I have been following my PSA for several years.

In 12/04 PSA was 3.0,
12/05 4.7,
01/07 5.1,
07/07 5.2,
01/08 7.4,
03/08 7.7, and
06/08 7.7.

Two previous biopsies came back normal but the latest results was one core positive with 3% of tissue being cancerous.

I have had a bone scan which showed no problems.

A second opinion on the biopsy confirmed the results of the first biopsy. I received those results yesterday.

Have talked with physicians regarding external radiation and seeds. It seems that all I hear is why radiation is bad from the urologist and why removing the prostate is bad from the radiologists.

I am open to active surveillance with a little reluctance from my wife. I feel the missing piece is a color Doppler ultrasound. Have consulted with Dattoli Cancer Center who would do the color Doppler as well as some other tests. Their initial response from reviewing my biopsy information is that I would probably benefit from both external beam radiation and seeds.

I am have an appointment with my urologist this week where I plan to discus my apprehensions on treatment and I consult with a medical oncologist, radiation oncologist, and urologist at Duke University Medical Center scheduled for later in July.

Any suggestions are welcome particularly sites that offer Color Doppler ultrasound. I am especially interested in sites near North Carolina but will go to Florida if need be.

Is there anyone out there that is using the color Doppler, PSA follow up, and additional biopsies to follow their cancer rather than radiation or removal?

Also if I did need to proceed with a treatment neither option seems to be better choice. I am leaning toward removal based on the fact that the side effects are pretty much known right away as waiting for a few years to see what develops after radiation treatment.

Any help is greatly appreciated.

Thanks.

Since I received my diagnosis in May I have done a lot of reading, talking with folks, and further consultation with doctors.

I got a second opinion on my biopsy which confirmed the original diagnosis of one of twelve cores positive at 3%, and Gleason of 6. PSA in March and June was 7.7, and I am looking forward to a new PSA in September.

I had several replies from my post on YANA which were helpful to me. I felt comfortable with Active Surveillance but there was some hesitation from my wife and I still think she would prefer some treatment but has become supportive of my decision. I had a consult with my urologist who was respectful of AS although he does not feel that I should wait too long possibly 6 months to 2 years.

Yesterday I had a consult with a multidisciplinary team at Duke's Prostate Center. All three people we met were extremely professional and respectful of my position. After reviewing my medical information and talking with my wife and me they supported my decision to wait. They recommended low fat diet, supplements of Vitamin D and Calcium, Soy Milk and Flax seed It was a monumental day for us.

I will continue to monitor my PSA every three months and proceed from there. Thanks to the men who responded to my earlier post, their support was helpful in getting me from May to July.

Will update with PSA reports in the future.

I had a new PSA done at the end of September which was 5.5. This is down from 7.7 in June. Not sure what it means other than it did not go up. Continuing on supplements of Vitamin D, fish oil, flax seed, and exercise. Will meet with the urologist next week to discuss my situation. Not sure what else can be done at this time other than be pleased that the PSA did not go up!

New PSA completed this week. Current reading is now 8.8 up from 7.7 in June and 5.5 in October. Having some prostatitis problems but this is still an all time high for my PSA.

Getting a little nervous about the elevated levels. I will be going to the urologist in February and will be discussing another biopsy.

It has been nearly one year since my diagnosis.

I had a another biopsy done at the end of February. It came back with one core out of twelve positive at 5%. Gleason of 6.

I was pleased as was my doctor so we are staying the course with active surveillance. Still on vegetarian diet, fish oil, flax seed, and vitamin D.

PSA in June was 8.8 the same as January. New PSA in September 2009 was 9.3. This is a new all time high. I am blaming some of the increase on prostatitis. Currently on an antibiotic and I have been asked to come back in for a new PSA at the beginning of October.

My PSA was 7.7 at the time of diagnosis so don't know what to make of the increase to 9.3.

I have had two additonal PSA's since my last post. The PSA continues to go up. At the end of September it was 9.8 and in November it is now 11.8. A pretty quick increase in the last 5 months. In May 2008 at diagnosis it was 7.7 and 8.8 in June 2009. However since June it has jumped 3 points.

Having another biopsy this week. The doctor is not sure what is causing the rise in PSA. I have been on several courses of antibiotics between these latest PSA readings. Will check back in after the biopsy results.

Today was another uplifting day in my battle with PC.

Went to the doctor today for results on my recent biopsy and bone scan. The first words out of the doctor's mouth is I have some very good news for the both of you! All of the 12 cores came back negative. This is after two biopsies with one core positive with 5% involvement. My doctor is now willing to continue with the AS.

He did start me on Avodart although I do not have an enlarged prostate or any symptoms. He also prescribed Flagyl or two weeks.

The thought is there is a lot of inflammation which I have felt for some time. So there will be no surgery at the start of the New Year and have a return appointment in March.

After the biopsy in December which came back negative I returned to the urologist in March 2010. A new PSA was done and was 5.2. The Avodart is responsible for the decrease. The urologist was fine with things as they are and I go back in June.

May 2010 will mark two years since the diagnosis.

I have had two PSAs done since December. In March it was 5.5 and in June 4.7. My doctor felt things were going well and I have a return appointment set for September.

It has been two years since diagnosis (May 2008) and I feel that I am doing fine. Started drinking pomegranate juice the last six months and meds remain the same.

I have just received the results for my sixth biopsy. No cancer in any of the cores. This is the second year in a row with no positive cores. PSA is at 5.3 down from 5.5 in September 2010.

This means I have had four biopsies that were negative and two that were positive with one core each at less than 5% involvement. May 2011 will be three years from diagnosis.

My question now is whether or not to remain on Flomax and Avodart. Avodart has resulted in sexual side effects which I would prefer not to have. My prostate is small so do not need the Avodart for BPH.

Hope that my story may help folks diagnosed with minimal cancer to take some time before they make their treatment decisions. At one time my urologist stated I was the only patient he had with this situation but now he has another patient in his early 60's who has also had a negative biopsy after the PC Diagnosis.

I felt pretty good about my choice of AS. However the problem child is my PSA. I just had a color MRI done which noted a possible area of concern. I went in to talk with the urologist and we decided for me to keep my appointment in January 2012.

However he did have me have another PSA done. I got the results on Saturday and my PSA is now 16.19 up from 12.6 in August. I now have a return appointment for next Tuesday to discuss what the urologist feels should be done. He has also recommended another biopsy for January.

My concern is how much weight should this PSA be given. It is getting a little more anxious for me watching it go up so quickly. I am thinking the urologist will be talking to me about treatment options at my appointment next week.

I have been told that prostatitis may be the culprit but how long can I hold out with the increasing PSA? [It may be of interest for Christopher to review the 28 Day Experiment I ran on my results ten years ago. Christopher is understandably concerned about a 28% increase over three months: I had a 33% increase in three days.]

Up early this morning (December 6) as I am finding it difficult to sleep, I have a 9:15 appointment with my urologist.

My last two biopsies have been negative and I went ahead and had a color MRI done last month which did not indicate cancer. I met with the urologist and our plan was for me to keep my appointment in January. However he did order a new PSA. That PSA came in at 16.2 up from 12.6 in August. He sent me the results and stated "Let's do another biopsy in January" and to call his office. I called and they asked that I set up an appointment to talk with the doctor.

I am thinking that he is going to tell me that I need to have treatment or he will not be willing to be my doctor as things are too risky. He was reluctant with my AS at first but has been ok with things so far. It has been 3.5 years since diagnosis, age 58, I am now 62. My concern is that the PSA rise is due to inflammation based on the negative biopsies.

I guess I will know the story in a few hours. I am not looking forward to treatment.

March 2012 - After my insurance failed to approve a saturation biopsy I had a 14 core biopsy down in January 2012. The result was 14 cores negative. I have now had 7 biopsies. First two negative, the next two positive with 1 core positive with 5 per cent involvement and Gleason 6. The last three have all been negative. Now looking for ways to address inflammation. I am supposed to go for physical therapy as a way to decrease inflammation. Have a first appointment later in March. May 2012 will mark 4 years since diagnosis.

In August 2012 I went in for a six month check up. PSA came in at 13.0 down a little from last winter.

It is always nice to have a down tick rather than an increase. Will remain on AS and return to the urologist in February 2013. It has been 4.3 years since diagnosis and doing well.

Most recent biopsy was done in February and rose a bit to 16. Given the small increase and the number of negative cores in the past (2 positive out of 86 cores taken) it was decided not to do another biopsy at this time. Will follow up with another PSA in August. May 08th will mark the 5th year since diagnosis, I will be 64 in June.

It has been a year since my last entry. Having visits with my urologist every six months will see him at the end of April. PSA remains high but fluctuates a little, I had a down tick at my last visit. Still doing active surveillance. Next month will mark 6 years since diagnosis. Since I have had so many cores taken and so many negative biopsies we are not planning on additional biopsies at this time. I did have a PCA3 done this past year hoping to get an indicator of the potency of the cancer but it was inconclusive. I forgot to check with my insurance before having the test done and ended paying $590 out of pocket for the test. Appealed to the insurance but they had an LPN review it and denied the appeal. An LPN? I wonder how much that person knew about prostate cancer. Will update with a new PSA after my April visit.

It has now been 7 years since my original diagnosis in May 2008 and I am still on the path of Active Surveillance. I have had two PSA tests this past year. In October it was 18.6 and in April it was 16.75.

I had a second Prostate MRI and another bone scan done in November which did not reveal anything significant and my doctor and I decided not to do another biopsy. I remain on Flomax daily.

I am pleased that I chose the AS path back in 2008 when it was not that popular. AS is now supported by more physicians and remains a good option for some men.

The YANA site was extremely helpful to me at the time of my diagnosis, when I was full of anxiety and not sure what to do. I continue to receive emails from other men through YANA and am more than willing to communicate with others about my experience with PC.

Next month will be 8 years since my original diagnosis. I continue to have semi annual PSA's and digital exams. There was a downtick at my last PSA in November. So staying the course for thge time being.

November 2016 - At my six month checkup my PSA went from 16 to 18. I told my urologist I thought it would good to get some new information as I continued my AS. We decided on a 3T MRI at a local cancer center. That was done on Nov. 30th. The results showed an area of concern and I made an appointment to see a physician at the cancer center. He performed a fusion biopsy on Feb. 14. The results from the biopsy showed two positive cores, one in the area of concern and another from a random core. The Gleasons were 4+3 and 5+3. The cores were sent to John Hopkins for a second opinion and the Gleason 8 was identified as a Gleason 7.

At that time it was decided that my low risk cancer was now high risk. I decided to have a laparoscopic radical prostatectomy performed by my local urologist which was done on April 20. This was not an easy decision as I felt sure that the MRI would be negative and at my age (68) I would be out of the woods, so to switch gears was a difficult decision. I was two weeks short of 9 years of AS.

The surgery went well. More discomfort than pain from the bloating from the gas and having a catheter. The pathology showed that 35% of my prostate was involved and was primarily Gleason 4+3.

One week after surgery the catheter was removed and the first day was difficult. After the first day I am using one or two pads daily and am dry at night. I had seen a PT over the summer regarding some pelvic pain and had been doing pelvic floor exercises since then. I did see the PT after the catheter was removed and we tweaked the exercises a bit. The impotency will be addressed at my next appointment at the end of May.

Even with the positive results, I have had some difficulty coming to terms with having the surgery and the side effects.

It as been a difficult year. After my prostatectomy I had positive margins which required additional treatments. I began hormone therapy with Lupron in August 2017 and external beam radiation in November. Side effects included some weight gain, some joint pain in my ankles, knees and wrists which I did not have prior to my latest treatments. The joint pain continues even though it has been several months since my treatments ended. Sexual side effects seem to be the most problematic. with the hormone treatments my testosterone levels plummeted as did my libido. Sildenafil did not help much. I also pursued Trimix injections. I was able to obtain an erection but with my libido still lost it has been impossible to come to an orgasm of any sort. Since it requires an injection and the results not being very satisfactory I have not used the Trimix very frequently. So the quality of life in the sexual arena has been poor but I have to remind myself that I am cancer free at the moment. thanks for reading my story.

It has been awhile since I updated my PC story. It is now 11.5 years since the day that I first heard that my biopsy had come back positive, May 2008. I followed AS until April 2017 when it was determined my cancer was more aggressive then we had thought and I had surgery. Unfortunately I had positive margins and needed to start hormones and prepare for radiation which ended in January 2018. Since that time I have had PSA's done everything six month. As of yesterday my PSA is still less than .05. I have not had any issues with incontinence through the whole treatment process. Erections are assisted with Sildenafil. Orgasms are another story, however I have been on an antidepressant which may impact that area. Overall my doctor and I are very thankful for the way things have progressed. I am more than willing to communicate with other men with PC, especially folks who are newly dealing with the issues. YANA was a blessing to me when I first started this PC journey.

It has been 4.5 years since surgery and 4.0 years since radiation. During this time I have had regular 6 month checkups and the PSA has been under able until my current check up. My PSA came in at .12. Doctor says not to worry. If or when PSA gets to 2.0 they would do a PET scan to locate cancer cells. At this time he said the cancer is too small to detect with PET scan. Was disappointed about the increase in PSA but otherwise things have been going well.

It's been a year since my first PSA uptick post treatment. (surgery followed up by radiation in 2017).

PSA in 12/22 was .42. My urologist has been supportive thru AS and treatment but it seems more difficult these days to get information. Since my PSA nearly tripled in one year, .12 to .42 I am wondering if the rate of increase is a problem and if a PET Scan is in order. I have sent a message to my urologist and posted on some prostate cancer boards to hear from others who may have had a similar experience.

It has been 7 years since my surgery and subsequent radiation in 2017. My PSA started to be detectable in December 2022 and in December 2023 it had risen to .84. In January 2024 I had a PET SCAN Which dectected a 4 mm cancer in a lymph node. I have consulted with a radiation oncologist and will have 3 sessions of radiation to that lymph mode. Given that it has been 7 years since original treatment and the fact there was only one small area of concern, my physician is optimistic. It has now been 15 years since my diagnosis in 2008. I had 9 years on AS. My side effects thru this entire process have been minimal I feel very fortunate for the way things have progressed. Oh course I am not pleased the cancer returned but feel positive about the future.

Christopher's e-mail address is: civy7 AT aol.com (replace "AT" with "@")