Removal or active surveillance which is best

User

Posted 16 Nov 2022 at 23:11

Hi new to this site and have just started the long journey with PC.

This all started with lower back ache that wouldn't go away with no other prostate symptons. So as part of the investigations was given a psa test this came back as 7.9 and the dre said the prostate was slightly enlarged.so onto the nest step which was a MRI this was inconclusive as it came back as a 3 on the likart scale. Then onto the biopsy.

While waiting for the results the back ache was looked at with an xray and came back as lumbar spondolosis.

So finally went to the hospital for the biopsy results and was told had PC. The Gleason score was3+3=6 and the staging was T1. So was advised to go for active surveillance.

So the long journey starts let's hope that the PC is as slow growing as they suspect. Is it better to remove the cancer now and put up with the side effects. Or to just wait and see and then have it removed when it's a greater concern.

Thanks

User

Posted 17 Nov 2022 at 08:19

Thanks elaine for the reply I wont be letting them be complacent, will be banging on the door when I'm due the tests. Cheers

User

Posted 17 Nov 2022 at 08:25

It's really a question of how you feel about it. Personally if I knew that radical treatment was required at some future date I'd want to get it over and done with. Other people are happy to live with the knowledge that they'll need future surgery. How do you feel about it?

Best wishes,

Chris

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User

Posted 17 Nov 2022 at 00:44

Well all your friends and family will tell you to cut it out, but they aren't the ones who may potentially suffer ED and incontinence. You will get more nuanced replies from people on this site who have a wide cross section of experiences.

I guess you are 61 and hopefully enjoying life. If I were in your position I would go for active surveillance. You may be suitable for a focal therapy like HIFU, but even that is overkill for such an insignificant level of disease. It is fairly unlikely this will develop much in the next five years, and if you are on active surveillance (make sure they don't lose your records) they should catch it before it is dangerous.

Hopefully you will die of something else before PCa gets you.

Dave

User

Posted 17 Nov 2022 at 00:49

Hi Trigger,

Sorry you find yourself here.

It’s seems pretty good advice from them with the scores that you have. As you say it could be extremely slow growing and you might never need treatment.

I guess the really important thing if you do opt for AS is to not allow anyone to become complacent. Make sure you have regular psa tests (I would have thought 3 monthly), scans and further biopsies. A friend of ours has these every 12 months.

Best of luck going forward

User

Posted 17 Nov 2022 at 08:17

Thanks for the reply Dave, think the AS is the way I was thinking of going yes your right I'm 61 with no health issues and life is good. Just didn't fancy those extra years of side effects after treatment, if can be monitored then receive the necessary treatment when there is a change, but doesn't feel right just to leave it there ticking. Cheers

User

Posted 17 Nov 2022 at 08:19

Thanks elaine for the reply I wont be letting them be complacent, will be banging on the door when I'm due the tests. Cheers

User

Posted 17 Nov 2022 at 08:25

Best wishes,

Chris

User

Posted 17 Nov 2022 at 16:19

Hi Chris, that's the million dollar question, if it's slow growing and get away with treatment for years that's years without side effects from the treatment. And I think I could cope mentally with the stress and anxiety due to waiting for test results to see if there is any changes.Where as now I'm young enough and healthy enough to possibly cope with treatment better, and who knows what around the corner as you age. Hopefully everything works out as planned.

Cheers

User

Posted 16 Feb 2023 at 09:34

Hi. Just seen this but for what it's worth I'm on active surveillance and have been for a year and a half now. I now have blood test every six months instead of 3 my next blood test is in July which will take it up to two years my Gleason score is 3)4 PSA has been between 5.13 Up to 5.47 it is now 5.14

User

Posted 16 Feb 2023 at 15:13

My Gleeson was T1 3+4 so not as good as 3+3 but I chose AS and didn't regret it. I was moniored at 3 monthly intervals and it did finally move to T2. With a bit of luck you could be fine for quite a while. Good luck

User

Posted 16 Feb 2023 at 16:12

Thank you Mike

User

Posted 17 Feb 2023 at 10:32

Thanks guys, for info should be due for my first follow up psa test soon, fingers crossed no changes.

User

Posted 17 Feb 2023 at 10:51

All the best

User

Posted 21 Feb 2023 at 16:06

Hi Trigger.

Every individual case is different, I am 68 & opted for ralp surgery which wasn’t to bad.

Incontinence was only a minor problem for a week or so, but ED was more of a problem at my age but slowly getting there.

Regarding active surveillance, don’t forget even after surgery you still have the anxiety of psa tests every 3 months “looking for re occurrence” for the first 12 months, & then at longer gaps for the following years.

In your case, you could have act surveillance for the next number of years & still be fit enough for surgery at a later date, if ever.

My main concern was that I didn’t want the continual biopsy follow ups that was inferred that I may have to have, & I felt that I was fit enough at that time for surgery but who knows how fit I will be in say 5 years.

Everyones circumstances are different.

All the best. Jeff.

User

Posted 21 Feb 2023 at 18:25

I agree with Chris. I was 3+3 and, after consultations and much thinking, decided on surgery, while also considering AS. My urologists (I consulted 2) and surgeons (2) were able to lay out the stats but all pointed to the psychological effects of either decision, In November as a fit, active 62 year old I decided to have the surgery rather than live with the waiting. I don't regret my decision but nor would I suggest others do it. It's a very personal decision, mind rather than specifically cancer related at the stage I was at,

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