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I am from India and my father (65 yrs) has almost been diagnosed with PrCa. Almost because the biopsy is scheduled for later this week.
My dad first approached a GP because of continuing problems with urinary hesitation and frequent trips to urinate at night. He had been diagnosed with BPH earlier so the symptoms did not seem unusual. In any case, the GP advised a PSA and a Transabdominal US. The ultrasound was okay but the PSA came in at 200 !! Meanwhile, my dad's symptoms actually got better since the day he approached the GP.
The next step was to call up another doctor who's been advising us since a very long time. He suggested a recheck of PSA. The recheck confirmed the original findings. Next, the family doc called up a urologist who first asked us to get a radionuclide bone scan done. Then, liver and kidney function test and a urine test. Everything came in normal including the ALP test and the bone scan!
So, with all reports in hand we went to the urologist who performed a DRE and found a suspicious lesion. He asked us to get a pelvic/prostate MRI done which was performed yesterday and then the biopsy later this week.
It's been about 21 days since we first approached the GP.
This is how the things stand today. Any advice would be much appreciated.
Let us know about the test results. Your Dad may have PCa but advice depends very much on the grade and whether the thing has escaped the prostate. With such a large PSA number (if it is PCa) it probably has, but don't worry until you have all the necessary facts. Then take comfort from the large number of men on this site with higher PSA numbers of a similar age to your Dad who are still going strong after many years of treatment.
Your Dad will be going through a worrying time but I'm sure you will give him all the emotional support you can - that will be invaluable.
Perhaps it is not helpful to quibble over staging at this point, but I don't believe you can have a T2 stage once the lymph nodes are involved. Because the cancer is no longer entirely confined to the prostate gland, even though the capsule is still intact, apparently.
My understanding is that physically the cancer can push through the capsule in an anatomical sort of fashion. But it can also leave the prostate gland via the blood stream or the lymphatic system.
You'll know more after the biopsy, from which the Gleason score will be important. We all wish you and your dad well, and in the upcoming months and years you'll find plenty of support from many good people on this site.
I had emailed Dr.Myers (through the website) but I believe he does not offer telephonic consultations yet. I'd be more than happy to visit his clinic. But I am unsure whether he would be willing to follow-up with our doctor here and how feasible that would be.