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Posted 8/1/2014 8:59 PM (GMT 0)
Been reading this site for over a month. If my sig shows up there is current info on my numbers.

58, healthy, went back to weight lifting, diet etc, but can't shake the belly fat or love handles so looked into TRT, HRT. First get full blood work specifically for PCa and vit d etc. All looks okay, vit d tad low at 30, T 444 etc. But know enough to be concerned with rather large % jump in PSA (2.25 to 3.5 in 2 years) and free % (9). Call my URO and get DRE and PCA3. PCA3 81. That's when I find you guys and begin my education. Reading leads me to Leonard Marks UCLA for targeted fusion biopsy which he recommends after 2 tests show 3.8 and 5%, then 4.2 with 9% within days of each other also urine shows no infection. Did it, more pre test stress than actual procedure (already had laser TURP). 13 cores. MRI shows one spot 7mm that he thoroughly hit (BTW prostate 29g, small). He's got an amazing manner, great staff given that it's at UCLA, and a really neat technology. Minimal discomfort, zero pain, maybe a drop of blood in urine, guess I'm one of the lucky ones.

So I go back next week for results. Like all here you prepare for worst hope for best. Have a couple young boys, 11 and 7 so have to be somewhat aggressive though not jumping into anything without multiple opinions. If it's low I'm happy to AS or watch. I live in L.A. so easy acess to Dr Scholz and Bahn, though not sure I need them. Also referred to Onc Dr. Agus. I am particularly interested in the TFT in Colorado that's been beaten around here a bunch if its really just a small deal.

I'm smart and calm but I wanted to get a thread started. If there is a positive result, I have learned from here to send for second opinion. Anyone local to L.A. or how would I send to say Epstein or?

Thanks for all you have given, it's been tremendously helpful.
Posted 8/1/2014 9:14 PM (GMT 0)
RE second opinion, You just have the Uro who read the slides fedex them to Epstein. Instructions are in JH website. Cost is$250.
Bob
Posted 8/2/2014 12:20 AM (GMT 0)
Welcome.

While the free PSA < 10% is not typically good news, the small prostate and relatively low PSA offer some hope.

Let us know the biopsy results.

LurponJim
Posted 8/2/2014 12:36 AM (GMT 0)
Send to either Epstien or Bostwick labs.

After you get results you might want to get a second opinion consult with Dr Scholz in Marina Del Rey and he will recommend the best options for your individual situation.
Posted 8/2/2014 1:28 AM (GMT 0)
Hey Jdad,

Welcome to HealingWell and I really hope you don't end up needing us.

It sounds to me like you really are smart and calm; you seem to have approached this smartly, and I'm confident that you'll be all right whatever the biopsy shows.

I have no advice for you other than to hang in there and keep your sense of humor. You'll get through this. This is a great community with lots of well-informed people who are very supportive. You landed in a good place. Let us know how you make out, and if you have any questions you know where to come with them.

Best,

Jonathan
Posted 8/2/2014 3:23 AM (GMT 0)
Thank you for your thoughtful replies. All is on my list per the many threads I read here. Thinking to see Dr Scholz or Gross (Agus' partner) in Bev Hills. Hoping for best based on PSA and size too, but the free %, .7 rise in a month and PCA3 give me pause. Hoping to be poster child for their occasional inaccuracies and false positives. I know I have a great place to work it out here. Thanks.
Posted 8/2/2014 4:06 AM (GMT 0)
Welcome aboard. Hope you don't need our services long term, but if you do, couldn't have found a better place online then to call your PC home.

Rather hope you are just visiting, but will be waiting to see your final results.

Good luck,

David
Posted 8/2/2014 5:01 PM (GMT 0)
Hi JDad-

Leonard Marks has been doing some great work in the development of mpMRIs/US fusion biopsies, and his radiologist, Daniel Margolis, is arguably among the best in the country. An great mpMRI is useless unless there is a rockstar radiologist to make sense of it. You certainly don't need a CDUS (Bahn, Ukimura) if you have a reading from them.

Here are the links for Bostwick and Epstein:
/www.bostwicklaboratories.com/services/laboratory-services/second-opinions.aspx
pathology.jhu.edu/department/services/secondopinion.cfm
I think you are very smart to get a second opinion, as several men in my support group have had there Gleason scores changed after an initial reading by a UCLA pathologist.

Dr. Marks is my Urologist - why not stick with him? I interviewed 3 urologists before I found him. I think he is excellent, and since he doesn't do surgeries, he is very open to all therapies. I don't know if he is taking on new patients. I think you are kind of putting the cart before the horse in looking at urologic oncologists before you even have a diagnosis. Agus/Grossman and Scholz/Lam are excellent for advanced PC - but kind of a waste at this point, imho. I suspect that if you do get a PC Dx, your TURP may affect treatment alternatives.
Posted 8/2/2014 7:16 PM (GMT 0)
Good advice. So if Dx, will send off for another reading. Marks did admire the TURP and said one of best he's seen, so maybe real clean. Never thought may limit my choices. I certainly won't contact anyone until I know, but good to line up the players then come here and lay it out. Quite certain he would keep me as patient. Great to have him lead, he's a great guy as well as doc. Feel confident I've done my homework. I'm actually pretty relaxed about it with posting here being my final act pre-results. Think I got it as early as could have. I've been pretty up on blood #'s and aware of the lack of depth internists and GP's have about these and other types of critical things (including my Bev Hills primary). I have had 2 life changing procedures that my internist chalked up as aging! But I was in my 40's and in great shape. Went from peeing every 20 minutes to every 5 hours and rarely get up at night. Really think folks should be willing to seek specialist when they aren't getting issues resolved and not worry about insulting their primary. The web is an amazing tool. I also had run away blood pressure getting worse even with double BP meds for 2 years. Great cardio scanned and found a fluke in a 90% blocked renal artery. Got a renal stent, BP 180/120 w/meds to 100/60 with no meds in days! No discomfort from the procedure at all. 20 minutes! You all have taken control of your issues and I admire that greatly.

Again thanks.
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