AS Update - Waiting for MRI Results

Hey All!
I've been on this forum since being diagnosed with G6 PCa way back in 2014, when I started Active Surveillance (sort of). My (ex) urologist was a surgeon and was not really up on proper AS protocols, but my PSA was so low, and my cancer was so low volume and low grade (see my sig), I wasn't too worried. However, because of this Forum, I became better informed about AS protocols than my urologist. You can never go back, you have to start where you are, and make the best decisions you can going forward.

So fast forward to COVID, and I could not get into my uro for my scheduled checkup, which would have only been a DRE and a PSA. When they opened back up for appointments I couldn't get in, so I went to my GP and got a PSA. Well that came back at 4.79 and I kind of freaked a bit. I asked my uro about getting an MRI or a biopsy and he literally said... "why would I do that? I already know you have PCa." At that point I knew it was time to make a change and I switched uros . I scheduled a consult with Dr. Zabell at the University of Minnesota, who immediately scheduled me for an MRI, which I had today. I will get the results next week. He also ordered another PSA and I got the results back in just a couple hours, and it has dropped back down to 3.59, which is more along the lines of the trajectory it's been on over the past several years. There are a few entries missing in my sig, but if I remember correctly, my last PSA pre-COVID, which would have been sometime last summer, was around 2.7.

Anyway, no matter what comes back on the MRI, I'm a bit relieved that my PSA has dropped by 1.2 over the past few months. If I can stay on AS, I am glad that I am now going to be following the proper protocol (MRIs, Biopsies). If it turns out that it's time for me to get treatment, I have more trust in my current uro. He is a surgeon but he will set me up with radiation oncologists at the U so I can explore all treatment options.

Anyway, wish me luck. I hope I can stay on AS, but even if not, I feel like I am getting better care, and I have more trust in the team at the U of M. I guess another point I am trying to make is that it's best to take control of your care and not be afraid to question your doctor, and make a change if you feel it's warranted.

Rock and Roll!
GeetarMan

You really haven’t been following an AS protocol. That would have required an MRI and a targeted biopsy every 2 years (varies among programs).

But, hopefully the MRI and subsequent biopsy will confirm your continued low risk.

You should ask about the availability of the Precision Point transperineal biopsy system. Only requires an exam room, local anesthesia, no antibiotics and no infections.

Nice, glad you found someone at the U of MN that you like. I have found the university to be pretty good with respect to cancer with my wife and it is a short drive. Only issue is that many of the doctors teach and do research so she gets half of her monthly visits with a PA. Everything has been via video since the pandemic began other than actual visits for scans. The merger with Fairview/HealthEast has caused some electronic records problems but they are getting better. My wife can just go down the street to a MHealth clinic now for blood tests which saves a lot of time.

I had a MRI prior to a biopsy and it went downhill from there. I hope you have good results and can continue on AS. If not, you go down a well travelled road that most people here have gone, not quite Route 66, more like a bumpy Minnesota highway at the end of winter.

Mort importantly, have you watched Guitar Man about Joe Bonanassa? Good story although a little too much like Joe wrote the script, the guy can play.

Hello, GeetarMan ~~~

Will echo your sentiment that we all need to have the right doctors on our "team" ~~~ and sometimes you have to "take the bull by the horns" and change doctors.

My original urologist saw "brick walls and closed doors" and nothing but LUPRON shots, when I was first diagnosed. My initial PSA was over 100 at diagnosis.

I knew I needed a new quarterback on my team, and added a medical oncologist. My urologist was taken aback, when I told him I needed more options.

I met my new oncologist on a Monday and he had new treatments going for me that same Wednesday.

He opened locked doors and chiseled out windows in that "brick wall" beyond all my expectations.

Along the way, I encountered another oncologist who spent no more than two or three minutes at each consultation. He was also very dismissive in his manner. Needless to say, I did not add him to my medical team.

One look at my health history below shows you that I need doctors who are proactive and visionary. I have the best doctors that I could ever ask for, and I am grateful, each & every day.

It's amazing to me how many fellows post here, who were not well served by their doctors.

Seek out the best --- and don't be afraid to "take the bull by the horns" --- just as you did --- and get the doctor that's right for YOU.

Keep us posted, GeetarMan! Let us know how you're faring!

With my best ~~~
CYCLONE ~ # Iowa State University

Hello GM,
I haven't had great success with biopsies myself, but I think you will be well served with a biopsy if your last was in 2014. I'm expecting one this year so we can be miserable together. Yes wrong answer by your first uro. I'm glad your getting the proper testing. Although I'm a prog guy, I don't get excited with how fast one can go through scales. I'm a campfire type of player who stuggles with barre chords so don't mind me.