Active Objective Surveillance

Well another dilemma for me to add to the mix, after talking with my VA urologist who referred me to the oncologist .He looked over my record and said I had at least 5 to 6 more years to live before I would even feel any effects. He threw the ball back in my court, asked me to think about it for a few days, gave me his cell and invited me to talk to him anytime or stop by his office for discussions if I like. Asked him if there is a way to tell if it is still contained within the prostate which he was a bit nebulous about and even advised against getting another biopsy in 5 months (because we already know you have cancer) which the urologist recommends. I have been on active objective surveillance since Apr 2014, Gleason score 7 (3+4), PSA was at 5.3 in Apr, 3.8 in Sep and 6.3 this month. I have already had a second opinion with another urologist outside of the VA system who said the same thing. Do any of you see any reason for me go through brachytherapy? I am fine with another 5-6 years since I am 71 and would like to be around to care for a spouse with Alzheimer’s who is 81.

Thank you Miki, there is a lot of information here and I am still trying to get through as much as I can. I am so thankful that you provided the link.

TRaymond. Welcome to HW. Sorry you have had to join us but you will find a wealth of information and experience here from all the great guys and girls.

Your question is a tricky one to answer. Mainly because as Tall Allen said we do not know if you have any other medical conditions that could determine if you should consider treatment. At your age and knowing that PC grows very slowly there is chance you will die with PC rather than from it. Around 80% of men aged 80 will have some degree of PC and many may not even know it. It is the nature of the beast.

I am also a 3+4=7 and had LDR brachy a few weeks ago. If you read my thread "The seeds have been sown" you will see I am doing fine. My doctor told me if I was a G6 then he would of wanted me to go on AS, but the grade 7 cells were the reason he advised me to have treatment.

You mention that you are caring for your sick wife. With LDR brachy it is the quickest, least invasive and offers the least risks with regard to side effects. This type of treatment could certainly work well for you and your ability to continue caring for your wife.

Nobody here is going to try and persuade you to have any particular treatment. That is a choice only YOU can make. All we can do is support and guide you through our own personal experiences.

If you have any further questions then please ask.

All the very best to you and your wife as you move forward.

Raymond,

Tall Allen gave you excellent advice. He usually does that. The only thing I might say differently is that I don't see the need to wait for the mpMRI scan to get some more information about the extent of the cancer. Active surveillance is all about watching for changes and the earlier you get a baseline for comparison the better idea you can get of how things are progressing. And, if you did decide on treatment, the scan would help you and your doctors evaluate your options.

While I don't know your situation I have to admit to being skeptical about your "five more years is enough" thing at 71. I don't come from particularly long-lived people but my dad is 87. Candidly, he is getting a bit vague and starting to really slow down, but when he was 84 he was still practicing medicine (he worked at a free clinic) and was sharp and active.

Mark Twain once said...

"The only people who don't want to live to be 100 are those who aren't 99".


I've had similar thoughts about just "riding it out" (albeit, for different reasons).

If it can be cured, well, as Forest Gump says..."One less thing".

Welcome to the forum you never intended to be but a place that offers help and great advice. You have already heard from some of the sage people in HW who have given experienced and researched advice.

I am not sure why they did not recommend a second biopsy from a prominent like Epstien as explained in the sticky thread above and advised on numerous threads.

I had to personnally figure out for myself that my PSA hikes were aligned with unfavorable future risks. I say this because my MD was the typical "don't worry because you are under 4". Now I wish I would have caught this thing before my PSAv and PSAd were troublesome figures. I am also a GS 3 + 4 and did not even consider AS because at the time low intermediates were told to take some time but take some action in the near future.

I am a Great believer in LDR because of the excellent advice I received on this forum. I had very few SEs, no penile shortening, no ED, and no incontenance. I normally respond to guys who are thinking about LDR because I have been through the process and want to help if possible.

Talk to people who have been through this, no matter what route they have taken, continue your research, and take care of that lady who has brought so much joy into your life. I wish you the very best and please keep us posted.