Question re: upcoming meeting with Urologist re: Prostate Cancer

[carlsbadjack]

Dx with Prostate Cancer on 12-20-2019. Biopsy found 1 core with cancer as follows

Prostate, right medial apex, core biopsy:

Prostatic adenocarcinoma, Gleason 3+4=7 (Prognostic Grade Group

II), measuring 5 mm and occupying 15% of the biopsy core (20-25% pattern

4)

All other cores were benign, with two having "with chronic inflamation". My PSA number fluctuates a lot. My last was 10.0 in April 2023, the highest ever. Before that in ascending order, I had a 2.9, 2.4, 8.2, 2.6, 5.39 and 7.79. I have a meeting with my oncologist on May 16. I am sure he is going to want a biopsy. I will request transperineal, as I have had an issue with the transanal biopsy the only time I have done one I have been on Active Surveillance since diagnosis.

My question is looking for input. I have not seen an oncologist or a pathologist. Which should I see prior to beginning any treatment. Would be especially interested in a response for Tall Alan if possible. Also, plan to send my slide to John Hopkins per previous Tall Alan's posts. Would appreciate any and all input regarding my next moves.

Thanks,

Carlsbadjack

[carlsbadjack]

Tall_Alan, could you respond to this please.

Jack

[newyorkman1107 in reply to carlsbadjack]

recommended reading: welcometoactivesurveillance...

1-have you had an MRI?

2-did you get Epstein second opinion on the 3-4?

3- do you know your gland size? With that you can calculate your PSAD.

4- Did you do any genomic test after your biopsy?

My suggestion - be armed with more info before your inc appointment.

And find a provider for the PrecisionPoint freehand TP biopsy

[RMontana]

Here is my 'shoulda-woulda-coulda' list of things I did wrong and by some miracle would do differently if I had a chance...you are just starting out! Watch out for yourself! DO NOT depend on any one Doctor or specialist; get 2d/ 3d opinions. Study your condition, know the affects from your treatment, make the best call you can and proceed! Then rinse and repeat...this is a long road that can carry you to a successful, fully functional outcome. Do not worry once you make a decision and make it based on the best knowledge you can obtain. Here is my laundry list of what I would do over again. Rick

healthunlocked.com/active-s...

PS watch out for your 1) a cure, 2) continence and 3) erectile function...do this all at the same time. Do not take a 1-2-3 approach...they affects the other at the time you seek a solution to each. Watch out for all three at the same time. Trust me once you reach a point where you realize you could well expire with this disease, not from it, (2 and (3 will bug you a lot...

If you want more reading check out my posts which will find under my avatar...good luck. Rick

[carlsbadjack in reply to RMontana]

Thanks R Montana. Yeah, my eyes are wide open. I'm not rushing in to anything. Urologist appt on 16th. I feel comfortable with him as he is a surgeon and said early on, let's watch for a while, and radiation if treatment needed at this time. But he recommended A.S. to start. Thanks for input. Trying to decide who to see for second opinion.