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New, PSA 20, Just Starting Process
Prostate Cancer | Last Active: 12 hours ago | Replies (38)Comment receiving replies
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.
Replies to "Well, it’s was an involved visit. I’ll tell what happened, but try to take it easy..."
@widude63
I understand the desire to get information as quickly as possible and would have probably made the same decision to go with the biopsy now vs waiting 30 days for an MRI.
As you may know, a 'standard' biopsy generally involves 12 cores or samples and there is also what is referred to as a 'saturation' biopsy which involves more cores. The saturation biopsy is more likely to detect cancer if the cancer is very small and confined to a single area of the prostate. The saturation biopsy will involve more discomfort obviously, but as long as you are going through the process anyway you may want to ask for the saturation biopsy to provide a higher degree of assurance of the results.
Hopefully the results of the biopsy are negative, but even if they are I would go ahead and have the PSE test. If the biopsy results are negative but the PSE indicates a high probability of prostate cancer you will know that additional testing is needed - probably an MRI and perhaps a follow up biopsy procedure in 12 months if the MRI doesn't show any suspicious areas.
My prostate cancer journey involved a gradually rising PSA with pretty significant fluctuations up and down over many years, and I had several biopsies which were negative. About 27 months ago I had a regular appointment with a urologist and at that time my PSA was stable from the prior test and the DRE was negative and the urologist basically gave me a clean bill of health for another year. I asked for one of the newer urine based tests and he prescribed the ExoDx test. That test result indicated an elevated risk of cancer (36%) which led to an MRI which was completely clear. I went ahead with a saturation biopsy and that showed a very small amount (less than 5% of the core sample) in two samples of the 24. The gleason scoring was 4+5 so surgery was warranted and I had an RALP six weeks later. Fortunately my gleason score was downgraded to 4+3 with tertiary 5 cells. My experience shows that cancer may be present even though PSA may be stable, DRE may be normal, and MRI may be normal. I would not have known I had cancer as quickly as I ultimately did if it were not for the ExoDx test, so I am a big believer in using those types of tests to supplement the more standard diagnostic steps like the PSA, DRE and even MRI. From what I have learned on this site, the PSE test is now more accurate than the ExoDx test which I had, so I would recommend that.
All the best to you as you move through this process.
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@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.