Worried this may be Prostate Cancer: Next steps?

Posted by Barco@2194 @wgatap21, Mar 8 9:48am

I'm 75 yrs old. PSA has risen over last few yrs. Rectal exam seemed ok. I had a blood test- 4K SCORE (OPKO) (LMW) that resulted with a 3.83 PSA(4.1 a month earlier). Results of the 4K score was 13.5, showing a "Intermediate Probability" of 19.7% of finding aggressive cancer upon a biopsy test. I request a MRI in 3 weeks. Great doctor and not worried but I'm new at this but born a worrier unfortunately. Thoughts please. Thanks

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@ovstampco

Just a follow up - PSA tests can vary over time my first PSA test was in January 2024 and it came back at 10.9 . I had a follow up test 6 weeks later and it came back at 11.0 . I had another test done in August 2024 and it came back at 8.6 . The urologist checked and after a 3T MRI they concluded that I don't have BPH . I am trying to avoid a biopsy as long as possible ( for several reasons ) I would prefer to get a PSE test instead at this time but I don't think my Health insurance company ( Kaiser - California ) will approve - I had to fight tooth and nail to even get an MRI . Biopsy's are more profitable for health care providers than MRI's ( or should I say much less costly ) . It's the same story with PSE tests - I know they are expensive and I'm sure that the doctors with lower or mid tier providers are under strict guidelines to follow the corporate mandates to avoid the more expensive procedures .
Top tier providers ( such as the Mayo clinic ) seem to be willing to approve tests and procedures that are the most logical and beneficial for the patient - regardless of the costs . Too bad the general public don't all have access to the top facilities - the current system is set up so even if a patient pays out of pocket they are not able to access certain procedures without being approved by their provider .

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High or higher PSA's - maybe just surveilance, then its biopsy (probably a poke and hope - basic), then if biopsy not sure definately get a URONAV Fusion 3d - only way to go to know. Then its an MRI wo/w contrast, then a PET w/nuclear contrast scan to confirn localized, then its decision time: Radiation or Prostatectomy. Sums it up.

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Has anyone did the Robotic Surgery? I'm schedule for May. Curious to hear about your experience.

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@toddsp

Has anyone did the Robotic Surgery? I'm schedule for May. Curious to hear about your experience.

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Many of us have done it. Do a new conversation and more people will find and reply to you.

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@toddsp

Has anyone did the Robotic Surgery? I'm schedule for May. Curious to hear about your experience.

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Make sure they can put you out I needed a smaller tube Took 6 anistegioligst to get me out Hand pumped me for 40 minute Then stopped the robotic as C to close to apex near bladder and would have made me incontinent Had 4 radiations 4 months later

Then don't eat until intestines' return back down body as they put you almost upside down on table. I almost died when bile piled up in my stomach Needed pumping out through nose
They also gave me a bunch of pills just before going in I had GERDS when I came out

Get everything detailed described

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@toddsp

Has anyone did the Robotic Surgery? I'm schedule for May. Curious to hear about your experience.

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My husband had it back in September. Surgery was not too bad. He had a lot of gas pains afterwards. Catheter for the week was more the issue. went to remove catheter it did not deflate properly and when they tried to pull it out he went thru the roof. Very painful and bloody. Had issues with incontinence much longer that he would have liked. Still has to get up 2-3 times in the middle of the night to use bathroom. Given his age they “anticipated” he would not have issues with ED since he didn’t before hand. Unfortunately that was not the case. But hopefully with time it will get better. It definitely was more emotionally draining on him all the way around. He was on a rollercoaster for quite sometime. But no cancer is better than all that put together

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Some opt for radiation instead of removal due to the high number of patients that have to eventually have to go through salvage radiation months or years after removal. I would probably reconsider my choice after salvage radiation 2 years after removal if I had to do it all over. If you go to a surgeon enough times you will get surgery as that is what they do. The same with a radiation oncologist you will get radiation. Nerve sparing is the surgeon's pitch. It's a roll of the dice. I'm not sure there is any clear answer to which procedure is better. Best thing I can offer are my own experiences. Best wishes with your decisions and outcome.

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@chippydoo

Some opt for radiation instead of removal due to the high number of patients that have to eventually have to go through salvage radiation months or years after removal. I would probably reconsider my choice after salvage radiation 2 years after removal if I had to do it all over. If you go to a surgeon enough times you will get surgery as that is what they do. The same with a radiation oncologist you will get radiation. Nerve sparing is the surgeon's pitch. It's a roll of the dice. I'm not sure there is any clear answer to which procedure is better. Best thing I can offer are my own experiences. Best wishes with your decisions and outcome.

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...start watching the YOU-TUBE videos produced by the Prostate Cancer Research Institute
(pcri.org). The clinician is a 20 yr experienced medical oncologist which limited his practice to the prostate. Semi-annual meeting will be at the end of March, annual in September.
Their advice does not have conflicts of interest inherent in direct therapy providers.

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@chippydoo

Some opt for radiation instead of removal due to the high number of patients that have to eventually have to go through salvage radiation months or years after removal. I would probably reconsider my choice after salvage radiation 2 years after removal if I had to do it all over. If you go to a surgeon enough times you will get surgery as that is what they do. The same with a radiation oncologist you will get radiation. Nerve sparing is the surgeon's pitch. It's a roll of the dice. I'm not sure there is any clear answer to which procedure is better. Best thing I can offer are my own experiences. Best wishes with your decisions and outcome.

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A roll of the dice indeed…who said, “I’d rather be lucky than good.”?

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@toddsp

Has anyone did the Robotic Surgery? I'm schedule for May. Curious to hear about your experience.

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Di Vinci robotic surgery is very common. I'm 73 and I, and a lot of my friends have had prostate issues, surgery and treatments. In the last 5 or more years, I can't remember any of them having prostate surgery that was anything other than "robotic".
Decades ago, my parents were scared to death of their new "microwave" oven. It's the 21st century.

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