Recently diagnosed: Treatment options for early stage prostate cancer?

@rcas75
You mentioned having prostate cancer. You mentioned having two MRIs. How was it determined you have prostate cancer without having a biopsy done?

A MRI is used to scan prostate and look for susupicious areas and tumors. MRIs are usually done after suspcious PSA test indicate a problem. Did you have ongoing PSA tests?

The results from a MRI are usually used to consider biopsies or not. The biopsies determine if you have cancer or not and your Gleason Score of the cancer.

Once you have your Gleason score the options for the need for treatments come up. There are many other test you will see posters and R/Os suggeting to be done once you have a Gleason Score. They are PSMA, bone scans, Decipher, etc. They give additional diagnosis of the cancer risk, and if confined to prostate, etc.

What are your MRIs saying? If just BPH then treat BPH. You did not mentioned your PSA scores. Are they high, continuing to rise? If I were you I would be getting a lot more answers from those treating you before considering biopsies. Getting second opinions are suggested by most MCC posters and since you have questions of what to do is get a second opinion from a major medical institutions with experince in prognosis of prostate cancer and the newest treatment for them.

Hopefully all you have is BPH

In my case, my PSA rose from 7.9 in late October 2024 to 10.5 in late January 2025. My primary care provider referred me to a urologist at Mackenzie Health Richmond Hill, Ontario who took 12 (or 14) specimens from my prostate on Jan 24. Finding: Gleason score 7 (3 + 4) on three cores. The Feb 14 "Nuclear Medicine whole body bone scan + SPECT +CT X2 Panel" found "No scintigraphic evidence of osseous metastatic disease from prostate." The CT scan of my pelvis and abdomen is scheduled for Feb 28, after which I will have my initial consultation with the oncologist. I will have the chance to choose between radiation or "surgery if both the bone scan and CT scan are both negative (that I hope they are)." Any one with similar situation in the past as mine -- PSA 10.5, Gleason 7, PC not spread, kindly comment which treatment path you chose, why? And the outcome. Thanks.

@virgil
Ask your oncologist about Decipher test. It uses the same biopsies (if qualify) to determine a more precise of your risk. This will help you and your oncologist a more precise options for treatments.

Example: My Gleason was 3+4=7 and intermediate risk. Oncologist recommendation was radiation and hormone treatment but wanted to do a Decipher test. It was done and came back low risk not intermediate risk. This changed my treatment recommendations (from two different medical facilities consultatsions) to just radiation.

I chose proton radiation low dose 30 rounds done at UFHPTI. I had mild side affects that slowly went away after treatments ended and I am back to normal 1.5 years from treatments.

Outcome. I was at 3.75 PSA when had treatments. Had gone up every 3 months for about 3 years from .75 to 3.75. My PSA is now .22 as of December 2024. My R/O goal was to have it below 1. So the outcome for me is positive results from the treatment. I have PSA done every 3 months and meet with R/O every six months. I see my PCP every 3 months.

Please consider the Decipher. It really changed me treatment options. Also if you have any doubt of your diagnosis or treatment get a second opinion.

I did not see you had the PSMA test done. I am not famiiar with the tests you mentioned using CT scans. The tests done on my at Mayo Jacksonville and UFHPTI were: MRI with contrast, Biopsies using MRI/Fusion, bone scan, Decipher, PSMA.