Hi. Welcome to the forum. We’re here to help.

I’m a prostate cancer patient so please don’t construe my responses as medical advice, just comments based on my own experience.

I was originally diagnosed with low risk Gleason 6 prostate cancer in 2020 based on a 24 sample ultrasound guided biopsy. I received brachytherapy radiation therapy with the promise that the cancer wouldn’t come back. The only problem was that the biopsy missed high risk aggressive cancer and the treatment failed. Cancer returned with a vengeance in 2023 and now I’m fighting high risk aggressive Gleason 9 Stage 3 locally metastatic cancer.

Your symptoms are concerning as they are more consistent with more advanced disease, not low risk Gleason 6. Please understand that I’m not making a diagnosis. I’m just commenting that your symptoms are similar to what I had when advanced cancer showed up.

Have you had an MRI and received a PI-RADS score? It’s possible that an MRI can give greater insight into what’s going on. I recognize now that my 2020 biopsy showed more significant disease than the biopsy revealed. I didn’t know that at the time or I would’ve sought a second opinion and likely repeated the biopsy.

You mentioned looking for a different urologist and that sounds like a good decision to me. Getting care at a center of excellence is also a good idea. When I was first diagnosed in 2020 I received care at a local second rate medical provider. When cancer returned, I sought here at a nationally recognized center of excellence and the difference in just blows my mind.

Here is a link to list of National Cancer Institute recognize sites. Obviously Mayo is on that list and they’d be on the top of my list for consideration. https://www.cancer.gov/research/infrastructure/cancer-centers

Good luck on your journey. We’re here for you.

You may have missed my post . I had an MRI which showed a T2 Score & PI - RADS 5 .
I followed this with an MRI Fusion Biopsy . Typically a fusion biopsy calls for 2 to 4 core samples . My Urologist , a former Head of Surgery & Head of Urology at a major hospital in Toronto , Canada , took 5 cores . He maintained " HE HIT THE TARGET AREA " .
My pathology results came back negative . Being proactive and not believing the pathology results - I proceeded to have a 2nd MRI this time with contrast and a 2nd MRI Fusion Biopsy . This time with 16 cores - of which 6 were from the same "Target Area ". This biopsy was performed by a Urologist from Princess Margaret Hospital in Toronto . Ranked in the top 5 Teaching & Research Cancer Centeres in the world .
This time the pathology results came back : 6 cores in the " Target Area " positive Gleason 3 + 3 = 6 The remainder were negative .
Once again not being satisfied with the conflicting pathology results I had a 2nd opinion of my 2nd Biopsy slides . Wait for it ; " It came back with all 6 cores in the target area upgraded to Gleason 3 + 4 = 7 -- All other cores remained negative ."
I am considering a 3rd opinion of my 2ns Biopsy PLUS a 2nd opinion of my 1st negative biopsy .
At this juncture . Who do you believe ?

Hi, ctb2024. It sounds like I have a similar story. From a small town, South Georgia, with the rising PSA. Urologist Did a biopsy with a score of Gleason 3+3, Frequent need to urinate with a very weak flow. Urologist prescribed flomax, but it did not improve. Suggested either radiation or robotic prostate surgery, and referred me to a larger institution. I chose Mayo. I had initial Teleconference and the doctor Discussed options. He suggedted active surveillance with follow up testing and MRI at Jacksonville Mayo to check for any signs of tumors, etc. That came back clear but they found my bladder was extremely distended due to being unable to empty it. That was their main concern as IT could lead to serious kidney problems. Had a HoLep procedure Where they basically run a laser and camera up and hollow out part of your prostate as it was impeding the urine flow. All the material removed came back benign and I can go like I did when I was a teenager. I’ve been back twice at six month intervals for PSA testing. It’s remaining level and they are suggesting 6 month PSA and annual MRIs going forward.