What PSA Score sent you to a Urologist?

Posted by jayhall @jayhall, May 17 12:47pm

I get PSA blood work done every 6 months. Last year my PSA was 3.25 and six months later it had increased to 5.5. My PCP sent me to a Urologist. The Urologist confirmed that if you score 5 or about it's wise to get a biopsy etc, to rule out Cancer and develop a treatment plan for your PSA. I'm curious what PSA score sent you to a Urologist.

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It was prior to treatment. Jesus cured me because my PSA has been zero for almost 19 years since robotic laparoscopic surgery in 2005 and I no longer have a prostate.

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My PSA went from 3.5 to 4.0 in 9 months so my PCP sent me to a urologist for a biopsy and I had approx 5 of 12 samples positive cancer with a Gleason Score of 8.

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@johnoclark

My PSA went from 3.5 to 4.0 in 9 months so my PCP sent me to a urologist for a biopsy and I had approx 5 of 12 samples positive cancer with a Gleason Score of 8.

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My PCP said to get a biopsy because of the increase of the PSA, not because of the value.

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The increase was prior to treatment, not during treatment.

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My PSA was over 6 when I went for a biopsy. Turned out I was a Gleason 8.

Had Robotic surgery.

You are in charge of your body

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It wasn’t my 4.2 PSA ; it was the fact it had doubled in one year!

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My PSA was just over 6 but steady for many years. There was a history in my dads family, grandfather, 2 uncles, one cousin died of it, my father had it but died of old age at 95, My doctor retired, and when I went to a new doctor he was reluctant to send me for a biopsy, but in the end he relented, Turns out my gleanson was 9.5 our of 10 of 12 samples. I had no indication. I had robotic surgery. YOU MUST SPEAK UP FOR YOUR OWN SITUATION

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My PSA went from over 2 to over 3.
At that time my GP ordered a followup. It was over 4 and he sent me to a Urologist.

I am in stage 4 but it was caught very early so my prospects are good.

This young kid saved me life based on his vigilance. He will remain my GP even though I now have to drive 50 miles to see him.

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@robertmizek

The first time I was diagnosed with PCa my PSA was 4.14 and rose to just below 8 in 6 months.

The second time I was diagnosed (after receiving focal treatment) my PSA rose from 2.55 to 3.41 in 6 months then continued to rise from 3.41 to 7.01 8 months later when I was diagnosed with recurrent Stage 3 PCa. It’s not just the value one needs to consider. It’s also how quickly the PSA continues to rise.

You may want to consider asking your urologist to do a PSA ISO blood test. It’s a better indicator of whether further investigation is needed.

Good luck to you!

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So you had focal brachytherapy in 2020…is that right? And your Gleason score was 6 and PSA a relatively low 4.14. How many cores were positive and why, in your opinion, was there such a big diagnostic miss?

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@ozelli

So you had focal brachytherapy in 2020…is that right? And your Gleason score was 6 and PSA a relatively low 4.14. How many cores were positive and why, in your opinion, was there such a big diagnostic miss?

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It was the unanimous opinion of five different doctors that reviewed my MRI results and my biopsy results that the biopsy missed significant cancer. The MRI report read and I quote: “PI-RADS 4 lesion measuring 1.4 x 0.9 cm in the right anterior peripheral zone at the apex of the prostate.” Using inch measurements that means it was about 9/16” by 3/8”. I understood that trans-Rectal biopsies cannot reach the Apex adequately so I transferred my care to another urologist who did grid type trans-perineal biopsies. I don’t know what the grid spacing was. All I know is that that biopsy only showed low risk cancer. Here’s what that report read:

“Prostate core biopsy, right anterior apex (4 cores):
-Adenocarcinoma of the prostate, Gleason score 3 + 3 = 6 (Grade group 1).
-Tumor in 1 of 4 cores, 5 mm discontinuously involving 25% of submitted tissue.”

I asked for genomics to be run on the sample and my urologist/radiologist oncologist told me it was unnecessary and there wasn’t even enough cancer present for them to analyze. He was mistaken.

I received 145 Gy to the right side of my prostate, the great majority of which I recently found out was nowhere near the lesion that showed up on the MRI.

I understand now that cancer that happens in the peripheral zone and near the Apex is extremely difficult to sample. My best shot at having received an accurate biopsy would’ve been a MRI guided fusion biopsy, which was not offered by the medical system I was with at the time.

I’ve learned from this sad experience the importance of getting care through a center of excellence and not just a local community for profit healthcare system that is more focused on volume than patient care.

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