Positive Biopsy and Active Surveillance

[srmLarry]

I'm 53, healthy with no health problems other than recently diagnosed prostate cancer and at 175 lbs, not over weight, not to physical, but I eat lots of fruits and vegetables all organic and walk a lot. However, I have had a PSA reading of 1.95 on my first reading 12 years ago to a high of 3.35 (several years ago) and most recently 2.5 staying about 2.3 to 2.6 over the last several years. My father found prostate cancer at 65 (12 years ago, the reason I started checking every year), had radiation and is alive with a .03 psa today at 76. My DRE is always normal and I have no symtoms, however the urologist requested a biospy due to my Dad's cancer and my borderline PSA so I had it 3 weeks ago and even though the ultrasound at the time of biopsy also showed nothing I was almost assured by the oncology urologist performing the biopsy procedure that I would be fine, however cancer cells were found in 1 of 12 samples taken and rated a 3+3, Gleason 6. The cancer cells were 30% of the 1 sample found and less than 5% of the total samples. I would think that I didn't just get cancer 3 weeks ago, judging from the PSA being about the same for 12 years I would guess that I have always had the cancer for at least 12 years and it hasn't really grown or spread much. Of course the Urologist wants to do a radical prostatectomy immediately within the next month but no more that 3 months waiting and I am thinking that what I have seeems so insignificant that I should do "active surveillance" which is against the Doctors wishes. I am also going to send the samples to Johns Hopkins for a 2nd opinion.  In your opinion should I be worried about waiting and how long should I wait to get another PSA test done or any other tests that you might suggest? Thank you in advance for your opinion and/or suggestions.

[mickey84]

Hi Larry,
You have a very mild case of prostate cancer. With your PSA staying low for so long, it*s
problably a sure thing it*s not aggresive. You have plenty of time to decide what you want to
do about your case. You can do watch and wait, or radiation. I would have my PSA checked
about 6 mos. Do another biopsy in 1yr. if PSA still low maybe 2years.
Prostate cancer that is not agressive, may never both you or maybe 20 years from now.
I would not make any radical decisions right away. Surgery or Radiation, will have some side
effects. I would get a 2nd opinion. Best of luck of what ever you decide. Some doctors think
watch and wait is a very good option.

[kojac]

Hello
I'm a 54 year old male I had a PSA test done Last yera 7-2010 and the rsults was a PSA level of 5.5. I went to a uraligist and he put me on antibiotice and the level dropped tp 3.2, then 2.7 12-2010 and noe 3 months later it wenr up to 7.5. I am confused and would like to knoe what's up with the flexuating levels. I appreciate any information.

Thank you
Sam M.

[curmudgen]

I would highly recommend reading the book "Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment or Loss of Sexual Potency" before you decide to do anything.  Remember surgery is irreversibly and subject to side effects that you don't want.  I have a PSA reading that hovers around 6.5 for the past few years, negative DRE...decided not to do biopsy since I don't think I would choose any surgery nor history in family.   every case is different.

[sharpmama]

It sounds to me like you have a fairly slow growing cancer, which gives you some time to think about it, read what you can on all the available treatments before deciding what is right for you.

I think the dr. wants to do as many procedures as possible (which bring in lots of money). But you have plenty of time to decide.

Good luck to you! You are relatively young, so you'll want to keep track of it as mickey84, above, suggested.

[mickey84]

Sounds like you have prostate infection. PSA does not fluctuate that much over a short period of time. You need to try another round of meds.
Good Luck