Seven Years on Active Surveillance

Hard to believe it have been seven years from when I was first diagnosed with PCa. I have had a total of 5 biopsies with only one core of G6 found back in 2012. From my signature you can see my PSA has been rising consistently about 1 point a year, now it is over 12. and Dr. said the rise can be from the biopsies. I was hoping my last biopsy would turn up one core positive so I can do a genetic test. Just though I would check in, this site has been a great source of information. I do miss Tall Allan.

Why would you say some form of treatment is needed? Looks like 5 biopsies and an MRI. I'm in a similar situation but my biopsies have all been negative.

Oh yes, biopsies can definitely jack up your PSA. Doubled mine one time and tripled it another. But, it returned to normal after about six months in both cases.

I will be having my SIXTH biopsy tomorrow. Not that I want it, or that anything showed up on my last MRI, it is just the protocol of the strict AS program I participate in. And, yes, almost five years since my last biopsy is not acceptable to Dr. Carter. Since he is the most successful AS group director on the planet, I’m not resisting this “last” protocol biopsy.

But, mine will be using the new Precision Point transperineal device, which produces no infections, and requires no antibiotics.

Enough of my rant. In your case I would recommend the PHI blood test, and then calculate your PHI Density using the prostate measurement from your MRI. Johns Hopkins has found PHI Density to be the most accurate predictive test for clinically significant prostate cancer. Good luck.

Anything causing inflamation increases PSA. Biopsies can elevate PSA for months. However, I agree with the comments pointing out that the systematic increase of PSA is worrisome. I had similar figures, about 4 in 2012, about 7 in 2017 and my prostate was removed more than one year ago. However, everybody is different I had a clearly positive MRI report. Do you know if your MRI reports give a PIRADS grade?. Sometimes biopsies are negative because they miss their goal (mine showed very small amount of G6) even when they are MRI directed but the mpMRI itself gives a good clue that something is wrong.

Thank you everyone for your replies, a lot of good food for thought. I was seeing a great Dr. at MSKCC who did two MRI guided biopsy's in 2014 and 2016. He couldn't explain the high PSA but wasn't to concerned. Said it could be due to infection or irritation. Unfortunately I changed insurance plans and can no longer go to MSKCC. The Dr. I am seeing now is the head of Urology at the Cancer Institute of NJ. Has done over 2000 surgeries. He wouldn't fight my insurance co. for a MRI and wouldn't put in a prescription for a PHI test. He said the biopsy is the only test. Its his was or the highway. I need to find a Dr. who is more geared to AS rather then surgery.

ASAdvocate, My prostate is fairly small at about 30 cc. I have been above the .15 value for the last 6 years. It is very concerning. Everything is pointing to treat except my biopsy and MRI results. If I ignore my PSA then I would be a prime candidate for AS. My last two Dr.'s from leading cancer centers (MSKCC and Cancer institute of NJ) aren't recommending treatment yet. I'm thinking if there is a spike in PSA or a positive DRI I would start looking into treatment more seriously