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Thread: What I Need to Know About Active Surveillance

  1. #151
    Moderator Top User HighlanderCFH's Avatar
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    Quote Originally Posted by Another View Post
    As I understand it, Chuck had his prostate removed because he soon was going to have to start carrying it around with a sling, use a catheter to urinate, and had already lost his erection function. Death isn't the only threat to health created by prostate cancer. Just to be clear. My own tumor had begun to create incontinence, yet it had been biopsied at a G6 while growing to 8 cores of the 12 samples. When you're clearly not a candidate for AS you know it regardless of the protocols you may want to manipulate with wishful thinking. I am not being critical of advocacy for AS. In our culture we have an automatic rush to treat drioven by so many medical successes.

    My personal view is we will not know the impact of the newer AS programs for some time. With it comes the new delimema of what percentage of failure warrants the loss of early treatment. That has been the mantra to date that is now under question brought to the surface by the magnitude of the failures in the learning curve of the treatments themselves. It appears to be a pendulum.

    My own mother is waiting to die at 96 hoping for whatever it may be that releases her from this world. It will probably be subcumbing to a antibiotic resistant bacteria as she is now on a regime of Cipro to deal with chronic urinary infection. I remember making this observation to my broither when this began for her, and his response was she can only hope that's true. In the face of maybe being able to choose my path do I want it to be prostate cancer that takes me? The slow nature of it, percentage of benign occurances, low morbidity, lengthening life span, and the expanding affluence of retirement makes this such a difficult disease to balance, imo.
    Indeed, the G6 PC that I got was actually a blessing in that it solved my urination problems.

    Wishing the best for your mother!
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Five annual post-op exams 2012 through 2016: PSA <0.1
    Semi-firm erections 5 years post-op whenever the moon turns blue.
    NOTE: ED caused by BPH, not the surgery.

  2. #152
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    Quote Originally Posted by Another View Post
    My personal view is we will not know the impact of the newer AS programs for some time. With it comes the new delimema of what percentage of failure warrants the loss of early treatment. That has been the mantra to date that is now under question brought to the surface by the magnitude of the failures in the learning curve of the treatments themselves. It appears to be a pendulum.

    I don't know about that, even though relaxed requirements for AS haven't been around for a long time- there have always been a number of men who have declined treatment against medical advice with localized PC, the data is out there. There are a lot of men with indolent disease, or PC that is marching slowly.

    A gentleman I met is 85, was diagnosed with Gleason 7 PC at age 70, backed out of braccy therapy on the day of the procedure and never received treatment. Still doing fine, although his PSA has gone up to nearly 30. I'd say he stands a pretty good chance of dying of something else- despite declining treatment AMA.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2.

  3. #153
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    Oh, I'm sure of that. One of them won't be me. As I said, my mom is 96. One grandmother lived to 88. Two other grandparents lived to mid 90's. With my prostate gone hopefully it's marching too slowly to matter for me. 70 is nothing these days. Imagine what it will be in another 20.

    My father died early at 67 of kidney cancer. Took him quick, 1 year. Not the case with prostate cancer. That's the tragedy of this disease. The good news is it's slow. The bad news is it's slow.

    One grandfather who lived to 95 had his prostate removed in his 60's and lived with incontinence for more than 25 years. Life expectancy then was probably early 70's. He died of something else - without his prostate. There's more than one way to beat this disease. This was well before DaVinci.
    Last edited by Another; 10-08-2017 at 01:47 PM.

 

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