tips/advice for my dad - pre biopsy

[Disney1989]

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.

[Tall_Allen]

Is there any history of prostatitis or urinary tract infections?

[Disney1989 in reply to Tall_Allen]

hi there, no not that I noted in his medical record.

[NanoMRI]

How wonderful you are helping your dad!

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.

[Disney1989 in reply to NanoMRI]

This is such great information, thank you so much

[allie2020]

Hi Disney,

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.

[addicted2cycling]

94percent.com/ ---- Prostate Screening EpiSwitch (PSE) blood test could easily be done if MRI is refused by Dr.

note - biopsy results from a Transperineal Targeted Biopsy are desired over a TRUS method biopsy.

note -- researching and ADVOCATING for your father is outstanding so remain pro-active.

[Disney1989 in reply to addicted2cycling]

Thank you! I didn’t even realize there was a difference in the biopsy type. I’ll follow up with them to see what he is booked for.

[addicted2cycling in reply to Disney1989]

Excellent idea to check. For myself, it is a TransP biopsy or nothing.

Good LUCK and keep all here updated.

[Mgtd in reply to addicted2cycling]

Not sure I would promote “or nothing”.

[addicted2cycling in reply to Mgtd]

Sorry, I neglected to add - *or nothing and proceed to find a provider who does TP biopsies.

Thanks for the comment.

[Mgtd in reply to addicted2cycling]

Thank you for clarifying this.

You may enjoy this story as a biker. I go to the gym everyday and are friends with a group of guys who ride stationary bikes together everyday. They have various medical issues but do what they can to stay in shape and be active.

So one day I asked them what their favorite color was and I went to the local silk screening place and had T shirts made with a stationary bike and titled The Biker Boys and under the bike Flagstaff, AZ.

In the year they turn 80 they are presented with a base ball cap with the following embroidered on it.

Limited

Year they were born

Edition

Those two items are worn proudly and with honor.

[cscmetsfacil]

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.

[Disney1989 in reply to cscmetsfacil]

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.

[cscmetsfacil in reply to Disney1989]

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.

[Vynbal]

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).

[Disney1989 in reply to Vynbal]

Thank you for this information!

[RussJun55]

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.

[Disney1989 in reply to RussJun55]

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

[jethrotullag]

mpMRI ordered? Please don't panic PCa is slow moving. transperineal biopsy is preferred

[j-o-h-n]

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.

Good Luck, Good Health and Good Humor.

j-o-h-n