Stay on AA or Brachy?

User

Posted 06 Nov 2024 at 16:01

I was diagnosed with Prostate Cancer in April 2022 and have been on Active Surveillance since then.

My last biopsy, the second I have had, was in May 2024 with result as follows;

Left side Gleason 3+3 = 6 in 2/15 cores. Right side Gleason 3+4 = 7 in 6/15 cores

I am T2 NO and have been advised to remain on active surveillance.

The biopsy in May was as a result of an mri scan which revealed an enlarging right peripheral zone appearance PI-RADS 4 and new tiny left zone PI-RADS 4 lesions.

Thus the cancer is progressing at albeit a slow rate.

I had a discussion about Brachytherapy with a Doctor who performs the operation and have been offered it if I choose.

I guess the dilemma I have is that the MDT team are advising that I stay on active surveillance and yet I can have treatment which in effect will rid me of the cancer.

My younger brother had Brachy 2 years ago, (PC is in the family) and is suffering no ill effects.

So I wondered if anybody has been in a similar position and what thoughts were?

Thankyou in advance.

Bob age 65

Edited by member 06 Nov 2024 at 16:14 | Reason: Not specified

User

Posted 06 Nov 2024 at 17:34

Not enough information to estimate progression.

However, you are mainly 3+4 now from what little I can derive versus 3+3 previously. 3+4 is not normally eligible for AA unless the 4 is almost insignificant, which makes me wonder why they are suggesting to stick with AA.

User

Posted 06 Nov 2024 at 17:39

Tell them stick the AA get it treated. Any 4 will eventually kill you so just get rid of it.

User

Posted 07 Nov 2024 at 09:14

Originally Posted by: Online Community Member

Tell them stick the AA get it treated. Any 4 will eventually kill you so just get rid of it.

Hello mate.

I think that's a little strong. Autopsies of men who've died of other causes show a high percentage had intermediate prostrate cancer without knowing it.

This research indicates that dependant on risk factors, Gleason 7 (3+4) can be deemed suitable for AS.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11034964/

Going through Barry's posts, when he was first diagnosed two and a half years ago, his PSA was only 3.3 and Gleason 6 (3+3)

So it does seem to have progressed. What would concern me more, is the disease seems bilateral and was once deemed T3a then downgraded to T2. Either way, it suggests it must be very close to the prostate wall.

Like you and Andy, this makes me wonder why the MDT have decided that AS is still appropriate.

Barry, what's your latest PSA?

Edited by member 07 Nov 2024 at 10:01 | Reason: Typos

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