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Thread: What I Need to Know About Active Surveillance

  1. #121
    This link is a May 2017 presentation by Dr. Laurence Klotz, of the Sunnybrook medical center of University of Toronto. Dr. Klotz has run the largest AS study in North America for over 20 years. He is a bit more "liberal" than Johns Hopkins in his AS selection criteria, especially with G7 patients. Those patients had lower success than the G6 cases. If you have the time (43 minutes) to watch, then this is best current information that you can get on active surveillance. If you are considering going on AS, then you can't afford NOT to take the time to watch it.

    https://www.urotoday.com/video-lectu...e-cancer-daily
    Last edited by ASAdvocate; 07-22-2017 at 03:16 AM.
    DOB: May 1944
    In Active Surveillance program at Johns Hopkins
    Five biopsies from 2009 to 2014. The third and fourth biopsies were positive with one core and three cores <5% and G 3+3. Fifth biopsy was negative.
    OncotypeDX: 86 percent chance of PCa remaining indolent
    August 2015: tests are stable; no MRI or biopsy this year for my AS program
    August 2016: MRI unchanged from 2/2014; PSA=3.9; FPSA=26; PHI=28. No biopsy necessary.

    A NOTE ON PSA: My readings have been erratic for over 10 years; typically being 3.5-4.2, but spiking to over 10 at times.
    These spikes are asymtomatic to me, and resolve themselves. A prostate biopsy can triple the PSA, which lasts for months.
    Last Free PSA was 26. I don't worry about PSA spikes anymore.

  2. #122
    Regular User
    Join Date
    Apr 2011
    Posts
    30
    Interesting study for people on AS with very low risk (VLR), low risk (LR) and low-volume intermediate risk (LVIR) prostate cancer. The conclusion is that AS may increase the likelihood of adverse outcomes in LVIR prostate cancer. Researchers found that the rate of adverse pathologic findings was significantly higher for LVIR disease when compared to those with LR or VLR disease, at 24.7%, 5.8%, and 4.7%, respectively.

    In total, the study included 1,264 men with clinically localized VLR, 4,849 with LR, and 608 with LVIR, as defined by National Comprehensive Cancer Center (NCCN) criteria. Researchers found that the rate of adverse pathologic findings was significantly higher for LVIR disease when compared to those with LR or VLR disease, at 24.7%, 5.8%, and 4.7%, respectively. This means that men with LVIR had almost a 4.5-fold increase in the risk of adverse pathologic findings compared with men who had LR disease, and a 5.2-fold increase compared with men with VLR disease.

    According to current NCCN guidelines, some LVIR patients may consider active surveillance, but the practice is controversial.


    https://prostatecancernewstoday.com/...ff560-71764697
    Active Surveillance
    PSA - May 2014 - 2.1, Oct. 2015 - 3.4, April 2016 - 4.0, Oct. 2016 - 2.5, April 2017 - 2.9
    Age 67
    TRUS Biopsy - May 2016
    Prostatic adenocarcinoma involving the right lateral apex.
    One Core - Gleason score 6 (3+3) involving one of two fragments, less than 5% of the tissue.
    Repeat TRUS Biopsy - July 2016
    Prostatic adenocarcinoma involving the right lateral mid.
    One Core - Gleason 6 (3+3) less than 5% of the tissue.

    July 2007 - Heart Attack - 2 Stents
    August 2007 - Defibrallator Implanted
    Can't have an MRI
    2012 - Gallbladder Removal

 

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