Active Surveillance of Prostate Cancer

[@BMT-by5ve]

Great presentation. I would love to have Dr Laurie as my urologist. Very knowledgeable and emphasizes patient shared decision making. Shows respect to patient. Thank you Dr Laurie.

[@MM-sf3rl]

What she didn’t say after the biopsy is that there will be blood in the ejaculate.

[@ivanatikhanoff8789]

A 74 year old man with a Pirads 4 MRI and transperineal biopsy resulting to Gleason score of 3+3 (6) and 3+4 (7) with a PSA of 3.25 a candidate for active surveillance?

[@MM-sf3rl]

Absolutely!

[@bb3b644]

The 3+4 may be concerning.

[@MM-sf3rl]

3+4 is concerning, however, it depends on what percentage of 3+4, and different institutions will let you be on active surveillance. It also depends on the kinds of cancer. If it’s cribiform, which is more aggressive, may need immediate treatment. There are 4 or more types; so one needs to know their type.

[@bb3b644]

@@MM-sf3rl That's why I said what I said. You said he was "absolutely" a candidate without knowing anything other than he's a3+3, and a 3+4.

[@ivanatikhanoff8789]

Thank you. We were not told what “form” of cancer it was. He had a transperineal biopsy with 33 takes and some were 3+3 and others 3+4. He had a robotic prostatectomy on 3/3 and now we are back at the hospital with an e-coli urine infection. He is taking 3 different types of antibiotics intravenously and we are leaving on Sunday hopefully. The final biopsy of the removed prostate is not out yet. He was operated by a very famous surgeon here in Greece, Dr Vassilis Poulakis. He’s been having some troubles though after the surgery like having difficulty urinating. It was probably due to the inflammation on the surgery site plus the urine infection that also came afterwards. He had a CT scan that was clear with no findings and a cystography that showed that the anastomosis is also ok. He is very upset and regretful for having had the surgery. This is the 3rd time that the catheter was put back on him. I hope that when they will remove it he will be able to pass urine properly and never have to put the catheter back again.

[@JB-be8co]

My husband is 73 years old. His PSA is 16.57* Prostate gland enlarged 43x41x34 mm in size and weighs about 31gms. MRI scan - shows PIRADS -2 Please suggest, presently no serious problems with him except the test results of enlarged prostate, high PSA & seems to be Bacteria in the teeth & bad breath.

[@Mark-rw3kw]

Continue active surveillance. At next PSA test interval, attempt to deal with any infections in the mouth or elsewhere 4-6 weeks before the blood draw, and refrain from sexual activity for at least 48 hours before the PSA test. The PSA of 16.57 is a bit elevated, even for that size prostate.

[@mskdnejwuibwiunsgertrhjdhrudke]

dont get screened