PSA confusion, Brachy, and AS

Your husbands PC is not following the rules and you are very wise to jam on the brakes and find out what's REALLY going on. A high PSA caused by PC seldom goes down unless it is being treated....You might benefit greatly by having a Color Doppler Ultrasound performed, or some other advanced scanning method, even if it means traveling to a distant treatment center to get it...Your case is unusual so you should explore all avenues before you accept a standard treatment for a cancer that is not behaving as expected..

Kuls,

I too had a PSA increase after my first biopsy.  After that, it went down slowly.  PSA does not diagnose cancer.  It can be an indicator of several problems, one of which could be cancer.  If your husband's first biopsy was in Feb. 2010, that's when he was diagnosed with cancer.  You get the diagnosis from a biopsy.  The stats you report from that Feb. 2010 biopsy are within the guidelines of most Active Surveillance programs.  PSA doubling time and velocity are problematic in your case as indicators since it goes up and down, just as mine did.  Remember, PSA doesn't measure cancer.  The PSA doubling time,  PSA density, PSA velocity, or an abnormal DRE can be indicators that a repeat biopsy might be in order for someone on AS.  I wouldn't dream of suggesting a treatment or tests.  You've done your research and that's your business.  I've been on AS four years and have no problems sleeping at night.  Periodic repeat biopsies have not changed my course.  The grief over posting about AS keeps me off the boards for the most part.  Since it appears that your husband and you are considering it, I would like to suggest checking the guidelines, or even better, get an appointment at one of the major cancer centers that use AS as an option before going forward with it.  Best wishes no matter what path you follow.  Your choice will be the best for you.

Boo   

Dear Kuls:

As you can see from reading the various recent threads on this board, AS is not without controversy particularly in a man as young as your husband...even though his statistics read very early stage.  I agree with Fairwind and JT and would also suggest that a color doppler at this point might be appropriate. In any case, a 10 core biopsy is hardly state of the art and there is a good chance that something was missed.  I would also go a step further.  The oversight of AS requires a specific regime of testing (reference Franchot's posts).  This oversight also requires an experienced physician, IMHO.  In general your RO may or may not be equipped with the knowldege to do this correctly.  If it was me, I would be consulting a protate oncologist at this point who can guide you further.

If you ultimately do decide to go the brachy route, it would seem to be a good choice from what I see of your husband's stats.  Assuming his urinary and sexual functionality are good now as well as his physical condition he would have an excellent chance of retaining those functionalities post BT.  Several of us on this forum have done quite well (so far) with that treatment.  Feel free to cut and past the link in my signature if you would like to see how my "journey" has gone.

Best of luck and please keep us infomed of his progress,

Tudpock (Jim)