Any advices would be highly appreciated

I am 62 years old. no family history. generally healthy. 11/2013 PSA 39.8 but my GP did not tell me until Jan/2015. I did another PSA Jan 14/2015 and it is increased to 47.9. MRI diagnosis is prostate cancer T3a. Repeat PSA on Jan 23/2015 and it is 42.4. I am waiting to do bone scan and CT. I am in panic now and I would be very grateful if any of you give me some advice for my situation.
Thanks a lot

andy

I agree. You need to find a good urologist, not sure about another PSA and free PSA, since the MRI already showed strong suspicion of PC. Seems like the next step should be a biopsy. And when you get the results, if positive, have the slides sent for a second opinion, to Johns Hopkins or Bostwick Labs. Reading Prostate slides is very subjective and should be read by a pathologist with a lot of experience specific to Prostate cells

I would fire your GP if I were you. To come up with that PSA in November, and not tell you until January, is unconscionable.

Who ordered the MRI.? Do you already have a urologist?

Good luck and keep us posted

It depends on your bone scan. If it's negative, talk to a radiation oncologist who does high dose rate (HDR) brachytherapy. With your clinical stage of T3a, surgery is a poor choice - only radiation has the potential to cure you. The best radiation for cases like yours is multimodal - a combination of brachytherapy and external beam radiation, probably with some hormone therapy too.

- Allen

PSA of 40 and your GP waited 14 months to tell you. That's shocking.

I agree that you need to find a good urologist. Links below in my signature are helpful for guys newly diagnosed with PC.

-Gedman

compiler said...
Am I missing something (help me here, Allan)?

I don't think an MRI is truly diagnostic.

Don't you still need a biopsy.

Prat gave you good advice.

In fact, this borders on malpractice (not telling you your PSA for 1+ years? Then not doing a biopsy?

Mel

My uro guy told me that an MRI was not 100% and wanted to be sure by me having a biopsy. I am glad he did, because my MRI showed nothing suspicious.

No. 3T means 3 Tesla, which is the magnetic field strength of the machine. Up to a point, you get better resolution with higher field strength. Endorectal coils may be used with 1.5 T MRIs to increase the resolution (but it deforms the prostate).

There are many parameters that an MRI can look at. When 2 or more are looked at at the same time, it's called multiparametric (mpMRI). For PC, some of those parameters, when taken together, can actually detect higher grade cancers and fairly small tumors that wouldn't be visible without them. It requires an expert radiologist to score and read the various parametric images.

So you can have, say, a 3T MRI that is not an mpMRI, or a 1.5T MRI that is an mpMRI, etc. with or without an endorectal coil.

- Allen

My husband had his psa tests done every year from 2005-current...back in 2005 and 2006 it was in 1.5 range---then doctor didn't tell him or inform us of any results after that until it hit 13.8 last year!!! We did contact a lawyer and it seems that although his PSA results were flagged by the lab every year as being too high, and his doctor's didn't inform us, we still don't have a leg to stand on.
It seems according to the lawyer, that as long as the Dr was ORDERING the tests every year, he was under no obligation to actually inform us of the results.
To this day, over a year later, my blood boils when I think about it. My children are probably going to lose years of time with their father, and I with my husband, because of some jack ass doctor with a God complex.
Ps. This Dr was a friend of hubby's and hasn't spoken to us since....hubby is afraid that if he sees him somewhere, he may punch him out.

WHAT???!!!!

I'm not a lawyer, but I thought that malpractice means that the doctor failed to maintain a reasonable standard of care.
Ordering the tests annually is great. But then doing nothing about such results???
Please get a SECOND LEGAL OPINION.

Mel

Good grief, we had a similar experience with our PC, except he ignored my husband's failing health and kept attributing his pain and foot numbness to his back issues. He also failed to follow up on a prostate exam for three years that he claimed was "somewhat enlarged and we'll keep an eye on it" when my husband complained of trouble urinating. His referral for PSA came from endocrinologist after I finally went over the PC's head. His PSA was almost 1900. With so many similar experiences, there needs to be a change among the medical community...but I've been on this soap box before. Whatever you do as far as lawsuit goes, don't delay in getting that biopsy, but also, don't panic too much. There are a lot of treatment options and you will get a lot of advice and support right here. Welcome and best wishes! Beth for Gary

Andy,

Have you had a biopsy yet? It is a procedure where the doctor pokes an ultrasound wand in your rectum and uses a spring-loaded needle to collect small amounts of prostate tissue for microscopic evaluation. The result will include several measures of your disease including a "Gleason Score" that describes the changes in the cells. A Gleason Score is written as the sum of two numbers. Mine is Gleason 9(4+5). In general smaller numbers are better and you want the first of the two numbers summed to be the smaller one. Gleason 6(3+3) is the lowest score that doctors will bother to report and Gleason 10(5+5) is the highest. The scores we usually see are these:

better -- GS6(3+3), GS7(3+4), GS7(4+3), GS8(4+4), GS9(4+5), GS9(5+4), GS10(5+5) -- worse

From what you have told us we can tell that you will need some sort of treatment but what sort of treatment will depend on the results of your bone scan and on your Gleason Score.