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Posted 4/26/2017 3:12 AM (GMT 0)
Tomorrow is the day my love meets with his urologist to discuss treatment options (which I feel we already pretty much know). I'm sending him with his pages of questions including asking for Prolaris test and paperwork for John Hopkins second opinion. He has finally agreed to ask his brother to sit in with him and doctor and he is taking a mini recorder with him hoping he can record it. Prayers please for clarity and for calmness for me while I wait to hear from him. His appointment is 10:45.

I'm praying for AS but not too sure doc will support it. He is 69 (closer to 70)...PSA was 4.5 April 2016 and 4.85 October 2016... was told at last appt when C bomb was dropped there was cancer in 1 of 12 cores and on a scale of 1-10 it was a 6 (we now know 6 isn't an awful thing thanks to the internet). Prostate is enlarged...we think 60cc and he was told there were stones at time of biopsy.

Post Edited (joyf00) : 4/25/2017 9:19:15 PM (GMT-6)

Posted 4/26/2017 3:45 AM (GMT 0)
Oh no, I thought that I had posted a long reply here. Where did it go?

Anyway, the decision is his and his supporters, not that of one specialist.

Anything other than active surveillance would need a LOT of explaining.

In Sweden, where the government decides the treatments, 90 percent of men in his situation choose AS after their doctors recommend it. Here, where medical care is for-profit, about 60 percent of the men like him are ushered into surgery (by surgeons), with all its side effects. Not good...not right. Of course, the Swedes live longer.

Best wishes for his decisions.
Posted 4/26/2017 7:58 AM (GMT 0)

ASAdvocate said...
In Sweden, where the government decides the treatments, 90 percent of men in his situation choose AS


Just a minor correction, it is the patient that makes the decision together with the health professionals. I think information and education is the key here together with that there is no profit interest when health care is tax-financed. I for sure made the treatment decision but was no candidate for AS with G4+3.

"In a study of nearly 33,000 Swedish men with very low-risk (stage T1) prostate cancer diagnosed between 2009 and 2014, the number choosing what is called active surveillance increased from 57 percent to 91 percent during that time frame."

Source:
www.health.com/healthday/monitoring-not-treatment-may-be-better-some-prostate-cancer-patients

Post Edited (Gemlin) : 4/26/2017 3:53:44 AM (GMT-6)

Posted 4/26/2017 10:16 AM (GMT 0)
Joy, with 1 G6 core, especially at age almost 70, AS needs to be high on his list. Like really high. G6 is the lowest detectable level, and with only 1 core, he would qualify for any AS program. The whole point of AS is to keep a close eye on things and act aggressively if and when something progresses. Which, about 1/2 the time it does, and about 1/2 the time it doesn't.
Posted 4/26/2017 11:09 AM (GMT 0)
ASAdvocate...you did respond with a longer post in the other grouo. I thank you so much for your input and will keep everyone updated. I guess the big thing is for that one core to be under 50%... I don't want to be greedy but I'm praying for a 5%.



ASAdvocate said...
Oh no, I thought that I had posted a long reply here. Where did it go?

Anyway, the decision is his and his supporters, not that of one specialist.

Anything other than active surveillance would need a LOT of explaining.

In Sweden, where the government decides the treatments, 90 percent of men in his situation choose AS after their doctors recommend it. Here, where medical care is for-profit, about 60 percent of the men like him are ushered into surgery (by surgeons), with all its side effects. Not good...not right. Of course, the Swedes live longer.

Best wishes for his decisions.

Posted 4/26/2017 11:11 AM (GMT 0)
Thank you also Gemlin and halbert. Gemlin I will be printing off your link and giving to him tonight.
Posted 4/26/2017 12:12 PM (GMT 0)
joy,
I think that if I was his age and there was great certainty that I was only G6 I would likely choose AS. I would stay on top of it though. Surgery or any other type of treatment are options to consider but are not necessarily requirements. Take your time, learn and make informed decisions. Your husband should know he is empowered. The doctors are there to help.
Posted 4/26/2017 12:56 PM (GMT 0)
I can't add anything to the previous posts. They are spot on. Please take their advice.
Posted 4/26/2017 1:05 PM (GMT 0)
joy - I was 68 at time of diagnosis and I, too, had a fairly favorable diagnosis. The ONLY reason I chose active treatment over AS was that I did have one core that was read as G3+4=7. For this (since it included G4 cells) I went on to SBRT.

Had I been diagnosed with G6, I think my decision would have been AS. None of the active treatments are devoid of side effects, and unless there was a real need to treat, I would have wanted to delay those side effects as long as I could.
Posted 4/26/2017 5:26 PM (GMT 0)
UPDATE.....

Doctor (urologist) spent about half an hour with my love. He asked first if he had any questions and said they would start with those. My man pulled out the questions I had prepared for him and the doctor started completing it for him. When he got most of the way down the first page he commented on how much he liked what I did and asked if he had another copy with him that they could keep on hand. He did (I sent him well prepared lol).

As for the discussion... Doctor said I have to offer you surgery and radiation but my best suggestion is Active Surveillance (answered prayer). He commented that it was unlikely for the cancer to spread. Where I asked about the genetic testing he wrote (I think.. doing the best I can with his writing) PTEN/ERG Promack -- very low risk catagory. He is a stage T1c... core was 12% cancerous. Prostate is 60 gms (not sure what it is suppose to be as I was thinking before he said 60 cc). He noted his last PSA was 5.5 (which must have been off bloodwork we don't have a copy of).

My guy goes in July for bloodwork and then to his GP in August. October 26th he goes back to Uro and is to get PSA a week before.

Thank you for all for your information and for calming my nerves as I waited for the news.
Posted 4/26/2017 5:31 PM (GMT 0)
Congrats. Active Surveillance definitely seems like the way to go.
Posted 4/26/2017 8:24 PM (GMT 0)
Now there's a cause for JOY!
Posted 4/26/2017 8:31 PM (GMT 0)
Great choice!

Andrew
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