THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2014 SO THERE IS NO UPDATE.

Hello I was diagnosed with prostate cancer in Jan 2010. During that time my PSA was 4.3 and my Gleason Score right base medial 1 core 5% 3+3, left medial 1 core 10% 3+3. The urologist recommends RP. Started a lot of reading and got a 2^nd opinion from Dr. Gerald Chodak (consultant) and he suggested getting another biopsy at a different location. I chose UVA (University of Virginia) with Dr. Steers. The second biopsy (3/29/1010) results were the same. Then I went to a US TOO prostate group meeting and the leader recommended Avodart. Dr. Steer supported my AS and getting Avodart. To get a third opinion I talked to Dr. Snuffy Meyers and he sent me to Dr. Duke Bahn in California for a Color Doppler (1/26/2011) left apex 2 cores 3+4, pattern 4 40%, tumor spans 30% combine core length, left external sphincter 1 core 3+3 spanning 10%staging T4 (now he thinks it has left my prostate). Dr. Myers was concern about the Gleason 7 and wanted me to go to Dr. Stephen Bravo 3/7/2011 in Florida for MRI/CT scan contrast Feraheme USPIO to check if the cancer had left my prostate. Findings, suspicious right common Iliac lymph node for cancer. Because of this Dr. Myers wants me to go thru 1 year of hormone therapy, radiation, seed implant, and touch up radiation. I thought that was too radical. I then consulted with Dr. Israel Barken. He suggested to double check Dr. Duke Bahn's findings with University of California San Francisco (UCSF) Multi-parametric MRI/MRSI. They agree with the findings. Talking to Dr. Barken I started a SAB (sequential androgen blockade) program 2 days of Casodex (50 mg.) and 7 days a week of Proscar. 05/14/2012 went to Mayo Clinic C-11 PET/CT scan/MRI their findings, cancer was organ confided, DRE no nodule. Keeping my options open I'm investigating focal HIFU, focal seeds and a new one focal Laser. I'm still consulting with Dr. Israel Barken. I'm eating a Mediterranean diet and have lost 25 pounds, exercise daily. 7/25/2012 PSA 1.1. This value is going down because I had to stop sequential androgen blockade therapy before going to Mayo Clinic. Below is my PSA history

Jan. 2013 With my research on focal therapy to help my wife's concerns of no treatment I talked to Dr. Barken. Hi FU, Laser, seed did not seem to be options. Hi FU not done in the states, laser experimental, seeds would not work since my cancer is so close to the left apex. So I went back to Dr. Duke Bahn to check on focal cryo. Dr. Bahn said my cancer has gotten little smaller since he saw me 2 years ago. He said because of my cancer is too close to my urethra and colon that focal cryo would not be safe. He said even radiation could cause other cancers for me down the road. RP would leave some cancer unless they went for all of it leaving me incontinence. His suggestion is just to watch it with PSA and 6 month imaging. If it changes then maybe goes on hormonal therapy. My wife is now in sync with me watching, quality of life and going with nothing invasive right now. She needed to hear that active surveillance from a Doctor is ok since many Doctors in the past wanted me to do an invasive treatment. It is all about quality of life for me. If I can control the cancer buying myself time for something new is ok with me. This is not for everyone. Going this route is not cheap. I talked to Dr. Barken about Dr. Duke Bahn's findings and I wanted to see what would happen if getting off of Avodart and 50mg of Casodex a week (even that small amount was causing left nipple to be sore). We agree to see what happens. I know my PSA will go up since Avodart cuts PSA in half. During this trial I plan to do monthly PSA and Multi-parametric MRI or color doppler. Being off of Avodart and Casodex starting 2/8/2013 baseline PSA 1.2 now 3/21/2013 it is 2.1. Next month planning to get the multi-parametric MRI here in Virginia very similar to the one I got in San Francisco UCSF. I continue to exercise and watch my weight.

Mark's e-mail address is: mark090 AT juno.com (replace "AT" with "@")

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