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74yo PCA Potential Diagnosis Followup

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Posted 1/9/2020 9:22 PM (GMT 0)
I posted here about my fil. He is now scheduled for surgery, but the doctor hasn't explained all the possibilities yet.
His PSA is 4.2 and volume is 200cc, with one nodule seen on the ultrasound.
What are the chances this is just BPH? Or is there a higher chance for it to be cancer? I assume his doctor wants to go straight to surgery without biopsy bc the prostate is already very large and he is uncomfortable.

Post Edited (Sandie83763) : 1/9/2020 8:12:16 PM (GMT-7)

Posted 1/9/2020 9:27 PM (GMT 0)
This is so weird. Almost sounds like malpractice, but we need to know a lot more to come to that conclusion.
Please fill us in. And, BTW, 30 cc is not large as far as prostates go.
Also note that many surgeons won't operate on guys older than 70 unless they are in very good general health, otherwise.
Posted 1/9/2020 10:07 PM (GMT 0)
First, did he have a biopsy confirming the cancer? If so what are the details? Without a positive biopsy Medicare will not reimburse for the surgery. 30cc is actually small for a man of his age. Not alarming. Most reputable surgeons will not remove a prostate in men over age 74. Hoe good is this surgeon? Who is he and where is the treatment taking place?
Posted 1/10/2020 1:24 AM (GMT 0)
Guys, in her earlier post, she noted that he is in Romania. We cannot make assumptions based on US standard of care, or whether medicare will pay the bills, or anything. This situation sucks. We can see that he is not receiving anything resembling what we are used to seeing or hearing. I'm not sure what else to say.
Posted 1/10/2020 3:12 AM (GMT 0)
Sorry I wrote this in a hurry and I have mistaken the volume. It is actually over 200cc, so by reading online it would make sense to just take it all out?
Posted 1/10/2020 3:35 AM (GMT 0)
I'm confused on what you mean by "surgery." That could be a removal or if they're treating BPH there's a different procedure that just removes parts of the prostate (TURP). Doing a full RP for BPH would be strange. Doing a TURP for BPH would be somewhat normal. Tissue removed from a TURP could be sent out to a pathologist to determine if there is any PC.

It doesn't make sense to me to remove the whole prostate for BPH.

But those are the standards used here in the states.
Posted 1/10/2020 3:37 AM (GMT 0)
He was told it will be radical prostatectomy, because of the size. I am not sure TURP is done when it is that big. Sorry for the confusion, it is hard to get any information.
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