(Editor’s note: Joel Axler with his favorable intermediate-risk Gleason 3+4 looked like a great candidate for Active Surveillance (AS) when he joined our young virtual support group for AS at AnCan in 2021.
Hi Joel, It sounds like you made a wise decision. I believe that an RP is a smart choice to increase long term survival for men with G 8-10 PCa disease. I was diagnosed at 72 years old with G 9-10, so the gland was removed. I had some tiny PCa cells in the margins, so the chase began. I obtain PSA testing monthly. When my PSA rose from undetectable and reached .2, I obtained the first in what has become a PSMA-PET scan every six months. I had SRT using proton beam of the prostate bed and for a met that was growing on my sacrum. At five years from diagnosis, PSA had risen to 5.0, so I had SMRT for a met in my lung and another on T-1 of my spine. I am following MDT and playing whack-a-met. I believe that had I not pursued an RP, I'd be a dead man. Chances are that I will die from PCa eventually, but my conclusion is that decisive interventional treatment has postpone my demise. Joel, once diagnosed with PCa, one's life changes. The disease becomes primary within one's life. One's own cells are mutating and changing, and the mutated cells might kill you. Life is not what it was the day before the diagnosis.
Young (50's is young to a septuagenarian) and fit--if the gland needs to come out, that is when to do it. And here we come to the dilemma: AS or treatment and the fact that early testing is essential. Let me add: better testing as well. Thanks Joel.
Thank you Joel for sharing your journey. Family health history, that includes medical grade, genetics testing, is something I never knew of largely because my older relatives kept illnesses secret, God knows why. When I asked my mom years ago when I was diagnosed PCa about my dad, she did not directly answer but replied "no problems down there". Let there be light, I say, on family health to the younger generations. Of course, some relatives may disagree and enforce privacy, but I hope not if there is genetic testing that indicates genetic variants known to cause cancer and other health burdens. The kids need to know.
Hi Joel, It sounds like you made a wise decision. I believe that an RP is a smart choice to increase long term survival for men with G 8-10 PCa disease. I was diagnosed at 72 years old with G 9-10, so the gland was removed. I had some tiny PCa cells in the margins, so the chase began. I obtain PSA testing monthly. When my PSA rose from undetectable and reached .2, I obtained the first in what has become a PSMA-PET scan every six months. I had SRT using proton beam of the prostate bed and for a met that was growing on my sacrum. At five years from diagnosis, PSA had risen to 5.0, so I had SMRT for a met in my lung and another on T-1 of my spine. I am following MDT and playing whack-a-met. I believe that had I not pursued an RP, I'd be a dead man. Chances are that I will die from PCa eventually, but my conclusion is that decisive interventional treatment has postpone my demise. Joel, once diagnosed with PCa, one's life changes. The disease becomes primary within one's life. One's own cells are mutating and changing, and the mutated cells might kill you. Life is not what it was the day before the diagnosis.
Young (50's is young to a septuagenarian) and fit--if the gland needs to come out, that is when to do it. And here we come to the dilemma: AS or treatment and the fact that early testing is essential. Let me add: better testing as well. Thanks Joel.
Thank you Joel for sharing your journey. Family health history, that includes medical grade, genetics testing, is something I never knew of largely because my older relatives kept illnesses secret, God knows why. When I asked my mom years ago when I was diagnosed PCa about my dad, she did not directly answer but replied "no problems down there". Let there be light, I say, on family health to the younger generations. Of course, some relatives may disagree and enforce privacy, but I hope not if there is genetic testing that indicates genetic variants known to cause cancer and other health burdens. The kids need to know.
Good points, Geofff. Ad thanks again, Joel.