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Active Surveillance (AS) Update

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Posted 5/23/2015 3:16 PM (GMT 0)
Had my 5th 3 month AS checkup on 5/20 and I'm happy to report that my PSA is still pretty low at .74.

I read this forum almost daily and I generally post my results every 3 months to help advocate for Active Surveillance, even for us "younger" guys. Every time I have had my checkup I am so relieved that A.) I found this forum, and B.) It gave me the information and strength I needed to buck my doctors very strong recommendation to have RP.

One other interesting note... I have read that having sex prior to a PSA test will elevate your levels. I generally abstain the night/morning before my checkups but this time I forgot I had the appointment and did the deed with my lovely wife in the morning, just a few hours prior to the blood draw. Since my PSA is pretty low generally I was afraid I might get an elevated reading and cause some concern. I was all ready to tell the doc that the reason for the elevated numbers were because of this. Well, he came back with the .74 so no need.

Anyway, all is good. Thank you all for this forum, and all you guys out there with a low to intermediate risk, please consider AS.

Best,
GeetarMan
Posted 5/23/2015 3:28 PM (GMT 0)
Great PSA number,
Keep them low numbers coming.
Andrew
Posted 5/23/2015 4:04 PM (GMT 0)
Great report. What is causing your low psa since bx?
Posted 5/23/2015 4:06 PM (GMT 0)
GeetarMan, congratulations. I'm really happy for you. I'm glad things are going so well and I hope you will continue to weigh in here occasionally so people know how well AS can work. Many of the rest of us can "talk the talk" on AS but you literally "walk the walk" with great cred.

Jim
Posted 5/23/2015 4:14 PM (GMT 0)
GeetarMan,
Good for you! I know that you are glad you bucked your docs very strong recommendation for surgery! Good luck in the future!
Posted 5/23/2015 4:23 PM (GMT 0)
I've the same question as Andy2000:

Can you any way account for the drop in three months post BX from 2.85 to 0.7?

Did you make any changes in exercise, diet, supplement - anything? Looks like you toggled an immune system switch. Where on the anatomy is that baby found?
Posted 5/23/2015 4:33 PM (GMT 0)
Thanks all. Just trying to do my little part to help others avoid unnecessary surgeries. Having said that I understand that the definition of "necessary" can differ from person to person. I would never criticize anyone's choice.

Andy2000 - The topic of "why the decrease in PSA since my BX" has been a topic of discussion both here and with my uro. If you look at my stats, they only found a very small amount (<5%) of G6 adenocarcinoma in 1 out of 10 cores. These results were confirmed by Bostwick Labs at Johns Hopkins.

One thing is for sure, my PSA was high for my age and had increased alarmingly over the course of a year, and it dropped significantly immediately after the biopsy.

This leads me to think there are only a few explanations...

  • The cancer healed itself
  • The biopsy removed the cancer
  • I never had cancer


Regardless, this absolutely argues for a "wait and see" attitude, combined with more tests, education, and second opinions, before proceeding with any intensive treatment for guys with low to intermediate risk diagnoses. I see guys jumping into surgery all the time with similar stats to mine and it's my opinion that it's over-treatment in a great many instances.
Posted 5/23/2015 4:35 PM (GMT 0)
And no... I have not changed my lifestyle, diet, or anything. I made some noises about it early on, but truth be told, I've done nothing by way of lifestyle changes.
Posted 5/24/2015 12:32 PM (GMT 0)
GeetarMan, With your stats I would think you have no or a insignificant amount of PC. You know what they say, 50% of 50 year olds have PCa and most of these men are walking around not being aware they have it. It is unfortunate your PSA spiked which lead to the biopsy. If it didn't you wouldn't be here. Do you have any plans of pushing your psa testing to yearly.
Posted 5/24/2015 3:01 PM (GMT 0)
I'm happy to continue with the testing every 3 months. It's a simple test and my uro is in the building right next door to my office, so it's very convenient. I suppose if the PSA stays level for a couple years I might be able to go back to yearly.

I really do not think I have PCa, or what I do have should not be considered as PCa, but I want to remain on this forum advocating for AS. If I would have had the surgery, I could be sitting here right now suffering from God knows what side effects and a clean post-op pathology. Wouldn't that be a kick in the pants?
Posted 5/24/2015 3:05 PM (GMT 0)
What's really weird us my PSA is back down in the range it was 5 or 6 years ago when I first started to get tested when I turned 50.
Posted 5/25/2015 5:54 PM (GMT 0)
Glad to hear that you are doing well, and showing less evidence of PCa. I would doubt that you don't have any now, just that you only have a small amount. My last biopsy was negative, but I am sure that it is still there, just maybe not enough to worry about.

You appear to be the ideal patient for AS, and want to be involved in the monitoring and research news. Not all guys can handle this, but those who do, seem content with their decision. New interventions, such as focal therapies, are making progress, and there may be less traumatic options in the future, if our cancers need treatment.

The usual advice on sexual activity before a biopsy is 48 to 72 hours. I've had urologists advise me five days, and even seven days, although that advice seemed extreme.
Posted 5/25/2015 6:50 PM (GMT 0)
Glad to hear your good news. I'm in year 6 of AS. Without this forum I would have never known what AS even was. My 1st uro never mentioned it, it was his opinion that the quicker it comes out the better.
Posted 5/25/2015 7:02 PM (GMT 0)
Let me add my congrats to you and wish you continued success. And glad you keep posting about your results as it shows that AS can be sensible approach for many of us.
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