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just got results of prostrate biopsy

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Posted 8/24/2017 4:02 PM (GMT 0)
one of 12 biopsies showed a left Gleason of 3+3. PSA is 4.82, rectal exam was normal and I am 64 years old. If I elect to wait and watch before I have it treated, what kind of risk am I taking?
Posted 8/24/2017 4:15 PM (GMT 0)
Welcome and sorry about your positive diagnosis. But that's a tiny amount of low-risk cancer.

Rather than "wait and watch" what you actually want to do is called "Active Surveillance" where there's a program that keeps tabs on you. There are many guys here on it and hopefully some will reply here. It's considered very safe--there's a 20-year study that shows that for low-risk guys they do just as well as those that choose treatment.

One thing I recommend before you go any further would be to get a second opinion on your biopsy slides from Johns Hopkins that specializes in reading PCa slides. You do want to confirm your Gleason 6 status. The newly diagnosed sticky explains how to do that.

Good luck to you and let us know how we can help.
Posted 8/24/2017 4:26 PM (GMT 0)
Welcome to HW.

AS, active surveillance, is a great option. We have guys here who've been on that for years. You want to keep in mind the "active" part. That is regular PSA tests, and follow up biopsies.

As long as the gleason score remains a G6 (3+3) your risk of bad things is very low.

There are AS programs out there where they can give you a better idea of risk and can do all the needed follow up testing. The trick to AS is to wait until just the moment when treatment is needed. Could buy years and years of normal life.

Well worth considering and researching.
Andrew
Posted 8/24/2017 6:35 PM (GMT 0)
The risk of active surveillance is negligible, and zero if you have a confirmatory mpMRI-targeted or template mapping biopsy within a year.
Posted 8/24/2017 7:45 PM (GMT 0)
Very low risk but not zero. The long-term follow-up study of AS patients by Klotz et al. found that after 15 years on AS 2.8% of patients have developed metastatic disease, and 1.5% have died of prostate cancer. At 5, 10, and 15 years, 75.7%, 63.5%, and 55.0% of patients remained untreated and still on surveillance.
Posted 8/24/2017 8:26 PM (GMT 0)
Gemlin-

Klotz points out that all of the patients who had metastatic disease were ones in whom the confirmatory biopsy found high grade cancer that was missed on the initial biopsy. That's why I added the caveat about the importance of that biopsy. I know that some AS programs start the clock from the confirmatory biopsy rather than the initial biopsy.
Posted 8/25/2017 3:06 AM (GMT 0)
Brent,
As already mentioned, AS is good option for low grade PCa.
It keeps all options open when treatment becomes necessary, and in meantime, you will enjoy life to the fullest.
I made a mistake going into surgery at age 51.
My Gleason was a bit higher 4+3 which fortunately was downgraded to 3+4 after surgery.
I wish I stayed in AS even against medical advice.
Surgical SE are terrible especially ED.
Before surgery never had any problems with achieving and maintaining erections, healthy, non smoker non drinking and not on any meds.
At 10 months post RP, my ED recovery did not start yet. Absolute zero down there and lost 2+ inches of length and lots of girth.
I have second navel down there where penis used to hang.
MK
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