A friend need help

The guys who know what they are talking about will be here in a minute, but if you want a shoot-from-the-hip opinion, I'd say he is very much a candidate for AS.

Continuing to pretend to know things beyond my pay grade I will add that the presence of that one, 30% core is almost a good thing. Faced with samples like the other two cores -- less than 5% involvement -- a pathologist is making grading decisions with a tiny little bit of tissue to look at and the possibility of mis-grading is higher. But with that 30% core they got a good look at it and the generally-favorable Gleason 6 score is much more likely to be correct.

Assuming I am right his doctors will probably want a fancy MRI to get a better feel for the size and location of the tumor and then they'll want to see him again in a couple of months.

Thank you Peter and Allen, I'll pass the word to him. I also suggested that he joins our Forum and post his stats.

Ed, I agree with the others who say that your friend would seem to be a good candidate for AS. Of course, a second biopsy opinion and advanced MRI testing would seem to be valuable if he decides to go that way. Additionally, here is the link to a blogradio program wherein Dr. Klotz discusses AS. If your friend is not too familiar with the protocols, he might find this interesting and educational. www.blogtalkradio.com/curepanel/2014/03/19/active-surveillance-in-prostate-cancer-with-dr-laurence-klotz?Aid=CJSource&utm_source=CJ&Pid=3747368

Jim

What is the protocol to follow on AS. Does it require annual biopsies? semi annual PSA?

One feature of some of the protocols that I like is a confirmation biopsy that attempts to sample the anterior area of the prostate -- a location that is frequently missed in a standard sextant biopsy. repeating the same biopsy will tend to give the same result which is a problem if the previous one missed something.

This factor looms large for me because, after four different sextant TRUS biopsies, both of the surgeons I talked to suggested AS, never suspecting that my post-op pathology report would show a large G9(4+5) cancer and positive margins.

Ed,
Also inform your friend that men over 65 have no survival benefit with low risk cancer.

Old67
You're stats look fabulous! I'm jealous!
Bob

My friend's has low T so his urologist prescribed testosterone even though he was diagnosed with PCa. does that make any sense? Is that normal?

There is a growing consensus among researchers that once a man gets well above castrate levels of testosterone (even if still well below normal) additional circulating testosterone makes very little difference to any cancer cells he might have. It's a bit like walking across a frozen pond. If the water is under 32 degrees you can walk on it. If it is a degree warmer you better be able to swim. Warming the water a bit more doesn't increase the chance of drowning, it just makes the swim more pleasant.

All of that said, it takes a nervy doctor to give T to a man with prostate cancer.