I went to a urologist complaining about occasional sharp pain in my groin area that my PC could not diagnose. The urologist ordered a scrotal ultrasound which came back negative and he did a DRE and took blood. The DRE revealed no abnormality and the prostate on biopsy was normal size. Because the PSA was marginally over the 2.50 threshold, he recommended a prostate biopsy. The results of that test are below:
Gleason scores of 3+3=6 on four cores out of 12
Base lateral 30%
Mid lateral 5%
I was referred to a local surgeon for a consult and he explained options, including AS, and answered the questions that I could think to ask. When I asked him what he would recommend to a close friend or family member with similar symptoms he did not hesitate to recommend Da Vinci surgery. He also recommended genomic testing.
Oncotype DX genetic tests indicated probability of freedom from high grade disease was 83% (95% CI: 77-88%) and freedom from non-organ confined disease 79% (95% CI: 73-85%). On the scale of very low, low, and intermediate, this puts me directly in the middle of the low rating. The overall likelihood of favorable pathology is 73% (95% CI: 66-79%)
The surgeon called me with the test and said he felt more confident about AS. He suggested that because of my disease presentation and the test results we could monitor the PCa without undue risk.
I also had a consult with a medical oncologist and he pretty much agreed with the urologist on everything. I asked for a second opinion on the biopsy pathology so he sent it to MD Anderson and they confirmed the original diagnosis.
I quit red meat a few years ago and I am have increased the fruits and vegetables and fish in my diet. New supplements include pomegranate seed and vitamin D3. I have been doing biking/running/lifting regularly for many years and am not overweight so I don't think there is any need for additional activity. I have also reduced alcohol consumption. I have battled borderline high cholesterol levels for many years (genetic) and am hopeful this regimen will help control that as well.
My wife was initially on the fence with AS (as was I) but I think she is OK with it for now.
I have an appointment today with the urologist/surgeon for a follow-up PSA and DRE. Another PC Dr. has suggested an abdominal CT scan to try to determine the cause of the groin pain. The urologist/surgeon would not recommend imaging because he felt the diagnosis did not suggest any was needed. I'll update with my results when available.
Thanks everyone very much for sharing your stories. I have found this site to be extremely informational and insightful.
The PSA from last week was 1.78 so a decrease from the "alarming" 2.52 that prompted the biopsy. The CT scan from earlier this week came back negative. The urologist/surgeon did not do a DRE and said I could look forward to that at a follow-up in 3 months. He is completely supportive of AS and more importantly at this point, so is my wife.
I should have mentioned that my dietary changes have also included almost entirely eliminating dairy products. My blood chem results this week indicated my cholesterol is now just below the threshold at 196 and triglycerides were 121 which is a huge drop from where I started lifestyle changes 18 years ago.
So all good news other than the mystery groin pain which no one can identify the cause other than advancing age.
I also have a family history of colon cancer so the PC wants me to schedule a colonoscopy since it has been over 4 years since the last.
My thoughts and prayers go out to each of you.
Since my initial diagnosis in September 2016 my PSA has been monitored regularly:
The AS protocol prescribed by my urologist called for a follow up biopsy after one year. This was done in October 2016 and the biopsy results were described by my urologist as "stable". From 12 specimen cores:
Right base: Gleason 3+3 - 3%
Left base lateral - 3+4 - 15%
Left base: Gleason 3+3 - 30%
Based on the Oncotype Dx results, stable PSA history and most recent biopsy, my urologist suggested continuing AS with a follow-up PSA in four months. Thankfully, no further biopsies will be done unless future PSA's indicate a concern. I happily agreed with his suggested treatment plan.
Most days I live my life without worrying about my cancer but still periodically search for news and new information on PCA. Hopefully, they will continue to make advances in the treatment and cures for this disease.
God bless and keep you all. If anyone has questions or would like to discuss has my treatment program drop me a note on e-mail.
Dennis's e-mail address is: firstname.lastname@example.org