Selecting Active Surveillance | Watchful Waiting-active surveillance | Forum

I've recently been diagnosed with what I believe is low risk prostate cancer, although I have yet to discuss with my urologist the results of the CT scan I underwent just yesterday.  I've decided to just be under active surveillance instead of any active treatment, with a prostate biopsy every one to two years and seeing if it shows any more cancer, and noting if my Gleason score increases, and noting if my PSA doubles in three years or less.  At age 75 it's doubtful if I have 20 years more to live to age 95, probably more like 10 to 15 years, statistically making it more likely that I'll die with prostate cancer rather than because of it.  I've been reading about the side effects of radical prostatectomies and radiation and they can be pretty awful.  I don't want to carry a urine bag, a stool bag, or walk around wearing a wet diaper.  I've already lost most of my hair so I'm beyond vanity about baldness, but I guess the debilitating pain and fatigue would be most important to me.  Am I taking a huge risk?  A risk, certainly, but I don't believe a huge one.  And what if, after a year or two, testing shows the cancer is progressing? I'll just have to deal with it when it happens and weigh some pretty awful choices, the most benign of which seems to be hormone therapy to stop the cancer's progression but not eliminate it.  Maybe I'll find I should have chosen hormone therapy to begin with instead of just active surveillance.  I'm presently stabbing at options in the dark.

Ironic, finding out at this moment that my routine blood workup, which included a PSA, led to a biopsy and my diagnosis of prostate cancer, right at this moment when there is now a storm of controversy over whether a routine PSA should be done at all for American men over age 50.  I was horrified at when I first heard this callus radical notion.  Without that casual blood work done on me I never would have known I had prostate cancer.  But will it ultimately make any difference whether I even found out?  There's a wonderful article in the New York Times Magazine Section of Sunday, October 9, 2011 called "Can Cancer Ever Be Ignored" putting the whole issue of routine PSA testing in perspective and shedding a different light on prostate cancer.