PSA soared from 1.7 to 55.2 in 6 months!

Thanks everybody, I have been pressuring myself all day with this next important step and I was stressing because I felt like I had to figure out whether or not I was going to cancel that appointment THIS MORNING and if I did would THAT be a mistake as far as waiting too long. Thankfully the Banner DR. answered my message to him within a 1/2 hour of when I sent it (I figured I would be lucky if I heard back from him tomorrow) and said that it wasn't THAT time-critical where every day counted. Of course, I won't be stupid and wait weeks, in fact, I would do it right now if I could, but I realize now that getting it done RIGHT is more important than getting it done RIGHT NOW. Micheal_T - you nailed it with: "getting yourself in the hands of some of the best in the business is what you need". Abso.....lutely!

I gave this a lot of thought today and thought about what a shame it would be if my insurance didn’t cover it, what a pain in the *** it would be to travel, etc. Asking myself if I was overreacting and does it really need to be “in-bore”. I came to the conclusion that no, it doesn’t have to be in-bore but this is “serious as cancer” for God's sake! Unless some info comes up that makes it CERTAIN I wouldn’t gain anything from it I am going to get an "in-bore" MRI-guided biopsy even if my insurance doesn't cover it. I HOPE I am overdoing it and I didn’t need to get the best. Because gosh darn it, I am worth it!

Am I rich? Hell no! Does it matter? Hell no! I make a comfortable, middle-class living so yeah, I will certainly feel the financial sting of this but oh well. I will get over that. I know it PROBABLY isn’t but this COULD be the difference between catching something right away or missing it for years with a false negative. Not to mention, the less blind needle poking at my prostate the better.

I am willing to bet my prostate that my current urologist does not have access to in-bore MRI-guided equipment. I had to go to radiology LTD to get the MRI and he will be doing the biopsy at his facility so even if his office staff couldn’t tell me (utterly obnoxious but true) I really don’t need them to.

I know most places don't even have them and I wouldn't be surprised if there wasn't even one in all of Arizona but I found one in California at least: https://desertmedicalimaging.com/prostate-cancer-program/

Mumbo, solid advice about calling Banner to see if they do "in-bore" MRI-guided biopsies. I am going to give them a ring first thing in the morning to find out. Researching on here and on the internet, it sounds as if "in-bore" MRI-guided biopsies are the latest craze and all the kids are getting one. But seriously, it is the most accurate correct?

Post Edited (PBH) : 5/20/2021 11:10:03 PM (GMT-6)

Don't underestimate the ability of experienced uros to interpret the ultrasound shadows when taking the random cores in the non-target prostate zones. My biopsy was prompted by a new nodule felt on DRE and I asked my uro to take a couple of extra cores, so he did 14 in all. The nodule turned out to be benign (as 50% of them do). However, without a prior MRI, he managed to hit two positive cores in two other zones, even though PCa occupied only 5% of my prostate as calculated in the post-RP report. That's pretty good aim -- "random" cores aren't always truly random.

(Just as with mpMRIs, not all areas that appear suspicious on ultrasound are PCa; in general all atypical tissue, whether malignant or benign, reflects and absorbs imaging energy differently than healthy tissue.)

Djin

Yep, my current, appt (to be cancelled in a few minutes) is of the Ultrasound flavour. So "it's a biopsy with a scope" is medical jargon for ultrasound.

Some insurers will pay for an MRI (only) after a negative biopsy. But that can be one way to avoid out-of-pocket cost.

Djin

Bad news and possibly good news. Got the MRI results back: PI-RADS 4 (I thought at first it said 5, yikes!) They describe 4 as High (clinically significant cancer is likely to be present, biopsy likely to show Gleason score >= 7, tumor volume >0.5 ml, and/or extraprostatic extension). The chance of prostatitis or bph is less likely. I will meet with a urological oncologist at Banner tomorrow, can't wait to hear what he thinks of this.

Now for the potential good news: Here is something crazy:
PSA in Sept 2020 = 1.7
PSA in March 2021 = 55.2!
Took another PSA test Friday, just got results this morning: PSA = 3.5! What in the what?!
Still a medical puzzler. I am not getting my hopes up but to me it seems logical that this decrease down to 3.5 gives me at least a chance for having just garden variety, slowly developing prostate cancer as opposed to the aggressive failure. Or at least something in between. Who knows though, maybe it means that the problem is something else entirely and this mystery ailment threw all the tests off. I wouldn't be surprised if even the urological oncologist I see tomorrow is as mystified as all my other doctors are so far and he tags in "Mr. prostate cancer specialist himself" DR. LEE! Dr. Lee is legend, well published and always actively involved in research. If HE is puzzled I think that means that I get to realize my lifelong dream: being a subject in a medical encylopedia of medical oddities! 🙂

What is your guys' take on this?

The items can be mutually exclusive in that you can have PCa and also have something else that is causing your PSA to fluctuate so your PSA becomes useless as a cancer indicator. This could be one of those coincidences where you might find PCa as result of something else.

My wife fell and bumped her head with some continuing back pain afterwards. She went to her doctor who ordered a CT scan just to be safe which showed an unrelated lesion on her rib that turned out to be a breast cancer recurrence. It was found for all the wrong reasons as she had no symptoms and without the fall, would have not discovered it until too late to do much. She is doing great so far.

I think you just roll with it and get a biopsy to put the PCa matter to bed. You either have it or you don’t. Time to start process of elimination and get to the bottom your issues.

PBH, you have every chance of coming back from biopsy with low to intermediate grade PC. Let's consider: the MRI did not suggest any bulges or extensions outside of the gland, no pelvic hot spots. That's all to the good.

It's certainly a discussion point to ask about your gyrating PSA readings, because if you do have diagnostic level PCa, and it's significant enough to treat, having an idea of what your PSA really is will be important down the road, especially if you go with a radiation treatment. It would be assumed that if you chose surgical treatment, whatever else is going on down there would be removed with the cancer.

Hey PBH, sorry you need to be here but I am glad you are. You have come to a good place! This is the best forum on the net for PCa with the most active and knowledgable users you could possibly want!

This is my second round with the beast. I had bladder cancer back in 2005 and beat that, and now I am 5 days out from RALP surgery for G8 PCa.

After reading through this entire thread I'll pass on the best piece of advice I can give to anyone on the subject. This is my own personal philosophy, and I'm sure others have touched on the same line of thinking, but I put it this way...

Don't worry about something until you know what you have to worry about!

You can consult Dr. Google for hours, you can imagine so many scenarios, you can find all kinds of similar cases that had everything from fantastic to disastrous outcomes. I find that a waste of time and energy. You can find so many things to worry about, and guess what? The vast majority of those possible outcomes will not apply to you. Go get the tests, wait for the results, and try and keep your mind off of it as much as possible until you know exactly what you are dealing with. Why waste time worrying about possibiltles that will not happen to you? Deal with the facts as known.

A lot of your comments are along the lines of "it might be this," or "it might be that," and "what if this?," or "what if that?" Or "this result seems to indicate that the chances are more likely that this will be true instead of that." I hope you take this advise in the spirit in which it is given. It helped me so I hope it helps you. You may have a long row to hoe here, and there will be a lot of information coming your way, and possible life changing decisions you will need to make. Take them as they come!

I think the best thing to research is once you know exactly what you are dealing with, do the research and ask the questions to decide on your course of treatment, that is time very well spent!