MRI-03-2022 found two areas that had lesions, one was PRIRADS #4 other was PRIRADS # 5
Biopsy 04-2022...12 cores taken.....7 were Gleason 3+3 =6........3 each were found in each lesion and 1 other.
NOW......my urologist suggested Proton Therapy. The Proton Therapy suggested AS. DaVinci surgeon suggested surgery. (of course). Another urologist suggested surgery . All that is left is an upcoming appointment with a SBRT Doctor at John Hopkins.
I think the most good indirect information I have received is reading "The Active Surveillor"..Thank you.
This is just a "sidebar", I also have some lung concerns, minor at this time, but could become serious. Something I was told by my Pulmonologist (after several CT's) that some of the damage to my lungs "could have" been caused by a general anesthesia when I had my biopsy. Saying that, he suggested that I "limit" getting a general anesthesia......biopsy, surgery etc.
Saying all that, surgery for by prostate isn't a consideration now. (Actually, never was) That adds to helping me to go the AS route, but still talking to anybody who can help educate me. (Knowledge is power)
So I will get my MRI and do my PSA as needed and go from there, and when and if the time come I will have to make another choose!!!
Thank you Howard for all the information you provide, it has really helped me along with many others am sure!! My hats off to you!!
Bert is hinting that he has joined our Active Surveillance Book Club. He will be reviewing these important books in a matter of days. BTW, feel free to contact me about reviewing a book on prostate cancer yourself.
In general, the 10 year survival for prostate cancer, whether treated or not, is similar.
Older men are at greater risk for higher-grade cancer. Yet we are still recommending PSA monitoring which has a 78% false positive rate. Furthermore, high-grade prostate cancers may not produce much PSA.
Then we still recommend the risky prostate biopsy which samples blindly and randomly only 0.1% of the prostate or, we recommend the MRI where there is a problem with errors-of-interpretation amongst radiologists. AS is not only embarrassingly unscientific but, it has yet to show irrefutable and reproducible evidence that it saves significant numbers of lives. We already know from previous studies that neither PSA testing nor prostate cancer surgery save significant numbers of lives. PSA testing is the definition of insanity.
Bert, thanks for weighing in. The PSA ain't great. Agreed, Some days I wish I never had one. I would have avoided 12 years of AS just because I had a ":bad" prostate day and a urologist found a single core of a lame cancer. The cancer never was seen again. My urologist told me that if I came in as a fresh patient today, I probably would never have had a biopsy and never would have been diagnosed with my so-called (Gleason 6) cancer. Woulda, coulda, shoulda. I can't unring the diagnosis bell. There are endless loops of debate about PSA and how it puts most of us at risk of over-diagnosis and overtreatment, while others point out PSA helps save lives. AS can spare patients from unnecessary treatments without concern of dying. But Bert are you saying we shouldn't have PSAs at all? Maybe someday. Dr. David Carter presents an interesting twist on this: https://www.medpagetoday.com/special-reports/apatientsjourney/97991 Note: Deciding to undergo PSA testing is between you and your doctor.
Why? Because, urologists own clinical studies have concluded that PSA testing and prostate cancer surgery fail to save significant numbers of lives.
and, the 2 amazing books
The rise and fall of the prostate cancer scam
and, the Great prostate hoax have confirmed the deception surrounding PSA testing an prostate cancer surgery. The prostate cancer narrative is simply an excuse for licensed medical malpractice.
Thanks for you service and kind words, Joe.
I should remind you I am not an MD though I do know a lot of them.
Sounds like you have high-volume Gleason 6.
Some docs would send you for treatment. Not all would.
So AS is not necessarily no longer a consideration.
You need all the info you can get.
Have you had a second opinion of your slides? Who did the first read? Hopkins-Epstein?
Get a second or third opinion.
Have you had DNA or genomic testing.
What about multi-parametric MRI?
What results do you have?
Each one of these are factors to help you figure out the puzzle.
You are fairly young so some docs would consider that a concern.
Your PSA sound OK--unless you had a steep climn. Some docs don't worry until you hit 15.
Your lungs were hurt in a transrectal biopsy?
Consider staying awake with a transperineal biopsy.
Consider going to the AnCan.org support group for AS on Wednesdays at 8 pm. Eastern.
Remain calm.
My AS story.......first my details;
61 yrs old
PSA tracking-2013-2.5.....currently 4.75
MRI-03-2022 found two areas that had lesions, one was PRIRADS #4 other was PRIRADS # 5
Biopsy 04-2022...12 cores taken.....7 were Gleason 3+3 =6........3 each were found in each lesion and 1 other.
NOW......my urologist suggested Proton Therapy. The Proton Therapy suggested AS. DaVinci surgeon suggested surgery. (of course). Another urologist suggested surgery . All that is left is an upcoming appointment with a SBRT Doctor at John Hopkins.
I think the most good indirect information I have received is reading "The Active Surveillor"..Thank you.
This is just a "sidebar", I also have some lung concerns, minor at this time, but could become serious. Something I was told by my Pulmonologist (after several CT's) that some of the damage to my lungs "could have" been caused by a general anesthesia when I had my biopsy. Saying that, he suggested that I "limit" getting a general anesthesia......biopsy, surgery etc.
Saying all that, surgery for by prostate isn't a consideration now. (Actually, never was) That adds to helping me to go the AS route, but still talking to anybody who can help educate me. (Knowledge is power)
So I will get my MRI and do my PSA as needed and go from there, and when and if the time come I will have to make another choose!!!
Thank you Howard for all the information you provide, it has really helped me along with many others am sure!! My hats off to you!!
JFrevele
Retired USMC
If you like the newsletter, it's free. But subscriptions are accepted. I have to pay my assistant.
Bert is hinting that he has joined our Active Surveillance Book Club. He will be reviewing these important books in a matter of days. BTW, feel free to contact me about reviewing a book on prostate cancer yourself.
In general, the 10 year survival for prostate cancer, whether treated or not, is similar.
Older men are at greater risk for higher-grade cancer. Yet we are still recommending PSA monitoring which has a 78% false positive rate. Furthermore, high-grade prostate cancers may not produce much PSA.
Then we still recommend the risky prostate biopsy which samples blindly and randomly only 0.1% of the prostate or, we recommend the MRI where there is a problem with errors-of-interpretation amongst radiologists. AS is not only embarrassingly unscientific but, it has yet to show irrefutable and reproducible evidence that it saves significant numbers of lives. We already know from previous studies that neither PSA testing nor prostate cancer surgery save significant numbers of lives. PSA testing is the definition of insanity.
Bert, thanks for weighing in. The PSA ain't great. Agreed, Some days I wish I never had one. I would have avoided 12 years of AS just because I had a ":bad" prostate day and a urologist found a single core of a lame cancer. The cancer never was seen again. My urologist told me that if I came in as a fresh patient today, I probably would never have had a biopsy and never would have been diagnosed with my so-called (Gleason 6) cancer. Woulda, coulda, shoulda. I can't unring the diagnosis bell. There are endless loops of debate about PSA and how it puts most of us at risk of over-diagnosis and overtreatment, while others point out PSA helps save lives. AS can spare patients from unnecessary treatments without concern of dying. But Bert are you saying we shouldn't have PSAs at all? Maybe someday. Dr. David Carter presents an interesting twist on this: https://www.medpagetoday.com/special-reports/apatientsjourney/97991 Note: Deciding to undergo PSA testing is between you and your doctor.
Yes - stop this insanity of PSA testing
Why? Because, urologists own clinical studies have concluded that PSA testing and prostate cancer surgery fail to save significant numbers of lives.
and, the 2 amazing books
The rise and fall of the prostate cancer scam
and, the Great prostate hoax have confirmed the deception surrounding PSA testing an prostate cancer surgery. The prostate cancer narrative is simply an excuse for licensed medical malpractice.