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Posted 11/18/2021 3:54 PM (GMT 0)
Had my 6 month PSA test yesterday. The result came back at 6.72. That is up quite a bit from 4.2 on the last one.

I am racking my brain trying to find a reason that it went up. Have not found one yet. I had a surgery a couple weeks ago on my foot. I donā€™t know if the antibiotic or just going thru the surgery could have had some effect.

When I couple that with the latest MRI going from T-2 to T-3 it is a bit worrisome.

I have a biopsy Monday, which was already scheduled as part of my AS protocol, and we will see what Dr. Smith has to say before the biopsy and once those results come in.

I guess it is time to put the worry hat on for a few days until the biopsy results come back after Monday.

Larry
Posted 11/18/2021 5:53 PM (GMT 0)
Hi Larry:

Iā€™m sorry to be Dr Gloom but the chances are good that you have clinically-significant PCa and not so good that a biopsy (if itā€™s 12-needle) will find it.

The good news is you have a full choice of treatments available and if you find the right surgeon should have minimal SEs even from surgery, if you go that route eventually.

Where is the MRI target? Does it correspond with biopsy 1? Will biopsy 2 be targeted? (They missed mine!). Can you get a saturation trans-perineal one? Itā€™s no fun but nor is ā€œproper ā€œ PCa.

Good luck and keep us posted.

SUM
Posted 11/18/2021 5:54 PM (GMT 0)
Your PSA history does not seem to be a good indicator of anything other than the initial jump from 2.7 -> 4.17 which led to your previous 3+3 biopsy. The 2nd biopsy should help determine if this is a significant concern or not. Were you doing any physical or sex things before the last PSA test? or any of them for that matter?

I am sure that Nov 22nd can not come quick enough for you but you don't have an issue until you do so try to keep that in focus. The what-if game is the devil's workshop.
Posted 11/18/2021 6:04 PM (GMT 0)
Pretty much what Mumbo said. Your PSA has been all over the place, so I don't think the most recent one tells a definitive story. Hopefully, the biopsy will shed some good light.

Good luck!
Posted 11/18/2021 6:18 PM (GMT 0)
PS I never replied on your other thread to your kind question as to how I am doing. Hunky dory, thanks! 2 of the trifecta in days but sweating the cancer one (first PSA Dec 15) because I should have treated earlier. Should be < but not convinced how long it will stay thereā€¦
Posted 11/18/2021 8:32 PM (GMT 0)
In your shoes I would call ahead and ask to have more than 12 cores taken at your next biopsy, perhaps 16 or 18, unless your uro already has even more planned. To continue on AS you want some indication that you don't have any lesions greater than 3+3, and if that is the case, that your amount of 3+3 hasn't increased significantly. If you agree, don't wait until your biopsy to ask, because the correct number of specimen cups need to be set up ahead of time.

Best of luck,

Djin
Posted 11/19/2021 3:55 PM (GMT 0)
Larry, @bbqdude, you have got me tinkering with some of the mathematics of uncertainty that IMO Drs need to understand. We all wish you luck: of course we do. So what is luck on Monday? It is not only a negative biopsy (3+3 only): it is also finding 4 if it is there. On a piece of paper, I get to about a 20% chance you have a 1mm piece of 4 and two 12-needle biopsies miss it. Depending on your personal preferences, that may be good enough for a year, so a negative biopsy is the luck we are wishing you. But I am not sure Drs appreciate that ā€œnegativeā€ biopsies are indicative not probative. Challenges welcome.
Posted 11/19/2021 4:49 PM (GMT 0)
Larry, For myself AS was not the best option even though I only had a small amount of 3+3. The data suggested that given my 12 core TRUS biopsy results and with a sound AS program I had a 50% chance of avoiding aggressive treatment and the resulting side effects. I didnā€™t feel the odds were good enough on AS and decided to explore treatment options. My goal was to find a treatment that had a very high % of stopping the cancer and offered a low risk of side effects. I found that with SBRT and my biopsy I had greater than a 95% chance of eliminating the cancer with minimal side effects. Almost five years laterā€¦no regrets.

I understand for some guys AS is a great option especially for guys diagnosed in their early 50ā€™s. I just want to suggest that your age, prostate size, past biopsy and PSA history suggest some aggressive treatment is in your future and SBRT is a good option to investigate. Other treatments I would suggest are Proton and HDBT. Good luck on your upcoming biopsy. Terry
Posted 11/22/2021 11:39 PM (GMT 0)
Updating- Today was biopsy day. It was performed by Dr. Smelser who does the majority of Dr. Smithā€™s biopsies (Dr. Smith did the first one when I first signed on with him).

This was a Artemis Biopsy. They did 15 samples. It was kind of neat and scary to get to watch the screen while he was doing it. He also provided play by play of the stress and allowed me to ask questions as we went along. I thought that was a great touch.

They even let me take a picture of the prostate and where the samples were taken.

He did the regular 12 cores in the pattern. He did 3 in the region of interest and made sure one of the other 12 was between the ROI and the exterior wall. It was good to see there was distance between the ROI and the wall. He explained he had enlarged the ROI shading on the screen. It looked huge to me but he said it was blown up some. If I knew how to do pictures here, I would post it.

He said they usually take 3-5 days for pathology there, but with this being a holiday week it would be more like 5-7 before I here from Dr. Smith.

I can any questions anyone has about this procedure.

You can get my email off my profile.

Larry
Posted 11/22/2021 11:54 PM (GMT 0)
Alright! Hoping for good news, or at least what you need to know.
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