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Consultation with urologist about mri results

Posted by benz57 @benz57, Jun 21 9:34am

Talked with urologist about mri results, who presented me with the choice of biopsy or psa test every 3 months. Im going with the tests. I did ask about the pse or anything similar that might move me one way or the other, but Geisinger doesnt typically use these, Im still going to see if my va primary can get a pse approved.

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bens1 | @bens1 | Jun 22 4:42pm

@benz57

I ordered the Oxford Biodynamics biomarker PSE blood test, which is 94% accurate vs 55% for a PSA test, through my primary care provider. Here is a link to their PSE product page. The order form for your PCP is available as well.
https://www.94percent.com/

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benz57 | @benz57 | Jun 22 8:35pm

A blood test like the Exodx is a good idea.

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benz57 | @benz57 | Jun 23 8:19am
In reply to @bens1 "@benz57 I ordered the Oxford Biodynamics biomarker PSE blood test, which is 94% accurate vs 55%..." + (show)
Profile picture for bens1 @bens1

@benz57

I ordered the Oxford Biodynamics biomarker PSE blood test, which is 94% accurate vs 55% for a PSA test, through my primary care provider. Here is a link to their PSE product page. The order form for your PCP is available as well.
https://www.94percent.com/

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@bens1 so if my urologist for some reason, denies the request for a blood test like isopsa or exodx, I can request it through my primary? Wouldnt he just refer me back to the urologist he sent me to?

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wheel1 | @wheel1 | Jun 23 8:37am
In reply to @benz57 "@bens1 so if my urologist for some reason, denies the request for a blood test like..." + (show)
Profile picture for benz57 @benz57

@bens1 so if my urologist for some reason, denies the request for a blood test like isopsa or exodx, I can request it through my primary? Wouldnt he just refer me back to the urologist he sent me to?

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@benz57

My primary is the one that ordered my ExoDx. At that time I knew nothing about it from my Urologist. He did not seem concerned that he was overstepping into my urologist wheelhouse. I had no issue when I got my results taking them into my urologist and share with him. No discussion even occurred about why my primary ordered it.

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bens1 | @bens1 | Jun 23 8:51am
In reply to @benz57 "@bens1 so if my urologist for some reason, denies the request for a blood test like..." + (show)
Profile picture for benz57 @benz57

@bens1 so if my urologist for some reason, denies the request for a blood test like isopsa or exodx, I can request it through my primary? Wouldnt he just refer me back to the urologist he sent me to?

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@benz57

My primary care provider had no problem, ordering the PSE test for me and did not see any conflict.

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alvainajr | @alvainajr | Jun 23 11:34am
In reply to @beachflyer "Hi benz57 Sounds like you have a lot of good data to go on including imagery..." + (show)
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Hi benz57

Sounds like you have a lot of good data to go on including imagery that shows little change. That is good.
So my surgeon (Dr Ahlering , Chair of Urology, at UC Irvine) stated that 8 to 11% of men can develop MRI negative cancer. He said coupled with low PSA expression, it usually goes undiagnosed until it is well advanced.
I was 65 and got concerned when my PSA doubled from 1 to 2 in a year and saw some brown spots in semen. My mother had died of a rare form of breast cancer that had been misdiagnosed early on as benign cysts and my sister had developed a similar and unusual precancerous condition that was successfully treated.
Both my primary care doctor and 2 urologists ( one associated with a major cancer center) told me everything was fine. They said that based on my low PSA and a lot of guys get spotty semen and Mother dying of breast cancer is irrelevant since it was not PC. Not trusting the Doctors, I pushed for a contrast MRI…and it came back clear. …ultrasound also clear.
Offered to pay for biopsy… bingo…there it was … Gleason 3+4, (30% was 4) and the lesion occupied 20% of the prostate. I received apologies from all 3 doctors involved. Apparently some cancers are on a cellular level and dont produce a well defined target mass for an MRI.
One last comment, medical centers are different and while the San Diego center did not place any weight on my mothers cancer history, UC Irvine disagreed with how my case was handled saying there is a link between breast cancer in a woman and PC in her son. UC Irvine would have fast tracked me through all tests based on what I had presented.I learned that Medical science is an art coupled with the bellcurve of treatment afforded by insurance companies and second opinions may differ greatly from original diagnosis.

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@beachflyer totally agree. For years my PSA level was at 3.8. when I saw my leukemia doctor he asked about family history and noticed that two brothers with prostate cancer and a father that passed from prostate cancer warranted a MRI. Findings Gleason 3 + 4 with aggressive features for high risk cancer. Had a radical prostatectomy and to be honest it's not going well.

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greg2026 | @greg2026 | 6 days ago

My advice is don't defer any suggested testing. Me, 2024 year registered a 3.3 PSA (Increase of only 75% from year prior). Discussion with my PCP and decided not to do further testing. In 2025, November, PSA at 4.2, immediately went for physical exam with Urologist which led to biopsy and PSMA PET. Stage 4 aggressive low burden. I REGRET not doing more tests in 2024 I might have been able to stop the metastasis at that stage. I say do as many tests as you can you might have issues a single test cannot detect.

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benz57 | @benz57 | 6 days ago

Im getting psa test every 3 months and he is now indicating willingness to order exodx which is very good at ruling cancer out. I would never just stop all testing.

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beachflyer | @beachflyer | 5 days ago
In reply to @alvainajr "@beachflyer totally agree. For years my PSA level was at 3.8. when I saw my leukemia..." + (show)
Profile picture for alvainajr @alvainajr

@beachflyer totally agree. For years my PSA level was at 3.8. when I saw my leukemia doctor he asked about family history and noticed that two brothers with prostate cancer and a father that passed from prostate cancer warranted a MRI. Findings Gleason 3 + 4 with aggressive features for high risk cancer. Had a radical prostatectomy and to be honest it's not going well.

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@alvainajr
I am so so sorry to hear that things are not going well.

This cancer train ride is so exasperating. I have found many in the medical community almost nonchalant about its diagnosis. We are all told it is slow growing or unlike many other deadly cancers it is very treatable, words like chronic condition versus terminal are often heard. I think it lowers our defenses and we readily accept good news like “lets wait and see” or “you are within normal PSA limits for your age so no need for MRI or biopsy”.
Yet as we all know early treatment affords the probability of a cure versus dealing with a chronic condition or worse.
I have always believed and repeatedly stated to the doctors and the cancer community that our diagnostic standards are too low!
When a man has any family history of cancer or history of chemical exposure and a 50% rise in PSA in 12 months the PSA thresholds should be cut in half for additional evaluation. That would save thousands of men from having to deal with advanced cancer.
Instead the medical community goes the other way avoiding PSA testing after age 70 to 75.
I have told many men aged 70 to 75 …to ignore their doctors medical advice and get PSA tested and watch the trend. As a result I recruited 4 men into our unfortunate club in 2025 here in San Diego. They were all treated (All received RT and some ADT) and are now quite happy they ignored their doctor’s advice to not worry about PSA or prostate cancer.

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alvainajr | @alvainajr | 5 days ago

Well said. I am in the hospital right now dealing with bilateral pulmonary emboli that resulted from the robotic surgery. I frankly don't think the surgeon did a very good job sealing off the inguinal lymphocyte and I also don't think he did a very good job in tying the ureter to the bladder. He mentioned a in quotation marks urine League went quotation marks as a possibility for my inability to pee without a catheter and also mentioned the lymphocyle as a problem putting pressure on the bladder. I totally agree with you that PSA testing should be done and trends should be looked at. Especially with the family history. My nightmare continues.

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