Active Surveillance and a New Wrinkle

As I have written in previous articles, I was diagnosed with prostate cancer in March of 2017. Given a PSA of 7, a Gleason score of 6, no more than 12% cancer cells in any of my twelve biopsy cores (the rest were 7%, 5% and 3%), and with an abdominal scan and a full body bone scan indicating that my cancer was contained, I chose active surveillance as my treatment. My doctor recommended surgery, but, without further investigation of the options available, I wasn’t ready for that option.

The active surveillance plan was simple. I would have quarterly PSA tests to track any increases and digital rectal exams to detect any changes in my prostate. At the end of one year I would have a second biopsy to determine by that method if my cancer was becoming any more aggressive. At any time during the year, my doctor assured me, I could request a change in my treatment plan; that is, have surgery.

Buying time?

During the first few months of my treatment, the results were good. My PSA dropped to a 6.031, no abnormalities were detected in my prostate, and I wasn’t experiencing any symptoms that would indicate any change in my status. I started to research the other treatment options available, focusing on surgery and the varieties of radiation, educating myself about the procedures and the side effects.

I joined a PC support group that has been ongoing at my local hospital for over fifteen years, one of the best choices I made, because I have benefited immensely from hearing about the unique journeys of each man in the group. Participating in the group ramped up my research, particularly about radiation and where it was offered, and about the imaging available to help guide biopsies and radiation. I remained comfortable with my choice of active surveillance.

A change of plans

However, my most recent PSA, in January, jumped to an 8.3. That sudden increase flipped a switch in my mind, made me realize that I might soon have to choose a more invasive treatment plan. My doctor and I scheduled a biopsy for March 7th with results available on the 14th.

Within days of my last appointment, realizing how much more time I was spending thinking about my cancer, I reached the conclusion that I would seek further treatment. With that thought in mind, I’ve scheduled another appointment with my urologist to precede my biopsy. I want to discuss my options and find out if another biopsy is necessary. If I choose surgery, there seems to be no point in having the biopsy, but the results might be helpful if I choose radiation.

Continuing the journey

All of my research leads me to believe that radiation is a better choice for me than surgery. In my support group, which includes men who have been attending conferences and tracking improvements in technology for the last fifteen years, each of the men who previously chose surgery said they would choose radiation if they were diagnosed today. In one-on-one conversations with friends, some of whom had surgery and some radiation, each came away feeling comfortable with his choice and outcome. Bottom line, it is a personal decision each prostate cancer patient must make, hopefully with support from his doctor and his family.

In addition to all I have learned, I value through this process blowing up the prevailing attitude “out there” that having prostate cancer is somehow not a big deal. It is a big deal, a very big deal. It changes one’s life forever. I will continue communicating my journey on this site after I get the results of my biopsy if I have one.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The ProstateCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (10)
  • Will Jones moderator author
    10 months ago

    Deemusician, All the best for your upcoming surgery. I’ll be having mine on April 16th. I’m getting all my ducks in a row. We’ll have to keep tabs on our progress as we recover.

  • Cateydid
    11 months ago

    Have you looked beyond your urologist? My husband chose “nerve sparing prostatectomy” on the advice of his urologist, (who was also the surgeon) after we did a great deal of research on radiation, seeds, etc. Regardless of the surgeon’s skill, the process was NOT nerve sparing and has taken away a huge part of our life.

    I encourage you to see an oncologist, if you haven’t. We found Cancer Treatment Centers of America and were very happy with the treatment we got there as we resumed watchful waiting post-prostatectomy in 2009. Joe’s cancer had leaked out and was found in one of 8 lymph nodes tested. We knew it would show up again. Eight years later, it did.

    It’s metastasized as a tracheal tumor. He underwent chemo last winter, and is now on Lupron bi-annually.

    We’re in Florida this winter and we’re seeking opinions from Moffitt Cancer Center, the University of Florida Proton cancer treatment program, and a pulmonary specialist to make sure we explore every possible option.

    Within a doubt, inclusion of a vegan lifestyle, naturopathic supplements and increased physical activity has helped balance his medical treatments with his health care.

    It’s a fight worth fighting, Will….but it IS your fight. No one is going to want you to get well more than you!!! Do your own research. I strongly encourage you to log into nutritionfacts.org and read “How Not to Die” by Dr. Michael Greger.. Wishing you health and wellness!

  • Will Jones moderator author
    11 months ago

    Thank you for all of your suggestions and support. I really appreciate it. After much research and deliberation, conversations with other men who have been down this road, and the support of my family, I have decided to have surgery in April. I will elaborate in a new article sometime this month.

  • Deemusicman
    10 months ago

    My surgery is April 4th ,good luck Godbless

  • foodfight
    11 months ago

    I wonder if you have made any dietary changes since your diagnosis . I am also in active surveillance , having been diagnosed with cancer in January 2017 . At the time my PSA was 6.39 and one core had 5% cancer . I was Gleason 6 . I immediately transitioned to a vegan diet ( with more than a few lapses ) and my PSA six months later was 4.59 . In December my PSA went up slightly to 4.7 but my December biopsy was unchanged from the previous year . My urologist and I agree on continuing on this path and if the PSA does not spike , I should be able to go 2 years until my next biopsy . There is a world of information on the link between prostate cancer and animal protein . Good luck to you in whatever decision you make .

  • Will Jones moderator author
    11 months ago

    I have eliminated red meat, cut back on carbohydrates and drastically reduced sugar intake. I have lost some weight, but I am already a lean person, so I’m adding other sources of protein to my diet. However, those choices have as much to do with fitness and overall god health as much with PC.

  • Deemusicman
    10 months ago

    I have always had a good intake of fish ,but never greens ,now I include greens in my meals ,blueberrys,and sweet potatoes and salmon hoping the omega 3 will help boost things.

  • Cateydid
    11 months ago

    I’m very happy to hear that you’ve gone vegan. My husband and I have done so and both of us are enjoying greatly improved health. We juiced daily through his 6 doses of chemo last winter, too. We believe that he tolerated that treatment as well as he did because of the holistic actions we included. While the medical team doesn’t see any connection, his health care team does.

    Keep researching!!!! There is almost too much information available anymore, so you must do your own checking and do what’s right for you.
    It’s your body, your life, your fight. You can be sure most medical personnel will push the medical model which may not best for your health.

  • foodfight
    11 months ago

    Thanks Cateydid . When I tell my urologist about my diet he doesn’t comment other to say a vegan diet is good for overall health including heart disease . I check out nutritionfacts.org also . Dr. Greger is informative as well as quite entertaining . If you haven’t read “Anticancer” by David Servan-Schreiber yet , I highly recommend you do . My best to you and your husband

  • JoeMurphy
    11 months ago

    Good luck hope you do well . Have a great night

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