hi there, my dad is turning 76. In April 2023 his psa level was 4.2. This October 2024 it tested at 8.2 and their retest in December 2024 came out to 9.7. There was “large” traces of blood in his urinalysis and leuokocytes. Everything else in blood work seemed pretty normal. He’s had some back pain and stomach pain.
We can’t get a biopsy until January 31st and I’m really concerned about the rate of the psa level increase and waiting so long. I also tried to push for an mri but they haven’t responded.
Any tips, advice, anything to do in the meantime while we wait. I’m really scared…and the only thing to help my fear is to find ways to help him and be active in learning.
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Disney1989
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Based on my ten years with this beast, may I offer this tip - focus on finding patience (not easy we know). Prostate cancer rarely (perhaps never) warrants rushed/immediate actions.
Many of us believe multiparametric MRI prior to biopsy are essential. (I had one before and another after my biopsy). If your dad's biopsy is scheduled without an mpMRI first, this may be where to focus your immediate attention. It seems many docs/practices still do not use mpMRI. My long established urologist did not and so I quickly replaced him (that was nearly ten years ago).
I came to learn strong patient (family) advocacy is often necessary with prostate cancer diagnosis and treatment decisions. Hope this helps. All the best for your family.
I fully agree with everything in Nano's reply. You certainly want an mpMRI before the biopsy. That way, the Urologist can do a 'targeted' biopsy which is what you definitely want. I'm no expert but if he had blood in his urine, that might point to an infection which would raise his PSA.
Prostate cancer is a complex disease. Try to educate yourself, starting with the basics of diagnosis. It is almost always a slow growing disease so you DO have time. If you are not comfortable/happy with your medical professionals, make a change. I had to move on from my first Urologist (the one my PCP sent me to) and found one I believed in and trusted.
Try to hang loose and support your Dad. I believe he is going to be just fine.
I also support NanoMRI's and other supportive suggestions. A great resource on line is the Prostate Cancer Research Institute (PCRI). They also have a help line, but the main source is a great library of videos done by a nationwide bunch of top docs, a resource library, and a staging guide to help you figure out what is what after the biopsy and to weigh the efficacy of different treatment options. Depending on where you live, biopsy options may be limited without some travel, but getting a high-end biopsy of his "low end" is a good idea if you can swing it. Absolutely and MRI guided one! Finally, see if you can find a prostate cancer support group. The Cancer Support Community is a nationwide network of cancer support services. When I was first diagnosed 7+ years ago, support groups in the Bay Area in CA, were indispensable, not only for great advice, but for being in the company of people who had been there, done that, and were easy to talk with. Please know that you are not alone.
This is great information / thank you so much! We actually moved from the Bay Area to the greater Sacramento area a couple years ago. We have kaiser and they unfortunately have been a little difficult so far but having all this information to take back to them and push is so helpful.
You might want to consider joining the CSC localized PCa support group that I facilitate. It meets every 4th Thursday, 1-3. It's a hybrid zoom/in-person meeting. To find out more about CSC and register for all the free support activities, go to cancersupport.net and scroll a ways down the opening page to a "get started" button and follow the prompts to provide some background information. You will go through a brief screening with me - we check to see if people have special needs and are appropriate for group participation - as most people are.
Mentioned by a2c above, a transperineal biopsy is greatly preferred to a tranrectal (TRUS) biopsy. Not only can it sample more of the prostate, it lowers the risk of post-biopsy infection. While a TRUS may have an absolute low risk of infection, if you are unlucky, the resultant infection can be quite severe (read life-threatening).
FWIW, we have a family member in the CA Kaiser system and they had MRI pre biopsy (and PET scan post biopsy), which suggests any foot dragging on the MRI is with the urologist.
This is really helpful! The PA told me they do not do an MRI until after negative biopsy results as their standard of care. It’s helpful to know it’s not the case. I wrote back to her already and am waiting for response. We go to his primary care Friday so I’m hoping if anything he can help push
The PA? How about consulting with the M.O.? Good Idea to update your dear Dad's bio for his and for your and our benefit (include pertinent data - all info voluntary) Good that you're acting as his adviser while fighting the beast. Most men are lax and fearful of medical issues that they are dealing with. As far as you're concerned you are his and our hero. Keep on posting cause we need you as much as you need us.
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