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test results and Urology Doctors letter to primary physician

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Posted 1/13/2015 1:34 PM (GMT 0)
Good morning to all,, new on forum and looking for answers..rec test results and shows psa 5.3 with Gleason score 3+3 and 21% of tissue with a test of 1 of 12 sites...rigtht now (test results were aug 14) doing watch and wait return Feb15 for psa and urinalysis..Dr wrote a basic synopsis to primary physician just basically detailing cold hard facts and nothing else.. I am 63 years old as of this Jan 16..no other heath issues...is this a pretty standard way to address this issue or should I maybe see about another opinion ..just reading the forum and becoming familiar with all this and really dont have anyone else to bounce ideas off of.. Thanks for any info..
Posted 1/13/2015 2:12 PM (GMT 0)
Hello Driver and welcome. Sorry for your cancer diagnosis but you came to the right place to discuss it. Not undergoing radical treatment is a smart thing for you with your diagnosis, IMHO. You pretty much have the mildest diagnosis any of us could hope for.

However "watch and wait" is old terminology and not descriptive of what should be done which is "active surveillance". Beyond just routine PSA tests, an active surveillance program might require MP-MRI testing or further follow up biopsies You should also get a re-reading of your biopsy slides from an expert prostate pathologist such as Dr. Epstein at JHU or Dr. Bostwick at Bostwick Labs.

The studies show that even if your cancer does progress, future treatment is just as effective as treating it now so, with AS you should be ok...just don't forget the "active" in AS.

Best of luck and please keep us posted,

Jim
Posted 1/13/2015 2:31 PM (GMT 0)
1952 (my birth year also),
Tudpock is right on (he often is). My stats were similar to yours and I did the AS (although it was called watchful waiting then) for almost two years. During that time I had no symptoms, of course, and no SE's. I would have done that indefinitely except that at the two year point, my cancer became 'significant' and needed to be dealt with, which it was with no complications from the two years on AS. I knew a guy who was able to do AS (WW then) for 11 years before any treatment was needed. It is indeed a valid path as long as you are under the proper guidance.
Best to you.
Posted 1/13/2015 11:28 PM (GMT 0)
I have little to add to Jim's excellent advice,

Some guys on Active Surveillance find that joining a PC Support Group helps them stay the course. There is a lot of mythology about cancer floating around out there, and many well-intentioned friends and family may say things that may lead you to question that decision. Sometimes a peer group will give the assurance you need so that you don't start to think you're crazy.

If you have BPH as well, Proscar or Avodart, aside from relieving any of the associated symptoms, may enable you to stay on Active Surveillance longer. If nothing else, it re-sets your baseline PSA so that it becomes a more sensitive measure of cancer progression. PHI, a new blood test, may be a better measure for tracking than just PSA.

- Allen
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