AS (with Gleason 7) update

It's been 20 months since my diagnosis in April of 2014. My local urologist has changed the frequency of my PSA tests from every 3 months to every 6 months; my last test on 11/03/2015 was 2.2 ! My doctor thinks I might be taking Finesteride on the side...

The docs at MD Anderson only want to see me once a year.

All is well for now...

peanut307 said...
Just curious, have you made any drastic changes that would explain such a big decline in PSA?

I have done just a few things... I have been deficient in Vitamin D, so I take 10,000 units a day and try to get more sun; I have cut down on eating red meat to no more than once a month, if that; and I have increased my champagne intake substantially...

Goodness gracious.

Good on you.

(Smile)

Good news! Does finasteride go well with champagne?

Great news.

Loving this thread.

I'm thinking of switching to champagne!

GOP said...
Great news, Lefty....just a quick redneck question...do you think one could substitute Coors Lite for the champagne?

GOP, I'm not a doctor, and I don't advocate any particular 'off-the-menu' treatment program, but I'd be willing to experiment with your choice of beverage...

Now, if you had said 'Bud Light,' I may have to take issue with that.

AllRIGHTY Lefty!

I shall endeavor to tread your path!

Thanks for the 2017 update!

(I guess I didn't see your earlier posts when I was on vacation, but glad to see you are closely monitoring...as called for)

Continued best wishes...!

This caught my eye. Is MP-MRI more accurate than traditional biopsy?
When evaluating the 230 men with clinically significant cancer, the MP-MRI had correctly diagnosed 93% (95% CI, 88-96) of those cancers as aggressive, whereas TRUS-biopsy deemed only 48% (95% CI, 42-55) aggressive. This indicated that MP-MRI was more sensitive than TRUS-biopsy (P < .0001).
MRI could reduce unnecessary biopsy in one in four men with suspected prostate cancer

LeftyW said...
It's been 20 months since my diagnosis in April of 2014. My local urologist has changed the frequency of my PSA tests from every 3 months to every 6 months; my last test on 11/03/2015 was 2.2 ! My doctor thinks I might be taking Finesteride on the side...

The docs at MD Anderson only want to see me once a year.

All is well for now...

Well, that is really great news! You are NOT taking Finesteride, correct?

10,000 a day of Vitamin D is a pretty stout dose, but really not any more than (or as much as) my body probably produced when I was a kid out in the sun at the swimming pool, beach or working outside often with no shirt. Of course, taking a pill is not necessarily the same as getting it from sunshine. But at the very least it does not appear to have hurt you! And something must be accounting for your improved condition, whatever it might be. I take 5000 a day, at least most days when I can remember to do so, though I take less in the summer when I am often out in the MS sunshine. Have you had yur blood levels checked? I get my blood levels checked now and then to make sure I am in the right range. Whatever that is, depends on who you ask. Maybe between 30 and 50 ng/ml?

Before I was diagnosed, I had been taking 2000/day for some months, and my blood level was "only" 30, which is "OK", but I expected a little more with that level of supplementation. After diagnosis, 10,000(again, probably not every single day because I would forget some days) got me up to 80, so I backed off to max 5000. My wife takes 2000, had hers checked for the 1st time a few weeks ago, and she was 45 ng/ml. So people vary in how much they need. Regardless, good for you, and I suppose your doc tells you that whatever you are doing, keep it up?

EDIT: OK, I apologize for the idiocy on my part. I saw the January OP and thought it was Jan this year, did not read the entire post, now that I have I see that rather than good news, after a couple of years of steadily decreasing PSA, you have recently had a spike in PSA, and though your MRI was fine, you are awaiting Bx results. Is that correct?

So, I received the results of my biopsy (No. 4) a few days ago. Two (of 12) cores with adenocarcinoma, Gleason 6. I will have the slides retested to make sure, but at this point, my doctor wants me to start Finasteride, and consider cryogenic-ablation for focalized therapy.
My dad had PCa years ago, and was treated with cryogenic-ablation, and he told me to stay away from it.

Thoughts?

Cryo has gotten a lot better since your father had it. The arguments for focal ablation (whether it be cryo, HIFU, FLA, PDT, IRE, etc.) are that it may slow down progression, have fewer SEs, and give you more years on active surveillance. The arguments against it are that it doesn't destroy enough of the cancer, often requires multiple ablation treatments, SEs depend on the doctor's skill level and there are few doctors skilled enough, SEs also depend on on size and location of the index tumor within the prostate. The other fact to consider is that some radiation therapies may have as low or lower an SE profile.

Here are a couple of articles you may want to look at:

/pcnrv.blogspot.com/2016/12/focal-ablation-unresolved-issues.html
/pcnrv.blogspot.com/2017/01/what-should-focal-therapy-be-compared.html

Pratoman said...
Lefty, I assume it's the jump in PSA that makes the Dr want to treat? Because obviously with 2 cores g6....you've been on AS for a while so why now?

My doc speculates that the jump in PSA is due primarily to prostate inflammation; pretty much all of the non-PCa cores in my recent biopsy were described as showing "chronic inflammation," when none of the previous three biopsies really said anything about inflammation. My doc wants me to start Finasteride to see if that helps with the PSA/inflammation.

We are going to monitor the PSA at least one more time, and visit about possible treatment again at that time.