Question Re; My Biopsy Results

Until recently my PSA was a non-issue to my doctor. about a month ago my PSA went from 3.1 to 5, this 'dramatic' jump concerned my doctor. He suggested I see a urologist, he put me on an antibiotic to see if that would bring the number down. It went UP to 5.2. Next step was the biopsy. Twelve core samples were taken.

RB = 20% (3+3=6)
RM = 30% (3+3=6)
RA = <5% (3+3=6)

At this point I don't feel it's necessary to rush into any type of treatment and deal with the side effects. I'd like to know what you guys think, since you've been through the same thing and there's a ton of conflicting information on the internet making it difficult to decide how I should proceed.

I'm 58

I agree with your assessment Luke, on the condition that the slides are read by a pathologist who reads lotsa pca slides. Not by the local hospital pathologist. Slide reading is subjective. kinda like card… er ,ah,never mind.

I was about your age when I was DXed with similar numbers in Nov 2007. I took 2 months to get the info I needed to make my decision as to the best course of action for me. In that time I met with several docs and ROs. It seemed that the Uro guys wanted to operate and the RO guys wanted to radiate. I felt I was too young for Watchful waiting.

I eventually chose the "glow-in-the-dark" regimen (Tomotherapy)and so far (knock wood), it seems to be working.

BTW, the reason(s) I chose radiation were twofold: I'm a chicken when it comes to surgery, and I didn't want to start wearing diapers at that age! With radiation I missed no days off work, and just a small amount of time in the mornings for 2 months to get my 6-minute treatment. If I had it to do all over again I would choose the same course of action. YMMV

Rotor

Luke,

You appear to be a good candidate for Active Surveillance. If I were you, I would do two things before deciding on how to treat the cancer:

1. Get a second opinion on the biopsy from a prostate pathologist such as Jonathan Epstein at Johns Hopkins University

2. Undergo imaging with a 3T mp-MRI to make sure there is no more serious cancer (of Gleason score 7 or higher)

With your numbers, you have time before rushing into a treatment that can severely impact the quality of your life.

Good luck! 

Welcome to HW. Avoiding treatment is a good option. Not all PC requires treatment.

Get the second opinion on the biopsy and set up an AS program - I emphasize "active." Figure out how often you should have you PSA checked, if you should get any scans and what would trigger going off AS and getting treated. Something like, "If my PSA goes over 10, I'll get treated with Brachy seeds." or some such thing.

The gamble you making is that the slides have been read correctly and you're at G6 - a low grade cancer that rarely does much but elevate your PSA. If your gleason score was higher, you'd want some treatment.

Hang in there and keep us updated on your progress,
Andrew

2 months