I’m now scheduled for RP at the age of 41. I cannot find a piece of mind that it’s the right choice so maybe talking about it here will give me something. In 2014 (I was 34 years), I had a regular medical check up done and they for no reason added PSA test to all the others. Got 1.54ng/ml.
Likely some infection they thought and sent me to a urologist. Two weeks later I got 3.79ng/ml. I didn’t feel I had any urological problem. But it started soon after – coincidence or psychological. I’d describe it as itching in the urethra (not during urination but rather pretty much constant, weeks ok and then again in varying intensity, very frustrating). Nobody believed I could have PCa. So, lots of different tests, antibiotics, 3+- months visits. PSA varying between 2-3ng/ml measured every few months.
Three years later, in 2017 (37 years), my first MRI (nonspecific prostatic changes, PCa couldn’t be ruled out) and biopsy. Only 8 cores, apparently small prostate. Negative, sings of prostatitis. 2 year later another biopsy – 12 cores with 1 core 0.6mm GS3+3 probably (too small to assess reliably). MRI again described some generic changes but couldn’t suggest anything for targeted biopsy. I went on AS.
Year later, 2018, MRI suggesting targeted biopsy on the left (PIRADSv2 score 3). Fusion biopsy 12 cores from the left, 6 from the right. Left nothing but right 3 cores with 3, 2 and 1mm what looked to be GS3+3 (again it seemed there’s uncertainty in assessing it because of a thin needle).
What’s interesting, and nobody could explain, every time I had a biopsy, and the more cores the better, my PSA dropped 6 months after to something like half of what it used to be before the biopsy. 5 months ago, I again had 1.54ng/ml as 7 years ago. Then it goes slowly up to 2.5-3 but difficult to say how far it would go as at that time there is another biopsy bringing it down. Not sure watching PSA doubling time makes sense here.
Reading a lot of material, studies, over-treating, under-grading, you name it. Several doctors now suggested to go for RP that because of my age it’d come later anyway and doing it sooner is better. Sort of makes sense but still. Also seeing several people here wrote about their GS6 being upgraded to 7 within few years.