Prostate Cancer Survivors






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Re: PSA, MRI and Biopsy

Tony, thanks for the additional information. It seems the quandary exists because your PSA was not checked for 7 years (2012-2019). Now you have a high PSA, especially for a small prostate. I am not a medical doctor, but I suspect that sometime during that period you developed prostate cancer. It's probably a slow growing Gleason 6. The only way you are going to know is a biopsy (preferably a 12-core). That said however, I've had 4 and have sworn I would never have another. My advice is to monitor your PSA every 3 months and see the direction (up or down) and its "velocity" (rate of change). Personally, if it was me, I would wait until your PSA was >10 and then get a biopsy. If you do actually have PCa, a biopsy will tell you how "aggressive" it is. With a few cores of Gleason 6, you might consider Active Surveillance for a few years to maintain your current Quality of Life. With a Gleason 8-10, some treatment might be in order. As to what to ask you urologist next week, I would ask him what would your PSA level need to reach before he recommended a biopsy.

Regardless, at 64 you still have many more years ahead to enjoy life.

There you have my thoughts, perhaps others on this site would like to give theirs.

Re: PSA, MRI and Biopsy

Hi Joe, You must be thinking along the same line as my urologist in that had I hit the PSA 10, he would have probably done a biopsy. I will ask him. Thanks for the advice.

Re: PSA, MRI and Biopsy

The only other thing I can recommend is to be cognizant of your activities the day prior to your PSA test as many activities (riding a bike, having sex) can artificially raise your PSA scores and create an unfounded concern.

Re: PSA, MRI and Biopsy

Thanks Willian and Joe for your suggestions. 6 months later and PSA still bopping up and down within my range 9.6 to 7.1 to 9.1 so I consulted with 2 different cancer centers since and they both say the only way to really know what is going on is with a biopsy so I agree and will have a 12 core done in 2 weeks. I am now OK with the biopsy idea as my older brother had one and his experience was comparable to a colonoscopy. There are more options available now to treat Pca than say 12 years ago and I rather know now in the early stages. Problem is, even a 12 core biopsy may miss cancer cells and give false results.

Re: PSA, MRI and Biopsy

Finally got my Biopsy done. Honestly, the after effect of the antibiotic needle hurt more than the biopsy itself. The pathology report says I have a Gleason score (3+3) 6. 12 Cores biopsy. Number of cores positive = 3. There was high grade PIN in 3 cores. Will be meeting with Urologist to discuss but I would truly appreciate comments from the fine folks here at YANA.