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Re: What would you do given the following...............
How old are you Tom? That's a very important factor in my opinion. These prostate biopsies are nothing to look forward to. My Gleason was a 6 and my PSA a low 3.2 but my velocity was high such as yourself and they indeed found I had a Gleason 7 after I had my prostate removed and fully tested. I was told that this was often the case. Being younger ( 58 ) my Urologist said that in retrospect I made the right choice to have it yanked as the cancer was turning more aggressive and dangerous. I didn't want to continually keep going through the biopsy process when I kind of knew that I would eventually have it looked after anyways. It's a tough personal decision.
Re: What would you do given the following...............
I don't know or recommend, but here is what Rick K. did here in Michigan and is noteworthy: diagnosed in 1995-6 era psa 11.0 2 positive cores (back then 2+3=5) so today Gleason 6's (don't know further detailed pathology). He decided to do primary therapy doing drug combo Lupron+casodex+proscar (ADT3) or (CAB) for 13 months per Dr. Leibowitz concept, then quit and stay on proscar. He just recently got rebiopsied for the 3rd time after and no cancer is found (yet), still can do any treatment if wanted. He has normalcy as a man, he claimed. Of course it takes bravery to do this, but his results are fabulous, so for quality of life and future hold off for new options????? Not saying cured and he won't claim that either, but great results (yeah).
Re: What would you do given the following...............
G'day Tom,
I don't think you can draw any PSA velocity significance from 0.43 to 2.7 to 0.93. But the free PSA of 25% is a good sign, as is the 15% of Gleasons 6 in 1 core out of 14. Tom, I had a look at your Experiences story for a bit more background, such as your age.
If it was me, I would be having 3 monthly PSAs until June, 2013, and not having another biopsy until then, unless the PSA results give a pressing reason to do otherwise.
And rather than the June, 2013 biopsy being the very unpleasant transrectal nail-gun procedure, I would be having a 20 core biopsy through the perineum under general anaesthetic by a urologist experienced in this type of biopsy. This will also ensure much better sampling of your prostate. If this results in only one, two or even three cores of low percentage Gleasons 6, I would stay on AS with 3 or 4 monthly PSAs and, with a favourable PSA history, not schedule another biopsy for about four years, sort of like 2017.
As for AS programs at the local cancer centre, I think they are more likely to be of benefit to them and their research work, rather than to your needs and desires. If you are not happy about doing a follow-up biopsy so soon, maybe leave the program and manage your own AS program with protocols that suit you.
