Active Surveillance

[ironmanburg]

Hello, I (70 y/o white male) was diagnosed with PC in Oct of 2021 (Gleason 3+3 in 3 out of 12 samples with 2nd opinion by JH) and have had 2 MRI's since then and 2 prior to then and they all were the same.

IMPRESSION:

* No imaging evidence of prostate neoplasm.

* No lymphadenopathy or suspicious osseous lesion.

* Prostatic hyperplasia with chronic bladder outlet obstruction.

* Partially limited examination due to imaging artifacts from left hip prosthesis.

PI-RADS 2: Clinically significant cancer is unlikely to be present.

What worries me is that I have had 2 PSA tests since I had bilateral TKR surgery in July, and they came back 8.0 and 10.5. I am wondering if the surgery or the fact that I had the 2nd PSA test right after I had contrast for the MRI may have skewed the results. Has anyone else gone thru something like this? I see the Urologists at the end of the month. Thanks.

[witantric]

Theoretically anything that inflames the prostate can cause psa levels to spike. Do you have history of prostatis? MRI doesn’t indicate that. But in your case they are indicating mri is of limited value

[ironmanburg in reply to witantric]

Thanks.

[tsim in reply to witantric]

MRI does indicate that, prostatic hyperplasia. So much that it is obstructing the bladder outlet intermittently.

[dadzone43]

PSA = Permanent State of Anxiety

[Cooolone]

Only Gleason 3 tissue identified, MRI with Pirads 2...

Agree with the Permanent State of Anxiety!!!

Add in the age factor and that diagnosis certainly lends to a place that should be of little anxiety. Please research Gleason score and potential for metastatic disease. As a reminder, G3 is not invasive tissue/cell type. Distant metastatic disease is what can be associated with OS (shorter). And dismissing the possibility of the diagnosis missing something else, like G4 or higher tissue, the reality of likelihood of even needing treatment, unless symptoms appear, is in all probability, very low.

There are so many things which can effect PSA scores, like strenuous activity, sex, bike riding, etc., this alone is why PSA ALONE is NOT used for diagnosis. As a whole, is why other tests are incorporated together in order to provide for an accurate diagnosis.

Instead of worrying what might be, or even could be, you should be jumping for joy and celebrating such a wonderful diagnosis. Not worrying about what isn't, or what the mind might manufacture... Because "Fear" is a manifestation of the mind!

Relax, shed the anxiety, enjoy your diagnosis and move on. My opinion of course...

Best Regards

[ironmanburg in reply to Cooolone]

Thanks.

[Tall_Allen]

Your high PSA is completely explained by your bladder outlet obstruction. Never heard that knee surgery or contrast interferes with PSA.

[witantric in reply to Tall_Allen]

I think the report was talking about the efficacy/fidelity of the MRI messages. I think..

[ironmanburg in reply to Tall_Allen]

Thanks.

[witantric]

BTW, two urologist (one at UW health and Stanford) said that 2 positive cores was their limit for AS. Maybe too conservative? I was chatting with someone from India. His GL score was 2+3 and he was being suggested surgery. No mention of AS. The standard of care is so different based on where you are... It is tragic.

[groundhogy]

Are you using your prostate for anything important these days?

[ironmanburg in reply to groundhogy]

Too funny.

[Hidden]

You may not quite be at the point of deciding on cancer treatment yet. Some guys, like my neighbor, have the attitude of "I'm just going to have it taken out so I don't have to worry about it again." If yours is contained to the prostate and hasn't spread anywhere, seriously consider radiation over RP when the time comes. Be your own advocate and don't let the doctors push you into what they want to do, especially if it means more $ for them. I was 4+3 in 2 cores and 3+3 in about 4 cores and contained. I had 27 sessions of IMRT. I have no problems with urination, I still get good erections, and I still have strong orgasms although not much ejaculate. It's been 3.5 years and my PSA has been .2 each year when I have it checked. I know a lot of men who have RP had to have it because their's was more severe but I've read some real horror stories on this site and others about all the problems men have after RP. Some even have to have radiation afterwards because the doctor didn't get it all. Just my humble opinion. Good luck to you and hang in there PCa warrior!

[ironmanburg in reply to Hidden]

Thanks for the input. It's always good to hear from survivors who have little or no side effects from radiation.

[groundhogy]

In my opinion, you have cancer. What are you waiting for. Waiting for it to get worse. You are in a good position now.

[ironmanburg in reply to groundhogy]

I’m waiting to see if it gets worse.

[groundhogy]

well, i doubt that if you wait, your G(3+3) will turn into a G(1+1).

You are not too much in a pickle now. I would suggest not joining this club. Don’t play with fire.

Also, if you start asking for your prostate out now, it will take the docs forever to get around to you anyway. Plan that in.

My opinion.