2022 at 16:24

Hi Paulo,

I'm only replying to your question after having been 'nudged' back onto the site my most welcome 'how are you' messages from another old-stager - after an absence of about 3 years !

Not sure if my details and previous posts are still visible / not archived, but suffice to say that I'm now about 14 years into AS/WW and still surviving, alive and kicking. In my case the associated conditions of severely wrecked bladder / 200cc prostate and other issues implied that simply doing nothing /living with it was by far the best option despite intensive pressures from Uros / Oncos to the effect that positive treatment was critical, even essential. For me, ongoing quality of life has been the guiding factor. in the very clear knowledge that treatment of any kind was in my case going to be life-changing. Should emphasise that there are always risks with AS as others have pointed out, but has worked for me . so far.

Everybody has to make their own decisions , based upon as much quality information as they can gather from all sources. My stance may well have been considered inadvisable by many others unwilling to go protracted periods with the PCa still there, but it's horses for courses - prefer to believe that mine is just a dozing 'Pussycat' rather than anything more aggressive lying in wait.... but, not everybody may be so lucky.

All very best / David

'It couldn't possibly happen to me....'

User

Posted 26 Jun 2022 at 17:16

Hi flyboy - thrilled to see you posting and to know that all is still well - whatever you are doing, it works!!!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 28 Jun 2022 at 01:29

Flyboy - I got your message!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 01 Aug 2022 at 20:37

Hi All,

I was diagnosed just over a year ago after GP did a DRE that revealed a small nodule followed by a PSA blood test at 5.8. MRI showed a 1 CM lesion PIRAD5, Biopsy returned a G3+3 from a 34 core biopsy, cancer detected from two sides the worse core being 20% and 5 other cores at 5% or less. I'm currently on AS but the PSA seems to bounce about which plays on my mind. It has gone up and down 5.2 up to 8.3 (The last one 8.3) A repeat annual MRI shows no change in the lesion size. The PSA three monthly checks get me in to a bit of a fluster and this last 8.3 one in particular. The MDT nurse has booked me in for a repeat PSA this Friday to see if its just a bump. Is this something others have seen during their AS time. I'm considering 4D Brachytherapy as my next move.

User

Posted 01 Aug 2022 at 22:34

I know two people on AS one gets PSA bouncing between 8 and 14.

Dave

User

Posted 02 Aug 2022 at 11:38

My PSA was a constant cause for concern for over a decade but thankfully my GP and I agreed on a regime of checking for UTIs after each raised raised PSA which always proved positive.

He would immediately prescribe a course of antibiotics followed by another PSA test and on every occasion the result would show a substantial drop.

As a stone former it was a forgone conclusion that my kidney and bladder stones would be the seat of the UTIs and following their removal my PSA would stabilise until the next lot of stones formed.

When my severe BPH was resolved following a HoLEP, my stone forming days were over but the diagnosis of a Gleason 6 (3+3) tumour made at the time of the procedure confirmed my view that PCa had been present for many years and accounted for the fact that my PSA results would never fully settle back to a level you would expect after the UTIs had been dealt with by a course of antibiotics.

Bouncing PSA results are in some cases a result of infection and would urge any man who experiences such too approach their GP and suggest that he prescribe antibiotics followed by a repeat PSA test.

Roger

User

Posted 20 Dec 2022 at 11:52

Hi All,

Just had my telephone appointment with the Specialist Nurse and my PSA has jumped to 8.7 from 5.5 taken in June'22. It jumped in December last year, but not as large in % terms as this increase.

Have also been prescribed Tamsulosin from the 16th November, but I'm not aware it has an influence on PSA. Because of the increase, we've agreed to another PSA test in 6 weeks. If no decrease, an MRI scan will be arranged to see if there is any increased activity.

Merry Christmas to everyone!

User

Posted 20 Dec 2022 at 12:43

Ive been on tamsulosin for a few years and not aware it has any influence on psa, certainly no one has ever mentioned it.

Merry X and all the best!

User

Posted 20 Dec 2022 at 16:24

Tamsulosin can lower the PSA levels in men who don't have prostate cancer but doesn't appear to affect PSA levels in men who do. It certainly doesn't cause PSA to rise. However, the reason that you now need tamsulosin may be the same reason that your PSA has risen... prostate may be getting bigger, impeding your ability to empty your bladder properly, or you may have infection / inflammation? You are probably due a new MRI anyway?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 31 Jan 2023 at 09:44

Just had my telephone appointment with the Specialist Nurse and my PSA has dropped to 6.6 from 8.7 taken last month. She's booked me in for an MRI scan, on the money again Lyn! The results will be discussed at the weekly MDT meeting. Have a lovely day everyone.

User

Posted 31 Jan 2023 at 16:59

🎉🎉🎉

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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