Hello all,
I am 65 years old.
After an initial examination and PSA test I had an MRI scan which showed a couple of suspicious areas. I went for a biopsy and the outcome was that I have prostate cancer. I'm told that mine is a very 'mild' and restricted form of cancer. That was in February 2020.
My cancer is described as Gleeson 3+3 in a single core - low volume disease.
My PSA was initially 8.5 but after the biopsy it increased to 11.5 - I was told that this could have been due to 'swelling' of the prostate following the biopsy. However it has stayed at about 11.5 for over a year now.
After the first MRI my prostate was 89 ml in size. After a second MRI a year later it has increased to 121 ml.
Apparently the cancer hasn't increased in size.
After the initial diagnosis, the consultant recommended Active Surveillance - to do more would be over-treatment he said. The surveillance was to be 3 monthly PSA tests and another MRI scan after 12 months. He explained that this should detect any change or possible spread, so that more intensive treatments could then be considered if required. This seemed like a sensible way forward.
My concerns are -
- the fact that my PSA remains at a relatively high level of 11.5 (this doesn't seem to concern the specialist nurses, who say it is the doubling rate that matters and mine is 4.7 years).
- the fact that my prostate has increased in size by about a third in a year (no comment from the specialist nurse).
- More generally, how effective is Active Surveillance - given that it seems to rely almost entirely on 3 monthly PSA tests, which are apparently notoriously unreliable. I'm not sure whether any future MRI scans are planned.
Does anyone have any thoughts on this?