Thought I had dodged a bullet, but the bullet found me

[VisualDeadlock]

Hi all,

Haven't been on in a while. Hope all are as well as they can be. Just want to summarize where I am at the moment:

Age 43

Back in March 2018 I had an MRI for something else, and we found hypointensities around the prostate.

March 2018 - PSA: 0.33. Normal DRE. mpMRI done, PIRADS score 2

March 2018 - Biopsy done TRUS - found no cancer but found 3 or 4 cores had ASAP cells. 10/12 cores had inflammation

October 2018 - PSA: 0.36. Re-biopsy, No ASAP cells found, no inflammation

March 2019 - PSA: 0.35. mpMRI PI-RADs 2 and PI-RADS 3

During this time I had started taking a bunch of supplements, including IP6, Beta Glucan, Quercetin, Milk Thistle, Curcumin and a couple others

I had thought I dodged a bullet, but just went in for mpMRI a few days ago. This time one section was PIRADS 2 and another section has become PI-RADS 3. Seeing Uro on Tuesday, and I suspect a biopsy will be the next step.

How worried should I be? I thought I was in the clear with the negative biopsy and my PSA velocity has stayed stable but seems like I will be getting cancer if its not already there. Especially with PIRADS 2 going to PIRADS 3.

[jdm3]

Maybe go to DEFCON 4 and get some different opinions from the docs. If it were me... knowing what I know now... I would probably consult a prostate oncologist. You are still very early in this process ... but can't be too careful with this disease. Good luck. Be well, Josh

[Tall_Allen]

PIRADS=3 just means it's equivocal on an MRI.

[CantChoose]

How very lucky you are to be catching it before it gets off and running. Good luck getting a surveillance/treatment plan in place.

[j-o-h-n]

Early detection is one of the keys in fighting Pca........... other one is being a woman....

Good Luck, Good Health and Good Humor.

J-o-h-n Sunday 06/30/2019 5:16 PM DST

[Hidden in reply to j-o-h-n]

To be ,or not to be?

[j-o-h-n in reply to Hidden]

Being....

Good Luck, Good Health and Good Humor.

J-o-h-n Sunday 06/30/2019 9:10 PM DST

[Hidden]

43 ! Dam man , that’s so very young ..worry won’t help but it’s inevitable with the not knowing . You’ll soon know more .. Get a second opinion if possible from a pc specialist .. I got lucky and had one that made the correct initial choices for me . .you take care of this correctly and you knock it out before it gets a better hold of you .. I’m not a dr but as one that nearly checked out with an aggressive pc I personally would stamp out pc early rather than later . With luck you can get the jump on it .. I was 53 when this train hit me .. I felt like the young guy as I sat with mostly 70 year olds in radiation .But you were 41 ,whoa ! Build your immunity up .. I’m into nutrients and holistic methods as well . I think that your Psa is still super low so don’t panick . You will deal with it appropriately .. They first told me that I had 36 months ,no matter what i did . My APC went into hiding for the past 31/2 yrs . Don’t give up on the good things you’re doing . I love curcumin . Exercise .. catching this earlier than I did is in your favor . They will probably be talking curative ,if you even have pc at all . I pray that you don’t .. you can’t diagnose yourself ..you’re going to be o k ... I was stage#4 t-4 which means prostate wall breached .non op .You are way behind that. Do you have any symptoms ? Or a family history of PC ? M father and uncle had APC . You dont have advanced prostate cancer hopefully from what I hear . If it pops up you’ll catch and , get on it .. 😎

[Hidden]

Please don’t tell yourself that you have cancer unless it is proven so .. ✌️

[dougnola]

Sounds like you’ve seen it early, if that’s the case. You’ve got options and you’re being proactive. Keep it up! As for age, I thought I was shockingly early being dx at 50...but that was at stage IV and psa of 500 without the typical symptoms. So, it was lurking in me probably around 45 given average doubling times according to my doc. There’s a lot of folks on this site just like you. We are all poster children here for early screening!

[VisualDeadlock]

Thank you everyone.

2 follow up questions

1) is it a forgone conclusion that I either do have PCa or will get it?

2) I agree catching it early is good. But what are really my options? Isn’t the first line of defence removal of prostate? (Read so much about urinary incontinence, that it worries me a lot) I believe radiation is out due to the apex being involved

[407ca in reply to VisualDeadlock]

First line defence is not necessarily removal. Not by any means. Many make the mistake of believing that when you cut it out then it is done and gone.

Before you decide on anything you need to learn much more about options. There are several types of radiation that have excellent results.

From what I read in your post you might be a candidate for Active Surviellance, which would not effect sexual and urinary function so drastically as radical treatment. Johns Hopkins and other centers have very well respected AS programs.

Educating yourself will chase away the fear and enable you to make choices with reason.

All the best.

[kayak212]

FWIW I think you have a good case at this point for AS BUT if i were your age I would definitely align myself witha top notch major prostate cancer center like Johns Hopkins, Sloan kettering and /or others who have all the capability and resources in one place to look at your case and not feel limited by RXing what they have in terms of expertise and treatment options. It may not be geographically easy to do that depending on where you live, but at your age you need to do it IMHO> I would also consider looking at getting a genomic test like Prolaris or Decipher among others ..whichever one best suits your case given their testing criteria ....to see what that says about your future progression probabilities. Good luck....right now you are in the driver's seat. PIRADS 2 and 3 are in the lower half of PIRADS scores and dont constitute a DX of prostate cancer. The best thing you have also already done is subscribe to this group which has some real heavyweight experts who have PC and have taken it on to help themselves and others. 👍