Safe to wait?

With a G6 and only 2 cores showing PCa why not look into active survaillence and put off surgery for now. What is your PSA?

PSA is 4.01. 58 yrs old. Two doctors both recommended removal with an understanding, based on results, urgent removal was not required. Active surveillance was discussed as an option. Looking for advice from this board on what is the best decision for now.

VPOP,, active surveillance sounds like a reasonable choice for you right now. Your age of 58 and just starting a new job has you in the spot of not wanting to "rock the boat" if at all possible. A PSA of 4.01, Gleason 6, and two doctors that feel there is no need to hurry anything right now are good indicators that you should be monitoring your prostate situation for changes but no serious action needs to be taken right now.

AS requires frequent (3 months) PSA testing, and yearly biopsy, with much more involved analysis by experts of your original biopsy specimns to decide that is the route to go. Thewre are a couple more tests that should be done, to provide additional info. in your decision. First step would be to get a second opinion reading of the samples by an authoritative path. lab. Second is to know every little detail of what the report says, especially the percent of disease in each core, as larch says.

All that said, we aren't medical professionals, we can't offer medical advice here, but only our experience and you should take it as such. You have a lot more research and thinking to do before making a decision for or against AS.

based on everything you have supplied, it would seem on the surface, that you could safely practice AS, until the timing of things are better for you in terms of treatment. but please remember, we are not doctors here, nor can we give direct medical advice.

also, don't assume that recovery will be quick from surgery. while that is often the case, there is no guarantee of that, not even with robotic surgery if that is what you are considering. also, don't underestimate the side effects risks from surgery. if you study the cases here of us surgery guys, incontinence and ED are all ove the spectrum. if you choose surgery, you stand the risk of long term incontinence and severe ED issues. many posts here at HW deal with both these subjects in great detail.

during the time that you practice AS, if that is what you choose, you can use the time to further educate yourself on treatments. with stats as low as yours, you would be open to all primary treatments, including radiation, either conventional or with seeds, they are typically less invasive on the front end, though side effects can hit you at a later date.

good luck to you, glad you found us, sorry you need to be here at all. take your time, and think through any treatment decisions, as there is no "re-set" button if things go wrong.

david in sc

VPOP,
AS others have said AS shouldn't be a problem. You should also look at things that will slow down your cancer growth while waiting. Diet and excercise have been shown to slow progression of low risk cancer along with taking Adovart. Pick up a copy of "Invasion of the Prostate Snatchers" by Dr Mark Scholz as it is the best referene on AS.
JohnT

VPOP.......

I am an active surveillance PCa guy, see my signature which is very similar to yours. I had 5 of 12 cores positive with less than 5%, Gleason 6 (3+3), PSA peaked at 6.1 and came down to 4.7, DRE was normal, PCa was rated very low grade, low risk at this stage. My urologist recommended AS. We had established all of the baseline stats to monitor. My journey included PSA and DRE checks at every 6 months and a second follow up biopsy at 14 months. Even though my PSA went down and the DRE was still normal, my 2nd Bx showed some advances on G6(3+3) to some G7(3+4) albeit only 5% to 10%. So I was on AS from Sept 2010 to surgery Feb 2012.

Check out Johns Hopkins website at http://urology.jhu.edu/prostate/cancer.php and be sure to watch Dr Patrick Walsh's video and also Dr Carter Ballantine's audio on AS - both are extremely informative for you.

So my advice given only my own personal experience and journey is you also are a good candidate given your stats for an AS program prior to moving to curative treatment. Confirm this with your URO. In the meantime enjoy life, get established in your new job and keep busy living!!!!

Keep us all posted.

Terry

Keep us all posted