What Happens if You Don't Treat Prostate Cancer? with Dr. Michael Ahdoot

I was diagnosed with Stage 1 Gleason 6 Prostate Cancer in 2006 through a needle biopsy. I researched all of my options, Robotic, Radiation, Proton, etc. I then brought my file to an Oncologist for a 2nd opinion. She reviewed my file and history and then recommended active surveillance. She adamently advised against any invasive treatment. I have been on active surveillance for nearly 20 years with my PSA dropping from 18 to nearly normal over the years. The only medical procedures that I have gone through are a couple of MRI and CAT scans both showing no indication of the cancer advancing nor even present. I am now 83 and relatively healthy due to a healthy diet and regular exercise. I now have a different Urologist as my original Urologist had insisted upon Radical Prostatectomy immediately.

I was diagnosed with prostate cancer April 15 (my father has PC Stage 4 metastasized in his bones. He's 92yrs old, having only been diagnosed 3 yrs ago. Dr. said he would pass of old age so to speak, before the cancer could get him). I had a Total PSA of 2.9 and percent free PSA below 10% (the red flag that alerted me). My in-bore MRI targeted biopsy confirmed Gleason score 3+4=7. After exhaustive research I elected for in-bore MRI focal laser ablation. Surgery was outpatient and it went excellent. Surgery was 8 days ago and I feel great, with no negative conditions following the surgery. The only inconvenience was having a catheter in for 8 days. There were no issues with the catheter other than "it was in there". My best to all that have been diagnosed with PC.

I'm 68 have always been in great health. Just diagnosed this month with PC after a continuing PSA rise to 16.5 within one year. I had no symptoms but some ED issues with no fluid upon ejaculation. First had an MRI showed a 1.6, lesion and scattered areas associated with prostatitis. Biopsy showed 7 of 13 cores positive, Gleason 9. Then had a PMSA pet scan showing it has not spread but I am classified as high risk. My urologist suggests immediate prostatectomy, but I know I have options of radiation and hormone therapy as well. I have heard horror stories involving both the surgery and also the radiation along with the hormone drugs. I have seen basically that the mortality rates between surgery and radiation are about the same. I have an appointment with a radiologist in three days. This is a nightmare that just does not seem to go away and I have reluctantly joined the undesirable club of thousands of other men. I realize that no matter which option I choose at this point, I may indeed regret as it will undoubtedly influence the quality of the remainder of my life.

This is a very helpful video. However, what is missing is a discussion of the terrible side effects of prostate cancer treatment and their effect on a patient’s quality of life. Virtually all treatments are difficult, hormone therapy, radiation, or surgery. Many people, including me, would prefer a better quality of life, even if shorter. Also, there are effective treatments for metastatic prostate cancer that were not available to the patients in these studies. Many people seem to be living extended periods with metastatic disease. For me, I would not seek treatment for intermediate prostate cancer at my age (62) or older. I observed treatment ruin the last years of my father’s life, and I will not allow that to happen to me.

I wish more doctors were more clear about it like he is. First thing is biopsy. When I had my prostate removed they told me that my prostate looked like a piece of Hamburg from the biopsy. Make sure they use all the modern technology when they do biopsy. Ultrasound is not a modern way of doing biopsy. They did 13 biopsies on me . I could go on but I recommend to find a support group talk to other men that are going through the same thing. Had no symptoms of prostate cancer. Until they did the biopsy.

A really interesting video but from my experience AS is a similar risk to having treatment - I'm 57 and after PSA rising to 6.9 I was sent for MRI (2 Pi-Rad 4 lesions detected), then biopsy (7 of 18 cores positive) and finally PET scan (no other cancer picked up). I was initially diagnosed as Grade Group 1, G6, but my Urologist strongly advised a Prostatectomy due to my age and high volume of cancer, and this was supported by a Radiation Oncologist. I considered AS but in the end the though of cancer being present in my body was too much, and I had a radical prostatectomy in Nov 23. Upon pathology my cancer was upgraded to Group 2, G7, and staged as pT3b! Thankfully negative margins and first PSA post op is undetectable. Had I gone with AS I fear my cancer would have spread quickly and the outcome not nearly as good. Only the person diagnosed can truly know what is best for them, its a very hard decision to make and all men going through this should be supported in whatever decision they end up making.

I'm so glad I stumbled across this video! As I'm heading towards dealing with a high PSA test result this is great information to take forward. I'm going to get informed and not just let the medical system run roughshod over me. Thank you for the video!

Thank you so much. So clear, so well presented!

Thank you Doctor. Great service to community.

This video is excellent for deciding whether to have active surveillance or radical treatment for prostate cancer . I have Gleason 3+4 low volume and was told by Urologist that best is to have prostatectomy because of my age 61 but never explained me why . After watching this video now I understand the reason.Thank you very much for this excellent video and for giving us all this information in plain english that everybody can understand.

Great video with lots of relevant information. Nice job.

Very informative videos, review of the literature very helpful. Technology is constantly improving diagnoses and treatment. Good that you bring all that into perspective.

As I am a diabetic person My physician asked me to do a PSA checkup test with Hemoglobin A1C .The result was a little bit high 5.54 ng/ml , and he referred me to a specialist. An MRI and a biopsy later, I discovered I was a 65 year old living with a Gleason 6 prostate cancer. I'm so grateful that my Doctor took action, knew that there was a history of prostate cancer in my family and encouraged me to do the test. I now can do active surveillance and get on with my life. Now I changed all my life style and start ketogenic diet In addition to I stop eating dairy foods and sugar and rice and and all products that feeds cancer since 3 months also I practice prolonged DRY fasting about 17 hrs for one month and i do two Psa tests one after 2 months and it was 3.54ng/ml and the other one after dry fasting and it was 2.7ng/ml . I lost about 12 KGS since 3 months That encourage me to complete fasting hoping that tumor marker will give me more good results.

Dr Ahdoot has a very easy accessible manner of presenting the information...thanks good series

Stanford Med School!! I'm forwarding this to my Primary Care MD from THE Buckeye U Recent elevated PSA hence my visit and new member

Thank you Doctor. Very helpful and informative!

Great informative video thanks for posting.

I’ve said this before but in November 1995 my doctor told me to get ready for death because of my psa test. The next April I ran the 100th running of the Boston marathon. It’s now 2023. I’m back to long distance training. I think scientists would be better for testing psa rather than a doctor. They would probably ask questions.

Excellent exposition. Thanks Dr. Ahdoot

Hello Dr. I’ll be 52 years old in July, i had my 1st PSA scan 6months after I turned 50, it was 3.4, so i changed my diet lost 25-30 lbs starting eating healthier. I’ve always went to Dr appointments every 3-6 months for many years. I do have hypertension and take 1 pill a day of low dosage medication. Well, to my surprise I went to my 6 month appointment my bloodwork showed my PSA was at now 9.45. I went to a urologist, my bloodwork showed that PSA was at 10.45 in 2 week period. Prostate Biopsy was done and of 16 samples 11 test for PC, mri showed PC, PET scan showed it has spread to lymph nodes, femur bone, hip bones, spine, PSA now at 22. I have no symptoms, no pain, no signs of anything other than what I’ve shared. I actually feel great, except mentally it’s very disturbing. My Gleason score is 9 and I’m high risk. I just don’t understand this… Thanks for your input advice and videos 🙏🏿