• my biopsy returned a very small positive on only one of 12 samples. Has anyone tried active surveillance in this situation?

    Asked by dhiggi on Saturday, December 1, 2012

    my biopsy returned a very small positive on only one of 12 samples. Has anyone tried active surveillance in this situation?

    13 Answers from the Community

    13 answers
    • nancyjac's Avatar

      That would really make no sense to me. Why wait for it to grow and be more difficult to treat than to just take care of it now?

      almost 4 years ago
    • tomget's Avatar

      Excellent question..and I've wondererd about that too..it seems to depend on one's doctor. Or it seems that way to me. Right now..who know's the future..there's a lot of argument in the medical community about when, how, or even "if to treat" specific prostrate cancers. And I don't have all the info, but I know doctors and HMO's and such vary quite a bit.

      In my case..my urologist is so "pro active" (aggressive) about treating prostrate cancer that it kinda put me off for a bit. And I had continued PSA studies done for almost a year, before I agreed to his performing a biopsy. He wanted to do the biopsy the minute I came to see him and I had a PSA that went from about 3.1 to 4.1 or so in about 2 years at that time and that's why my family doc sent me to him. And we continued frequent PSA tests and it soon went to 5.1 within about a year. So eventually i got the biopsy, and had three out of 16 samples with Adenocarcinoma and each had a Gleason score of 6(3+3). I Googled around and found some info that allowed me to call this a Stage 2A level of prostrate cancer. You might want to study up on the "Gleason Score" and "Stages of Prostrate Cancer"(you'll soon know more or as much as me)

      The summary of all samples was 3 positive for adenocarcinoma/six infammation/and one ASAP(asap?). "My doctor" was certain that the "active surveillance" period was over, and that I needed to treat this in one of many different possible methods.(but like I said-he's aggressive about it..maybe too aggresseive in general-other doctors would differ?) Maybe he just wants some new golf clubs? I don't know. Its funny..ask a different doctor.."get a different answer". If you want 8 different answers..ask 8 different doctors. I don't know how much this helps a patient.

      He told me how he wanted to treat it, and told me a long list of other suggested treatments as options available from other doctors and such. And at this time I've elected to go with the robotic prostectomy..scheduled for a couple weeks away..for my specific situation. One because the PSA numbers are continually increasing at a fast rate/two I have a family history of this disease/and three while there are unfortunate side effects to the prostrate removal(and of course there are other treatments) for my particular situation I believe its the best overall choice. And btw everyones' situation is unique. As is yours.

      Goodluck Tom

      almost 4 years ago
    • tomget's Avatar

      Oh..i left out that there six benign samples.

      almost 4 years ago
    • Harry's Avatar

      I think it depends on the cancer. Some cancers aren't curable but they can be treated. If the cancer isn't causing problems and is under control, then further treatment is not very effective. It can even cause problems in the future. So, the best thing to do is monitor and withold treatment until it takes a turn for the worse. I'm in that state at the present.

      almost 4 years ago
    • GENMAR47's Avatar

      Hi dhiggi. Welcome to what next. I was diagnosed with stage 2B PC in August, 2012. I had a psa of 2.37 with a gleason score of 6. I had cancer in 5 of 12 samples with both sides involved. I am in active surveillance at this time because of ongoing health issues. I just had a psa last week and my psa is down to 2.21. The only change I made was in my diet. I am scheduled for my next psa in 3 months. My urologist-oncologist suggested this approach. Whether or not it will pay off is yet to be seen. Learn all you can about this disease and treatment options and above all keep a positive mental attitude. I believe this is the main key to beating this monster.
      God Bless and the best in your journey.

      almost 4 years ago
    • flkid's Avatar

      I had the same thing, grade 6, one out of 12, my psa went up .9 in one year, urologyist said safey was about one year. i had removed by robot within six month. psa been zero for seven months.

      the final report was grade 7 and close to themargin even though less than 10%. I would not wait personlly, you too young.

      almost 4 years ago
    • Peroll's Avatar

      dhiggi, Prostrate cancer is known to be one of the least agressive cancers so when indications are marginal they will often monitor it as surgey can cause incontenance and or impotenance, which to some people find worse than the cancer. I suggest you always ask why your Dr makes a recomendation and if you still have questions then seek a second opinion. It sounds like so faryou are about as lucky as a caner patient can be you have non-agressive cancer that was cought early. Continued good luck and let us know how it goes.

      almost 4 years ago
    • boomerchop's Avatar

      I match you in that I also only had one small positive on one of 12 cores. It somewhat depends on what they actually found, which is reflected in your Gleason score. Cancer cells are rated from 1 to 5, with 5 the most aggressive. They actually look at the most common cancer cells, and the second most common, and combine those scores, so Gleason scores range from 2 to 10. Six and below is considered less aggressive and so active surveillance MIGHT be an option. 7 is intermediate stage and 8 and above is aggressive. I was a seven, and was told that active surveillance was not an option, due to having some of the more aggressive Gleason 4 cancer cells. I should also note that you can have a Gleason score of seven in two ways, 3+4 or 4+3, depending on what the majority of the cells are. I had robotic surgery, got rid of the cancer and haven't looked back. Best wishes, Paul

      almost 4 years ago
    • WizardOfWesley's Avatar

      It's like the expression .... She's only a little pregnant.... ;-) keep a close watch ... If your doubling factor starts to rise... Then be prepared to do something... I'm sorry I had to wait ...for insurance reasons ... and that I couldn't get Proton therapy...but on the other hand ... I'm still here ..feeling good ... enjoying life ...living with only one side effect ... Mild ED....but it is geting better ... I had RP May '11 PSA before surgery was 1.6 Gleason 6 3+3 PSA after ..<0.01four months later started to rise Gleason after surgery was a 7 4+3.. so you never know Opted for salvage radiation..noe PSA in on the downhill ..get a few more opinions...Wish you the best ...G-d's Speed ...but don't think you have a little PCa... and it will go away ... Chances are it won't.. I've watched one to many men watch themselves wither away while watchful waiting ..You have to do what's "good" for You ...

      almost 4 years ago
    • mgm48's Avatar

      I share the view of the other answers. You came back positive and while it's early treat it. With any luck you'll never deal with it again. Once it gets out of your prostate, it's basically incurable and you start down my road. A constant war on cancer, always looking for the next treatment while hoping that they find the cure. Check it out, I haven't seen many who regret their surgery. Mine was exceptionally easy with no really significant after effects. Find a good surgeon and deal with it in a positive manner.

      Keep it positive and smile :)

      almost 4 years ago
    • Dick_K's Avatar

      I am also a stage IV Melanoma patient and have been participating in a phase II clinical trial for it since March 2010. Part of the trial protocol requires PET/CT or CT scans on a regular basis. The CT scans showed an enlarged prostate and later on, the PET/CT showed hypermetabolic activity with current uptake values ranging from 3.7 – 4.0.

      I went and visited a urologist for advice. My PSA came back 1.8, but based on the scans, we decided on a biopsy. It came back with a Gleason 6 (3+3) with only 2 cores involved at 5%. About six months later, I had another biopsy by a different practice and the result was the same.

      A consult with a surgeon was uplifting. His opinion was I probably did not have to worry about the prostate given the prognosis for stage IV melanoma. Ha, I’m proving that all wrong.

      Anyway, my current PSA is 2.04 and I am still on the path of active surveillance. There are so many different opinions for you to consider, all with very valid points. You have the difficult task of weighing all the information here, from other sources, from your doctor, and making the decision you feel is best.

      Good luck to you.


      almost 4 years ago
    • yww's Avatar

      I too had 1 core out of 12 being postive and of which 11% was cancerous with a Gleason score of 6 last month. My urologist said I should consider tomotherapy radiation instead of surgery to preserve my active lifestyles and better quality of life. I also asked him about the DeVinci robotic surgery and he did not recommend it since he was not sold on it. My radiologist oncologist and head of the Prostate Cancer Center however said I should be a good candidate for "watchful waiting" since my cancer is currently early stage and slow growing but she also said tomotherapy was a better choice if I didn't want to wait since it offers minimal interruption to my day to day activities and less risks than surgery. I'm currently deciding what option to go. I should mention I was leaning towards the DaVinci robotic surgery until ABC News reported a week ago the Government has started an official inquiry to look into the many complaints with complications and robots malfunctioning during operation. Good luck to you.

      over 3 years ago
    • jDay's Avatar

      I did active surveillance with 2 of 12 cores positive (Gleason score of 3+3=6). After 1 year, my psa increased and I had a second biopsy with 5 of 24 cores positive (Gleason 7 and 8). I had robotic prostatectomy on 3/5/13; am now using 1 or 2 pads per day, and waiting for ED to improve. I feel great and psa is less than 0.08 non-detectable.

      about 3 years ago

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