Four years on Active Surveillance

I found out I had prostate cancer four years ago last December. I had a twelve core biopsy performed and only one core showed 5% cancer. I started taking finasteride and Flomax. I quit the finasteride last July as it was causing side effects. I had a second biopsy performed in six months as my PSA # was climbing a bit , even while on finasteride. Long story short, to date, I've had four biopsies. Only the first one was positive for cancer. The other three came back negative. Since I got off of the finasteride, my PSA # has climbed from 2.5 to 6.1, which is to be expected. I have another biopsy scheduled for July. God, this stuff is hard to deal with. I'm better today though, then I was when I first learned of the disease. I feel sorry for the new guys. Active surveillance is not easy, but for now, is the best course of action for me. My doctor said I may get lucky and never need treatment. If I do need treatment, I think I'll go the HDR BT route.

For the guys who are scared of their first biopsy, don't sweat it. It ain't near as bad as you'd think. I call the device the "Miniature Albino Alligator".

It's very common (about 50%) for there to be no low grade prostate cancer found in men on AS who are taking a 5ARi (Avodart or Proscar). This may be because it shrinks low grade cancer, and prevents new cancer from forming.

While your PSA is explained by BPH, the continued rise while taking a 5ARi is suspicious. You've had a lot of biopsies - maybe try a blood test - PHI - before having yet another one. If suspicion remains after PHI,you can either have an mpMRI-targeted biopsy (including systematically taken cores) or, for a more definitive biopsy, you can have a template mapping biopsy. For either, you have to have it done at a place that is proficient at those techniques.

foxbo54 said...
I went to Hopkins and had an MRI a couple months after finding out I had cancer. I went up there twice. I'd rather die than to go back to that horrible place.

What was so horrible, there?

Wonder why foxbo54 doesn’t chime in anymore.

Probably still lost in Baltimore trying to get home…

I have been on AS and Finasteride for 8 years now. Been 3 or 4 years since my last biopsy. My first biopsy showed 3 cores with 3+3, second showed 4 cores and last one showed one positive core. My PSA was 4.7 when diagnosed. It has been under one most of the time, two months ago was 1.11. Doctor is doing a DRE every quarterly visit and is fine with my continuing on AS. Maybe because I am now 75. I believe that because I am G-6 with stable PSA and my age the doctor is not being aggressive and I am fine with that. The biopsies are not fun but I do not find them so bad that I dread getting another.