Here are some interesting facts about Active Surveilllance that were published by Klotz, a long time researcher in Active Survelience. He gathered these while reviewing the 18 studies on AS as well as data from his own research study. J. ClinOncol 23:8165
Gleason 6, Stage T1C- T2A, PSA less than 10 are favorable stats for AS
- A PSA doubling time less than 2 years is associated with more agressive PC and a high likeyhood of locally advanced PC.
-Determination of agressive vs non agressive PC can be determined in 2 years with 8-10 psa data points and 2 sets of biopsies.
-1.7% of those with favorable low risk stats will die within 10 years DISPITE any aggressive local treatment.
-70% will show no sign of progression.
-20% will be treated because of PSA progression.
-10% will be treated because of Gleason Grade progresson
- Decision to treat made when PSA doubling time is less than 3 years or Gleason grade increases.
In other studies I have read indicate that the cure rate for delayed treatment is exactly the same as if the treatment was done immediately.
My take on this and other studies done on AS is that the "window of cure" is fairly long and if you just happen to be one of the 1%-2% with low stats, but agresssive PC the window was never open to you anyway. Given a 70% chance of non progression and a similar cure rate to immediate treatment if progression does occur AS is a no brainer for those with low risk stats.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.