HealingWell
Search Close Search
☰

Newbie- reading and learning in Indy

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/6/2017 12:21 AM (GMT 0)
Hi everyone

First, thank you for all of your information, perspectives, advice, etc. This forum has been the resource I had been looking for. I have been lurking for a couple of months since my PSA results in March and April. I will post my info below.

At my annual physical in March my PSA was 4.571, DRE negative. Doc put me on a round of antibiotics and scheduled a new PSA 4 weeks later. In April it had jumped to 5.38 and Free PSA was 9%. I was referred to a Urologist in the IU Health system.

The first available appointment was 4 weeks out. When we met with him, the doc was less than excited that I had questions. He had an assistant doctor who was great and told us about the various options available to us. Urologist did no exam, informed me that I needed a biopsy and someone would call me to schedule. I scheduled the biopsy (another 4 weeks) and contacted some physician friends that I work with as well as my wife's former Endo (also work with him). He recommended a different Urology group. Long story short I had an appointment with a Urology Oncologist who specializes in prostate cancer. Really liked the guy. Let us ask as many questions as we needed, was never in a hurry to get out of the room and actually did an exam. DRE still negative. I scheduled a TRUS Biopsy with him that was performed Tuesday June 27.

I received the results by phone. I was told that all 12 were clear and the doc wanted me back in 6 months for a recheck exam and new psa test. I have not seen the actual report yet. I am waiting for it to be released to my online account.

Relief...yes, but still have concerns and questions. My PSA is up for a reason. My Endo friend also suggested I talk with the Cleveland Clinic. Anyone have any experience with CC? Should I relax and wait the 6 months before doing anything else?


Daron

Age 51 - 1965, 52 on Friday!

06/27/2017 - TRUS Biopsy 12 samples clear
4/11/2017 5.381
3/14/2017 4.571
3/3/2016 New doc. No psa pulled
12/4/2014 1.7
11/21/2013 1.5
9/6/2012 1.3
8/17/2011 0.8
8/6/2009 0.7
8/18/2008 0.6
Posted 7/6/2017 1:02 AM (GMT 0)
dmanIndy,

Welcome to the forum. Sorry you have worries but glad you found us. Hope we can help.

I don't see you have many options besides wait-and-retest. Waiting the full six months probably won't hurt you but you can ask for a recheck in three months if you want to. You might ask about a test called a Prostate Health Index (PHI) next time. It's a newer test that is better than PSA and free PSA. Insurance will usually pay for a PHI but, even if they don't, it's not crushingly expensive and it gives better information than PSA/fPSA.
Posted 7/6/2017 3:49 AM (GMT 0)
Hi Daron, While the negative biopsy is cause to celebrate, the low free psa would indicate a need to keep monitoring you for the possibility of prostate cancer.

You very well could have prostatitis, with its spikes and false psa negative tests.

As Peter mentioned, request a PHI test the next time. Also, any follow up biopsy should have an MRI beforehand, so that the needles can be fusion aligned with any suspicious images.

For now, just relax.
Posted 7/6/2017 4:17 AM (GMT 0)
The negative biopsy was a good thing..The first biopsy will find the cancer if it's there 90% of the time....But 10% of the time it fails to spot the cancer..It took 3 biopsies to finally spot mine....Unfortunately, having multiple biopsies is not that unusual..They will be watching your PSA number carefully. A rapid rise means more biopsies....
Posted 7/8/2017 1:45 AM (GMT 0)
Thanks for the comments and perspectives.

Hope everyone has a good weekend.

Daron
Posted 6/13/2018 3:20 PM (GMT 0)
Hello again

My PSA jumped from 5.4 to 8.48 during my annual physical in May. Urologist ordered an MRI. The results are below. My doctor's wife had a baby so my appointment with him to go over the findings has been pushed back two weeks.

I will assume another biopsy is in my near future. Any thoughts on what I have been given. I should have insisted on the MRI last year when they did the normal TRUS biopsy. Oy.

Start of report:

Imaging was performed with and without contrast per prostate protocol. 12 mL of gadavist was administered.

The prostate gland has dimensions of 3.7 x 3.6 x 3.9 cm. This would give an estimated volume of 26 mL. There is a 6 mm focus of restricted diffusion within the mid substance/mid gland on the left. This demonstrates mildly restricted diffusion on series 11 image 16. It is somewhat low in signal intensity on the ADC images on series 10 image 16. There is a large area of restricted diffusion at the junction of the central zone and peripheral zone at the apex of the gland. Please see series 11 image 13. This measures up to 1.7 cm in greatest dimension. This is markedly low signal intensity on the ADC sequences. Please see series 10 image 13. There is also marked significant enhancement in this region.

There appears to be mild central gland enlargement with a focal central nodule in the right within the mid gland measuring up to 1 cm. The peripheral zone contains mild heterogeneity on the T2-weighted sequences along the mid gland. Prostate capsule is intact. There is symmetric fluid within the seminal vesicles. There is no abnormal pelvic lymphadenopathy. The STIR sequences demonstrate no abnormal bone marrow edema or focal T2 bright lesion. The patient is slightly asymmetric herniation of fat along the right inguinal canal. No bowel extends into this region. The muscles are symmetric without atrophy or abnormal T2 signal.

Impression:

1. Estimated prostate volume of 26 mL.
2. 1.7 cm area of restricted diffusion at the most caudal or apical portion of the gland. Given its appearance and signal characteristics this would suggest a prior RADS 5 lesions: Very high (clinically significant cancer is likely related to be present). On MRI this appears to extend along the anterior margin of the prosthetic urethra.
3. 6 mm small nodule within the peripheral zone of the mid gland on the left. Please see series 10 image 16. This demonstrates mild restricted diffusion and is of low signal intensity on the ADC images. This would suggest a PI-RADS 3 lesion: Intermediate (the presence of clinically significant cancer is equivocal)
4. Mild central gland enlargement with a benign-appearing round nodule on the right. This would be considered a PI-RADS 2 nodule: Low (clinically significant cancer is unlikely to be present)




Daron
Age 52 - 1965

06/06/2018 - Prostate MRI completed
05/22/2018 8.48 - Big jump for six months
12/22/2017 5.368
06/27/2017 - TRUS Biopsy 12 samples clear; 2 samples labeled Acute and Chronic Inflammation
4/11/2017 5.381
3/14/2017 4.571
3/3/2016 New doc. No psa pulled
12/4/2014 1.7
11/21/2013 1.5
9/6/2012 1.3
8/17/2011 0.8
8/6/2009 0.7
8/18/2008 0.6
Posted 6/13/2018 5:25 PM (GMT 0)
Whatever it is is in an unusual place (along the bottom of the central zone). A recent study highlighted the importance of taking 5 cores in the high PIRADS area, so make sure they do that. Let us know what the biopsy finds.
Posted 6/13/2018 7:21 PM (GMT 0)
Thanks Tall Allen. I am anxious about the results. Sometimes Google is not your friend.
✚ New Topic ✚ Reply