Prostate problem

[kawakiri]

just got back from hospital, been advised that the biopsy found the needle in a haystack.
PSA levels have been6.6; 2.7 and 5.4.
Gleason score of 3+3
Just have to decide what to do, I am favouring active surveillance.
Has anyone or know someone in similar position?
What option did you/they take?

[Sqad]

The good news about prostate cancer is that with regular screening, in most cases it is very curable and can be treated successfully. You will die with your cancer rather than because of it.

Me?...as far as i know, I haven't got it, but before i answer your question, I have to know your age and the results of a body scan.

[woofgang]

also what advice you have been given by the medics

[kawakiri]

Been given a booklet with the options and another appointment next week to discuss the options with surgeon/oncologist.

[kawakiri]

Im 55 by the way. Didnt have a body scan for this just the usual trus biopsy.
This is my second run in with cancer, I am 11 years remission from Hodgkins Lymphoma also.

[Sqad]

You still haven't told me your age.
Sqad..over 65years of age, with a malignant prostate with a Gleeson score of 3+3 and PSA levels ranging from 2.7....6.6.

I would opt for "masterly inactivity" with 6 monthly P.S.A's.

If the PSA'started to rise over a period of 2-3 years and I was over 65 years then i would opt for DXT and hormone therapy.

Hope that helps.

[Sqad]

kawa...I have just seen your age and my opinion remains the same, except that if the PSA rises over the next 2-3years I may well opt for surgery.

[kawakiri]

Thanks for the input Sqad

[Clanad]

About a year ago, during a routing flight physical, my physician (here in the U.S.) did the blood test for PSA and found it somehat elevated. She elected to send me to a Urologist who I felt was overly agressive at promoting a biopsy. Fortunately, I had just read about this test:

Beckman Coulter's Hybritech free PSA (fPSA) test, Beckman Coulter's Hybritech free PSA (fPSA) test, is able to more accurately distinguish cancer from benign prostatic conditions. A report to this effect was published in the August 2000 issue of the journal Urology. The test has now been approved by the Food and Drug Administration (FDA) for clinical use. According to William J. Catalona, MD of the Division of Urologic Surgery at Washington University School of Medicine, Free PSA is the best available way to improve the accuracy of total PSA tests. Free PSA ratios can provide the bonus of telling patients and physicians how aggressive the cancer is. Free PSA is measurable through a simple blood test. (Source: The Cancer Cure Foundation).

He did the test at my request and the results indicated a high ratio (which is desired) and based on that elected to watch and wait. I requested a new PSA after about 6 months frommy original Doc (Doctors just love self-diagnosing patients, don't you know?) and the PSA had returned to "normal" with no other flare ups. You may wish to discuss it with your health provider... Best of luck!

[kawakiri]

Update is that after another set of biopsies after another raised psa my Gleason was still reported as 3+3. However the following week I received two unexpected appointments for MRI and bone scans.
The upshot is that the urology team reviewed my notes and requested the scans due to re assessing my Gleason to a 4+4.
MRI did show evidence although not clear that the surface of thevprostate had been compromised. The bone scan was clear.
I am now waiting for pathologists at the Christies to review the last biopsies, however it looks
Ike I will benlikely to be having HDR brachytherapy.
Oh deep joy.