Prostate lesions found, biopsy results, No symptoms

I know that it sucks but get the biopsy to find out. If you had a MRI, you may be able to forgo the maximum samples. They may just hit the areas of concern. My psa has slowly gone up and down over the last few years, I’m 58, and my last psa was 6.7. The doc wanted a biopsy to check, for sure. Had the full spectrum and they found cancer, Gleason 7. I’m awaiting my MRI and then I see what my treatments will be.

What does your urologist say???

I would recommend another PSA in 3 months and, likely a biopsy after that to get some Gleason scores. Next, a PSMA test could determine the spread of cancer.

If you later opt for surgery, do about 4 weeks of Kegel/Pelvic Floor PT prior to the surgery to reduce risk/time of incontinence - this helped me TREMENDOUSLY!

Thanks for reply, did the 12 point biopsy , Gleason score 3-3 , they find 1mm cancer cell and in another place a 2mm one .
My urologist recommended to do another PSA test in 3 months , I saw an oncologist who recommended to either give me shots to castrate ( bringing my testosterone level to zero for six months !!!
Or go for radiotherapy now .

Finally done the biopsy, result: Gleason score of 3-3 , with 1mm cancer cell and another a2mm one , the issue is my rising PSA levels which did go from 8 to 14 during this past year ( 2022)

That's a tough one...with a GS 3+3, you would normally continue to actively monitor.

The rising PSA is the question along with the confirmed spots in your imaging and DRE.

You have options:
surgery
either internal or external radiation to the prostate
radiation and add short term ADT, six months. That may address any micro-metastatic disease that may have escaped the prostate.
continue to actively monitor.

One thing to do is calculate your PSA doubling time, MSKCC has a online calculator - https://www.mskcc.org/nomograms/prostate/psa_doubling_time. This will give you an additional piece of clinical data

General rule of thumb is if PSADT:
> 12 months continue to actively monitor
6-12 months the grey zone, consider treatment
<6 months time to treat

DO some more homework and look at three things:

Doublet therapy - here's one link to get started - https://www.urologytimes.com/view/the-role-of-doublet-and-triplet-therapies-in-prostate-cancer
NCCN Guidelines for patients - https://www.nccn.org/patientresources/patient-resources/guidelines-for-patients/guidelines-for-patients-details?patientGuidelineId=49

Kevin

From my perspective, if I have verified cancer within my prostate, I would take immediate action to remove it permanently before the cancer metastasizes. However, it is a personal decision and there are many factors that need to be taken into account - Age, health, life expectancy, willingness to go through surgery procedures, etc.

When I was diagnosed with Gleason 7 (4+3), I was praying that I had at max Gleason 6 (3+3). From my research, it is highly likely that Gleason 6(3+3) can for the most part be "cured" and minimize the possibility of reoccurrence. I went with a radical prostatectomy (age = 56, good health, surgery on Nov 3, 2022), which I felt gave me the best chance of long-term survival.

Best of luck with your decision,

Jim

Get it out robotic or surgery and get on Zolodex to stop testosterones

Your delay is playing with fire

Hello everyone, it’s been about two months since my last post so finally did the biopsy and here’s the result as attached , my concern is that of my rising PSA , anyone can help seeing the biopsy? Thanks

@fredz, thanks for the update about your biopsy results. I moved your post to the original discussion you started so fellow members can see your diagnostic journey and support your decision making here:
- Prostate lesions found, biopsy results, No symptoms https://connect.mayoclinic.org/discussion/prostate-no-symptoms/

Please see the helpful responses from @kujhawk1978 @hammer101 @melcanada who share their thoughts and experiences.

Fred, what treatment options are being suggested for you by your cancer team?