New, PSA 20, Just Starting Process

@ozelli I agree with this. I had a DRE after my PSA rose and the urologist said if he felt 100 prostates today, mine would feel the most normal. He still sent me for an MRI and my lesion was found. Don’t settle for a DRE if you have other markers/symptoms.

@jeffmarc just to follow up. My MRI was a Pirads 2, Prostate 70 ml volume which is a 26% decrease from last MRI in March. Last PSA was 7.1 in September. My urologist still believes I should do a biopsy but with nothing to target I'm hesitant. I'll do regular PSA tests and if numbers change, I'll biopsy. But he said "as long as you know the risks of an undiagnosed cancer". Of course that will stick in my mind daily!.

@widude63

Sooooooo...how'd it go?

I was first diagnosed with an enlarged prostate in 2016 and a PSA of 4.3. I had both an MRI and biopsy which were negative. Straining to pee was a problem and Tamsulosin worked great. In 2022 I changed urologists. My PSA was up to 7.7. My prostate volume was 68. She said that was a normal PSA for that volume. I had another MRI which was negative. We decided to do another biopsy which showed 2 cores of cancer, one at 3+4. I decided on surgery. It went great with no side effects, including no incontinence issues. However, my pathology report showed my cancer was actually 4+5. It will be 2 years since my surgery. My PSA has been < 0.01 ever since with my next PSA result today. Hoping and praying for more of the same. Whatever you do, make sure you feel comfortable with the decisions that you and your doctor make. As you can see, my tests, especially the second MRI and 2nd biopsy, were inaccurate. My best wishes to you. 🤞🙏

Well, it’s was an involved visit. I’ll tell what happened, but try to take it easy on me. The main decision was an MRI 30+ days out, or do the rectal biopsy this Friday. One large driving factor was my confirmed PSA at 20.3.

My desire was to start with an MRI, but again, I’m not at a 4, it’s 20. I decided to go with the biopsy this Friday morning, he fit me in.

On a better note, the urologist was great, experienced, but well aware of current treatment options. I just thought I should stay in the fast lane for a bit, to see what’s going on.

Any follow on advice is welcomed. Thanks.

@widude63

I honestly don't think that was a bad decision. The sooner you have more information, the better. You'll have a yes, it is or no, it isn't answer next week.

Unless it really sucks, then you might get a call over the weekend. (Or in my case, Friday night but my biopsy was on Thursday afternoon.) Wishing you a boring biopsy.

@ezupcic
A PSE test could tell the doctor whether or not you really need to have a biopsy. It is 94% accurate and can tell whether or not there is active prostate cancer in your system. A PIRADS 2 Is really not something to worry about. Your prostate is still significantly larger than normal and could be the reason you have a high PSA, so the test really could make sense.

sounds like a good idea I will pursue with my primary. But in the meantime I’ll do another PSA. I think for me if that number hits 10 even with a pirads 2 I’ll need to biopsy. My father had prostate cancer at 62. Had surgery and lived until 86. So it’s something, like many, I must monitor.

I’ve read some pros & cons about the unpleasant procedure. My plan is to try to have an ‘out of body’ experience. My body will be there, attempting to cooperate, my mind will be far away. It should be mostly over inside 10 minutes.

@widude63
DRE is worthless on me. Stick to PSA and MRI