Most Recent MRI

[ironmanburg]

Hello everyone, I am 72 and have been on active surveillance for prostate cancer since I was diagnosed in August 2021 but probably had it prior to my first MRI in 2020. I have had 2 biopsies and 5 MRI's and countless PSA tests. First bx showed 3 cores at 3+3 and 2 cores suspicious, confirmatory bx a year later showed 1 core at 3+3 and 1 core suspicious. My PSA has risen from 3.9 in 2018 to 12.7 and back to 11 this year. My previous MRI's showed a bladder outlet obstruction and BPH and one probable subcentimeter utricle cyst rated Pirads 2, the latest MRI report showed the probable subcentimeter utricle cyst as Pirads 3 (grew a bit) and didn't say anything about the bladder outlet obstruction or BPH. All surrounding areas were fine. When I saw my Urologist I brought this up and he had no answer for me other than to say I moved up to an intermediate unfavorable risk since my PSA was up. Said the size of my prostate was borderline enlarged anyway. I suggested that maybe riding my bike 5000 miles a year for over 20 years may have something to do with my rising PSA since the prostate may be in a constate state of proctitis and he had no answer. Of course he suggested a prostatectomy which I am not going to do at this point. I have no other symptoms, I train and compete in Ironman triathlons, eat a Vegan diet and get plenty of rest/sleep. My question is, has anyone else have a similar journey and where did you end up? Thanks for your time.

[pd63]

If you are unfavourable intermediate AS is not appropriate, treatment is needed.Seems to me you are trying to convince yourself otherwise, what is your gleason score?

[ironmanburg in reply to pd63]

3+3 in one core.

[EJC61]

What were the GS scores for the suspicious cores?

[ironmanburg in reply to EJC61]

There wasn’t a score. Not enough presence to make a determination.

[EdinBmore]

Start with a second opinion from uro and radiation oncologist and, depending upon their input, a medical oncologist. I do not have a MD but, given my experience, I'd be concerned about your PSA and PIRADS score. FYI: I was "on" AS for 7 yrs and I think that my Hopkins uro waited too long to recommend treatment. As a result of this delay, I was treated with IMRT, brachyboost, and ADT. ADT was awful for me. Keep on top of this. Btw, remember that uros are surgeons; they recommend surgery. Radiation was the better choice for me. Weigh the pros and cons of each.

Good luck to you,

EdinBaltimore

[ironmanburg in reply to EdinBmore]

Thanks.

[aceace12]

i would thik riding your bike would have something to do with this

[ironmanburg in reply to aceace12]

That’s what I’m thinking too.

[Estaban2021]

If you're a Gleason 6 (3+3) it doesn't really sound like you need a prostatectomy, which could potentially ruin your quality of life. Sounds like you need a second opinion.

[ironmanburg in reply to Estaban2021]

Thanks. I’m transferring my care to an oncologist at a cancer treatment center.

[DGLSky]

Outside of you having pc you are going through life as well as anyone. I have had pc since 2021 at 54 years old with PSA at 4 and Gleason at 6. Now PSA is 6.25 and still Active surveillance. I do not do iron man or much of anything. You keep going.