As above, over the last several years my PSA has risen and last fall my PCP recommended I see a Urologist to investigate the rise to 7.0. The PSA was confirmed and a DRE performed. The DRE was 'normal', but a Random needle Biopsy was recommended and performed. This was 'awful', and not at all painless. I should have known something was up when asked to sign all the release forms. The biopsy results showed several small cancer cores, all Gleason scores of 3+3=6, group 1.
Now in March, I had PSA checked and the number went to 7.6. After researching I had abstained from sex and anything that might increase the PSA. I will see the Urologist again next week for a follow up DRE. Well, Active Surveillance for now but what is instore?? The journey begins.
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cristo1953
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PSA is a pretty lousy indicator - Prostate Health Index is better - but you have to have a confirmatory biopsy (probably mpMRI targeted) within a year. It is important to get on an AS program.
Ask for a periprostatic or pelvic plexus nerve block next time (you need a urologist who can find those nerves on an ultrasound), or have a transperineal biopsy with a spinal block.
Yes, PHI is on the list for discussion this meeting with the Urologist. And, we are planning a mpMRI this June while continuing my AS program. On the subject of pain reduction, maybe a valium before the random needle biopsy would have been appropriate. It's not like things up my ass being a problem, but a needle in my Prostate. Come on.
Valium won't help - it's just a tranquilizer. I've had 3 biopsies. The first was "raw" and I almost passed out. The second was full anesthesia, and I was groggy for two days. The third was the peri-prostatic nerve block. She injected lidocaine slowly on the way up to the nerve, and I didn't feel a thing. I was awake and alert. You have to have a doctor who can do them, and you have to ask for it.
BTW - in the longest running AS program in North America, more than half of men who started 20 years ago are still on AS.
Hate to say "Welcome" to the group. Personally, I am surprised you have not been placed on ADT which is Androgen Deprivation Therapy. If you are aware of what that is, Sorry! I was not trying to be condescending. All the best.
Perhaps "Welcome" is not the word, but sharing is important. There is no way ADT would ever be a consideration. Too many risks, especially at the outset with the small likely hood of high grade cancer at this juncture. Thanks.
As you continue your surveillance program, you might spend some time over on Tall-Allen's blog, "Prostate Cancer News, Reviews, and Views". The Archives there for December 2017 have some nice lists of questions one might ask when interviewing other specialists for different types of treatments, if/when the time comes.
Alas, this is not a club any of us wants to be a member of! Wish I could resign. LOL
I guess I was lucky with my biopsies (all 5 of them). Uro used lidocaine and, although uncomfortable, relatively painless; but definitely no fun. And bloody pee and cum is a def turn off. E
And, yes, targeted biopsy is the best way to go to obtain reliable results. And PSA IS a lousy indicator (read some of the articles by the man who developed it and his complaints about how often the PSA is misused or used in ways never intended) but uros rely heavily on it.
I was in AS for 7 years at Hopkins before my numbers changed and indicated the need for treatment. I had PSAs, Prostate Health Index, DREs, biopsies (MRI fusion guided biopsy is important) and OnotypeDX. I got second and third opinions from urologists, radiation oncologists, medical oncologists, and internists and glad I did. It's a rapidly changing field.
Read and learn as much as you can (Patrick Walsh's "Surviving Prostate Cancer" is a good source). This field is filled with jargon and abbreviations; can be a tad overwhelming.
I to have Gleason 6 3+3 and on AS for several years now....I have had 4 mri's and 5 Artemis biopsies, they are not fun but it is what it is....I plan to stay on AS for as long as I can
Hi, Wishing you and all others good luck. I haven't started my treatment yet (CyberKnife), but I will share with you that if you express a concern about discomfort for a future biopsy there are urologists who will perform them under light sedation which is what I had. It's outpatient, no after effects in terms of pain whatsoever, and in my mind this should be standard practice that one does need to ask for. Nothing to lose by asking!
I have had biopsy taken in the Andross clinic in Amsterdam. They use the technology to overlay the MRI results with the live ultra sonic picture to prcisely locate where the biopsy must be taken. It is done through the plennium which gets a local anastetic. The procedure takes less than one hour and is painless. No pain afterwards too.
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