Hi all. Just had a phone appt with Urologist. To review what brought me to this point. On 10/28/21 I had a PSA test of 4.6....next test as follows..11/26/21 (4.4)...3/17/22 (3.8)...10/20/22 (5.4)...11/30/22 (5.0)...65 years old, Dad diagnosed with PC at 75 years old 88 years old now doing great. My wife had a TIA event(mini stroke) Nov 3rd. I'm her caregiver 24/7 traveling to and from hospital for 21 days. During this time I had developed an extreme urge to urinate throughout the day. Sometimes I could barely get started, morning especially. I started drinking cranberry juice, pomegranate and plenty of water. Symptoms resolved and haven't returned. Was tested for UTI and no evidence. So maybe really dehydrated or ?. Urologist said by his calculations if it is PC it is not aggressive and could wait 3 months and take another test or do biopsy. My 58 year old brother had elevated PSA and did the MRI and biopsy in that order and was all clear no PC. I haven't asked about PHI, MRI, test and surprised Urologist hadn't either. Any thoughts welcome. Thank you.
Update: He sent my history just today which I could find past 2020. Starting age was 51 in 2008.
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In my case my highly rated and experienced Urologist said the same and put me on a similar path forward. PCa is slow moving and these days the outcomes are far better. But IMO and what I did was pushed him to move along the process. He would recommend the MRI, Biopsy, full body scan and etc etc steps so they all had to be scheduled & reviewed. This took weeks if not a month! Even if PCa is slow moving, its moving. So I pushed and wanted to know the whole process if things turned out I had PCa and to start planning and scheduling immediately! Don't panic but drive the process.
You will hear that you don't have to rush but you are the captain, the owner, the one in charge so you have every right to push. Others will disagree here possibly while others might have slowed rolled their process and found out to late that the PCa had metastasized .
Personally IMO, knowing everything I’ve learned now, I would definitely get scanned and a biopsy. My husbands spread so quickly…. I wish I had this knowledge when his PSA was slightly over 4. I would have made him be more proactive. Wishing you all the best!!! This group has been very helpful for me with both info and support!
I advise getting an mri guided biopsy soon. 3 years ago I had a psa of 5 but I put off a biopsy for a year. After a year the psa was 7 so I had a biopsy and it turned out to be high risk (Gleason 9) cancer. Wish I had done the biopsy sooner when psa went to 5. Biopsy is not fun but it is only a few days of discomfort and then you will have more info to work with.
Start with the MRI. If they see a lesion, and you’re in a good facility, they will do an MRI, guided biopsy, which tells them exactly where they need to go to get the cores.
Got this message below from Urologist. Is this something in line with a good experienced Urologist?**********************
As for the MRI, it's a good way to find out if there are any suspicious areas in the prostate that can be targeted with a biopsy. I wouldn't rely on it to diagnose or rule out prostate cancer alone. Sometimes even if the MRI doesn't show anything, there may still prostate cancer there. (The false negative rate for MRI can be up to 20-30%). So if your PSA rises, I would recommend a biopsy regardless of what MRI shows.
Yes to your question above. I would also determine how many years & patients has he had. If it is PCa then you want a Doc who has done a thousand of prostate operations, not hundreds. Uroligist for PCa will want to operate.
Also research now and ask his office what Oncologist they recommend. Because again, looking ahead, if it is PCa you will want an another opinion from a GOOD Oncologist who provide alternative treatments. All of which you can investigate some here. If it's not PCa then nothing lost, but if it is you will a couple steps ahead.
My PSA jumped from 4 to 7.5 in 6 months and boom!....GL9 high risk prostate cancer. If your Dad has PC, it may run in the family. And urination problems can be a sign of PC, or maybe just an enlarged prostate or infection (you checked this). An MRI or biopsy may be in order. If it shows you are clear of cancer, at least you know it and it's good news. Godspeed!
Agree with moving forward. First an MRI with a 3 Tesla machine (strength of magnetic field), then targeted biopsy if MRI shows anything. Norm is 12 cores across all areas plus 2 to 4 more targeted to lesions found in MRI
If Gleason 6 or 7 (both 4+3 and 3+4)and all in the prostate, one alternative is NanoKnife IRE focal ablation. Technology has been around for 10+ years and is now being approved for prostate cancer.
Uses high voltage electrical pulses in a clearly defined field to avoid side effects of heat or cold focal ablation. Currently clinical trials around the US. I did it and 6 months out no issues.
On April 16th I had urinary retention. It was so bad I needed an ambulance ride to ER. A foley catheter was placed and still in place today. Two additional trips to ER. To make a long story short. Kaiser Medical Urologist recommended Turp or Holep. I decided on Holep. I was told about the side effects. Retrograde ejaculation, incontinence, possible ED. In investigating options on my own I found Aquablation treatment. Done by robotics and uses water jets not heat to laser away prostate. Prostate size 96cc. Very little chance of RE or incontinence. Still actively intimate before UR this was for me. Unfortunately Kaiser does not perform Aquablation and could not refer me outside.
I scheduled a consultation with Dr Brubaker in San Carlos, ca. He wanted me to schedule a biopsy with Kaiser before I switch insurance since my PSA had went up from 5.0 to 8.7. We both had felt it was due to foley but in order to move forward with procedure a biopsy made sense. Biopsy result was no PC . Thank God. Finally light at the end of the tunnel.
Aquablation is not so much Dr dependent from my understanding and a short learning curve. It's precise. 5 year studies are strong with great results.
I just found out Kaiser is in the making of performing their first Aquablation therapy in Calif within the next 6 months in Santa Rosa before going wide spread. Bad timing for me I guess. All my appeals to get referred outside failed. Such an unnecessary delay. I could have moved forward months ago and been on the mend today. Running 5k which I love to do and being active. Staying positive. Hope this information helps anyone in need.
God bless you all.
Just praying I picked the right Uro and right procedure.
The main difference is that both, TURP and RESUM, GL including, generate plenty of HEAT inside the prostate, HEAT is transferred to the surface of the capsule, where the bundles of critical nerves responsible for the erection and ejaculation are located. Damage to some nerves impairs erection and causes frequent ED up to three years after surgery. Nerves has the tendency to restore themselves sometimes and erections return, but not always.
Aquablation’s robotic technology combined with its high-definition imaging and surgical mapping helps to ensure that the prostate tissue is removed with precision. This technology allows urologic surgeons to only remove the excess prostate tissue needed to provide relief for BPH symptoms and avoid removing the parts of the prostate that can cause complications like retrograde ejaculation. Additionally, no incision is made since the prostate is reached through the urethra.
A surgical map of the prostate is created by urologic surgeons, then a robotically-controlled, heat free WATERJET removes the prostate tissue that was outlined on the map. Aquablation combines ultrasound imaging with a thin camera (called a cystoscope), giving surgeons the ability to see the entire prostate in real time. This allows the surgeon to accurately target the prostate tissue that needs to be removed.
Aquablation therapy is performed in a hospital and is done under anesthesia. The procedure typically takes less than an hour and involves an overnight hospital stay.
I'm in contact with several patients that have already been through Aquablation that are very happy with results and none have any complication or side effects. That alone was encouraging to me. But you never know, everyone is different. Just praying I see the same outcome. I'm so ready to get rid of this catheter, be intimate with my wife and get back to enjoying being super active. I was training for a 5k when this all started, fishing, golf. I believe Hawaii is calling my name!!! I'm ready !!
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