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The risks of active surveillance for men with intermediate-risk prostate cancers

May 27, 2016
  • By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

About the Author

photo of Charlie Schmidt

Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

Charlie Schmidt is an award-winning freelance science writer based in Portland, Maine. In addition to writing for Harvard Health Publishing, Charlie has written for Science magazine, the Journal of the National Cancer Institute, Environmental Health Perspectives, … See Full Bio
View all posts by Charlie Schmidt


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Ronald McFarlin
July 22, 2016

I just want to find out does the sauna help in prostate treatment

Shuping W Gaelic
May 31, 2016

After learning that biopcy procedure might be possible to the cancer disturbed and spread, patients need to know the side effect before ordering it. I would like to know if there is other tests for the prostate? PSA is not the effective way of test? Why not research a better way to test it? My husband has Gleason 8. PSA 10 , 3 month later PSA is 14. Changing diet, exercises, loosing a couple of kgs, He feels good… . Could he be possible to be in the surveillance if he doesnt want operation? What is the best methods to be followed up. Will not do another biopcy though.

Peter Northrup
May 30, 2016

I generally concur with Mr Swanson. I had an RRP 15 years ago, 37 radiation treatments 6 years later, and now I am on Lupron Depot 22.5. My urologist wants me to consider these antineoplastic injections q3months, but they have horrendous side effects. I take the shots about every 9 months now because they work and I don’t want the cancer to mutate any quicker than possible. My Gleason was 3+4–better than 4+3–and I take anti-inflammatory + antioxidant herbal supplements.

Carl Swanson
May 30, 2016

I notice that you label men with Gleason score of 6 or less “low risk”. I would remind you that in many cases a man who had a Gleason 6 BEFORE prostatectomy had a Gleason 7 following surgery, when a more complete pathology could be done. I would put Gleason 6 in the Intermediate Risk category to be safe.
I would recommend the Prostate MRI or Color Doppler test for men who have not yet had a biopsy, to avoid the possible complications of bleeding or infection that can occur from a needle biopsy.
Since there are 8 different possible causes of an elevated PSA, false positives can be avoided by avoiding things that can mislead.
There are a great many non-invasive tests available now that can be checked out before a man gets a biopsy that were not available 5 years ago.

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