Two “mpMRI’s” were negative with no suspicious areas …. one was last Aug 2020 and one done recently on 9/10
PiRads 2
Diagnostic radiologist: Cancer unlikely
Images consistent with BPH
PSA is 7
DRE normal
Doc wants to do TRUS
I don’t want it
I am almost 70
Excellent health
Should I get an invasive biopsy that is at most going to sample .3% of the gland?
Please help me
Ask for Prostate Health Index (PHI) instead.
PSA 7. Get a biopsy!
Your asking this question to a bunch of men who have terminal stage 4 cancer that they are trying to manage for as long as possible before we likely in the end lose the fight. A biopsy? that’s nothing to worry about compared to chemical castration, chemo, radiation, surgery, bone mets slowly breaking down your bones causing crushing pain.
Get the test and put your mind to rest
You may want to pose your question here instead
healingwell.com/community/d...
There you will find men who are closer to the problem you are currently facing.
Many men here had psa’s in the hundreds or even thousands when they first found out…..and honestly would love to turn back time and be in a position to catch it early.
The truth will set you free.
Thanks!
Another non-invasive tool before a TARGETED BIOPSY *not random please*
Accurate biopsy method >>
seedos.co.uk/Prostate%20Bio...
Thanks I agree
No no no. Random biopsy’s are insane. I learned the hard way. 0/14 on random and 3-3 on MRI guided biopsy. If they see nothing in your MRIs, I’d wait and keep doing your PSA Every other month and if it continues to rise I’d do another MRI. Or if your PSA breaks 10, and another MRI is negative, maybe you do a random. Another option is to have your MRIs read by a top Radioligist at a top center like ucla etc Ff or. Second opinion.
Schwah
Thanks
Thanks I agree with you and will tell doc I want to wait
Maybe because of a 17% on a 4K he wants to cover all bases
However with two negative mpMRI’s and a normal DRE I think I could wait even though PSA is 7
The mpMRI report said I had BPH so that could be the reason for a rising PSA
My volume is 61cc and the density is .11
I wish this stress would go away but being type AAA in personality my nerves are shot
I also know a random TRUS is not reliable
DREs are very imprecise. A normal DRE means nothing. I had normal DREs when diagnosed with stage 4 mPCa with cancer in 11 of 12 zones targeted in my prostate biopsy. Gleason 8
My PCP felt the lump in prostate and she said to go to urologist. STUPID ME didn't follow her advice since I was training for my 2nd IRONMAN TRIATHLON and at age 64 I needed all the training I could get. FINALLY went to URO. some 8 months later and the result was 5+5. REALLY STUPID ME for procrastinating.
Did the same....til my np said....go to uro.....today!.....and you see what ship’im on..
I agree DRE very subjective but my mpMRI done twice show nothing
Just saying that knowing where I am NOW and was 6+ years ago, if I was in your position NOW I would 1st avail myself of one or more of the *non-invasive tests* that could shed some light on condition and then proceed always realizing that nothing is as accurate/informative as a proper biopsy.
docpanel.com/blog/post/3-wa...
Great article discussing the subject that underscores the accuracy of MRIs vs biopsies.
“Compared with biopsy alone, MRI with or without targeted biopsy was associated with a 57 percent improvement. in the detection of clinically significant prostate cancer and a 77 percent reduction in the number of cores taken per procedure.”
Those are big numbers.
Schwah
Thanks so very much I am so nervous
Most guidelines for biopsy after a positive MRI include a standard 12 core biopsy....though small in number, an additionaal number of significant cancers are found. I'm a good example, 6 total cores from my PIRADS 5 found nothing but benign tissue........ one of my standard nontargeted cores contained 4+5 cancer!!!!! Another core was 3+3. Good luck with your decision ! Did you ask your Doc for reason to advise standard biopsy also?
I would say no. For a start, your urologist should be doing trans perineal biopsy, if they are stillDoing trans rectal, get another urologist !
PSA is pretty high, but is it increasing? What’s the psa density (psa compared to Volume of prostate). What makes the urologist think they will find cancer with a biopsy ?
PSA increasing a little and at 7
Age 70
Density is .11Two negative mpMRI’s
The 4K test came back at 17%
I guess urologist wants to be thorough but I really don’t want a biopsy with no targeted areas since two mpMRI’s were negative for suspicious areas
I would be just as hesitant as you. A biopsy would be shooting in the dark.
At this time no. What is your prostate volume on MRI?
What is percent PSA?
What is your PSA density?
Second read on MRI from major center.
Could even do short trial of 5 alpha reductase inhibitor to assess if PSA level is affected.
Any other medical issues?
There is no hurry!
PSA density is .11No family history
Excellent health
160lbs
Good shape
I at get a second read but the diagnostic radiologist that reads is well known in NJ and reads thousands
Thoughts?
Family history?
Your gland is twice normal size. Theoretically you can double your PSA value to 8 and therefore most likely PSA is coming from large gland. No guarantees of course.
If a trial of 5 alpha reductase inhibitors significantly drop PSA that would be supportive evidence for the BPH being responsible for the elevation. Again no guarantees.
If second read confirms first you are in no hurray to do anything other than what has been done. You are on top of this.
Biopsies are invasive and not without complications. What was your percent free PSA, if done.
My percent PSA was 18% I believe it’s best higher ?
True but it is not 10%! Has it been repeated?
I would accept your report as cancer unlikely, BPH likely. "... benign prostate hyperplasia (BPH) in elders may show PSA level of 7 or 9 as well in early stage." See: bloodtestsresults.com/norma....
"I need good honest logical insights"
See a Gypsy Fortune Teller ASAP...
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 10/02/2021 12:31 PM DST
I used to have crysyal balls.....i digress..
We're they.............
cubic,
tetragonal,
hexagonal (trigonal),
orthorhombic,
monoclinic, or
triclinic?
I concentrate...
Good Luck, Good Health and Good Humor.
j-o-h-n Saturday 10/02/2021 9:52 PM DST
Uh.....round....
Uh.... Russian egg shaped...
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 10/03/2021 2:39 PM DST
Yeah thats it ...without the fabrege fillagreee ....very socialistic
I was referring to the Ukrainian hand painted Pysanky Eggs (before they're boiled)....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 10/03/2021 8:26 PM DST
GVJosephDoc did you get a second opinion on the MRI, who did you go to ? I am in NJ as well and this info would be more than helpful for me
I need oncologist in Chattanooga.
Anyone have any insight on Metformin?
How do I find a good doctor?
I need an adress from India
Prostate, do I need to worry
