some not great news/ still a lot unknown

[Willie51]

I’ve posted before about my first introductions to prostate cancer: primarily significantly increased PSA yr to yr (3 to 6+). Did the EXODX urine test and score came back 25.9 out of 100 (15.9 being the cut off to keep from proceeding with biopsy, so I figured I’d at least need to do that. ) Finally (I’m increasingly dissatisfied with my urologist, he has yet to communicate with me about any of this . I have an appt next Monday) I got all this info from my GP. SO…MRI results came back just yesterday and aren’t good and TBD how bad. A few quotes : “1.6 cm lesion in left posteromedial peripheral zone at the mid-gland of prostate is PI-RADS 5. There is a questionable extraprostatic extension and close approximation of the neurovascular bundle.” “prostate is 3.2 x 4.0 x 4.3 cm vol 36ml” “ neurovascular bundleclosely approximates the lesion increasing the risk of possible micro invasion” “no enlarged lymph nodes seen “. Some of this sounds very scary. A good friend is a radiologist and went over the report in some detail with me. I’m very interested in how many of you would interpret it?

Even though I’ve heard many of you say “slow down, take your time,” I feel like some things in the report look urgent to maybe prevent spreading.

I’m not happy with current urologist but feel like I need to stay with him through biopsy if he’ll move quickly to schedule it. I live in San Diego where there is very good/ maybe great medical care (tho in high demand). I have an appt with a highly recommended Urologist / Oncologist at Scripps named Ramdev Konijeti (any reviews?) on 2/15. Any other recommendations?

Interested in your thoughts / advice. How bad is this report? I know it’s unconfirmed until biopsy. How urgent is the situation? I’m a very logical person and appreciate hearing the honest answer in order to understand how to proceed. Thanks .

[Tall_Allen]

It only shows suspicion. Let us know what the biopsy says.

[Hidden]

Don’t panic. Easy for me to say as I am past the initial panic and about decide on which procedure in the next week. My initial biopsy was at the end of September. Every doctor I have seen (and they are some of the best) have emphasized that there is time and don’t feel pressure to make a quick decision…that the disease has been with you a long time and grows slowly. My doctors have said if a doctor says you must make a decision quickly you need to see another doctor. I have also been told that the process from biopsy to procedure is often 3-5 months. There are many options…take your time..find a urologist you are most comfortable with and consider second and even third opinions. Good doctors are not offended when you do that. Keep us posted.

[Willie51 in reply to Hidden]

Thanks so much. I’m finally seeing my urologist on Monday (he hasn’t spoken to me or returned any calls since before Christmas….and I plan to dump him after biopsy , thinking sooner would just slow things down). There are things in my MRI that sound like the disease could escape the prostate and one never knows when, thus my rush to biopsy. After initially freaking out for about 24hrs I’m much calmer now. But your feed back really helps.

[Veloquate]

I have been seeing Dr. Christopher Kane at UCSD urological cancer department and am very happy with him so far as he has taken his time to explain and anwer my questions. I am now assessing treatment options and seeking input from radiation oncologist and a second urologic cancer opinion to ensure that I cover my bases. Check out Dr. Kane's videos here to get a sense: providers.ucsd.edu/details/...

[AlvinSD in reply to Veloquate]

Dr Kane is outstanding. I went to UCSD for Radiation Oncology and saw Dr Brent Rose. Amazing RO and the head of the GU Oncology Team.

[Willie51 in reply to AlvinSD]

Thanks. I’ve collected a few names now and will check them all out. I have a new appt with Dr. Ramdev Konijeti at Scripps Clinic on Feb 15th who also came highly recommended. Dr. Carol Salem also was recommended. I’d appreciate any additional reviews. My biggest concern is how slowly the system is working. I first learned about my big PSA jump in Nov. and now the soonest I’ve been able to secure a biopsy is Mar 5th through my original urologist. It’s so frustrating. Is this typical?

[Willie51]

Thanks !

[Polobutt]

my advice is to follow through the the biopsy as you are already this far in with your provider. The information you have at this point in minimal and I’m sure that it’s quite frustrating.