It doesn’t even feel like I have prostate cancer

Hi Andy.

Your recent PSA was 6.6  but what was it when you were first diagnosed in Sept 2024?

Any constant rise in PSA levels could be a reason for concern and require further investigation.

Please don't ever get complacent about  being on active surveillance. Keep getting your regular PSA tests and ensure that you get periodic follow up MRIs. I am speaking from personal experience where my Gleason 6 (3+3), T2 disease, in just 20 months, progressed to Gleason 9 (4+5) T3a. During this apparent progression my PSA remained relatively stable.

Despite my AS failure  I'm still a fan of active monitoring  so long as it is ACTIVE. Also remember most men don't have any symptoms until it's too late.

There is debate as to whether Gleason 6 (3+3) is clinically significant cancer. The problem with that is, biopsies are not a exact science, often, probably as in my case, more aggressive cancer cells can be missed.

I hope your AS like the majority of those on it is successful, but always take care.

Good luck mate.

Edited by member 09 Nov 2024 at 20:57  | Reason: Additional text

Hi again Andy.

I didn't realise that you've been having regular PSA tests for the past 8 years. I thought your first would have been about the time of your diagnosis in summer this year.

Apart from your latest biopsy, 22/08/24 have you had any others or MRI scans during the previous last 8 years? 

Is there any particular reason why you've been having PSA tests for so long?

Cheers Andy thanks for the clarification.

I'm not medically qualified, but as your PSA has remained pretty similar for years and as your cancer is low grade and is safely contained in the prostate, AS seems ideal.

I hope all goes well, and like many who are been monitored, that you never need any radical treatment.

Good luck mate.👍

Hi,

Consultant.’s diagnostic confirmation letter stated:

Left anterior - Three cores of prostatic tissue are received, one of which contains animated type adenocarcinoma Gleason 3+3, measuring 7mm in maximum size (discontinuous growth).

Left posterior - Nine cores of prostatic tissue are received all of which contains animated type adenocarcinoma Gleason 3+3, measuring 12mm in maximum size (discontinuous growth).

My first was an up the bum,  TRUS biopsy. Only 2 out of 15 cores, only 10% cancerous, Gleason 6 (3+3), T2a

My second, 20 months later, was transperineal under GA, in their words "It's  more accurate." 25 cores, 20 cancerous to 40%, a combination of 3+4, 4+3, and 3+5 overall Gleason 8 (3+5), the cancer had breached the prostate wall, T3a. After surgery upped to Gleason 9 (4+5).

I have a strong suspicion that the less accurate TRUS biopsy missed the more cancerous cells. Apparently it is quite rare for a true, accurate Gleason score to progress. It begs the question, "Why not go for the more accurate biopsy in the first place?"

I believe TRUS biopsies are being phased out.

Hi Andy,

For what it's worth and it's only my opinion, I would imagine that given your relatively young age, at some point you're going to have to treat this.

When my 2nd saturation TP biopsy came back positive, I only had 2 cores positive. Both only had small amounts of cancer detected (5mm in one and 4mm in the other) and both were 3+4 (only 10% pattern 4)

Although younger than you, it was made clear to me that whilst it was fine to go on AS, that could only ever be a stopgap before treatment became inevitable.

For me the big thing was that obviously, if it were to have developed and become more significant then I would have had fewer treatment options.

You'll see from my profile that having had Brachytherapy about 18 months ago, I'm currently in a bit of no-man's land (which also isn't that unusual!) - but regardless of my current 'status', I believe I made the right choice - even treatment failure would prove I didn't have time to hang around! 

So, although my final destination is a little unclear at the moment, I still wouldn't hesitate in recommending Brachy. It's got a fantastic success rate (something over 93% from memory) and from my experience, the procedure and side effects are no worse than having a biopsy. Walk in the park 😉

Good luck! Paul

This was my scenario too, the surgeon and oncology nurse both said that I will need treatment at some point. I didn’t want to take the risk of the disease progressing to a point where my options became limited.