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New and Need Guidance: What questions to ask about prostate cancer?
Hello everyone, sadly I have had to join this area of the internet which we don't wish on anybody.
I am on here because my father who is 70 had a blood work done on 1/23 with a PSA of 26 and another blood work on 2/23 with PSA 20.
We are in Michigan, USA fyi.
Completed a 3T MRI on 2/23 and today got the results showing a Pi-RADS 4 with a lession found to be the size of 8mm. The doctor also mentioned that the MRI could also see the close by lymph nodes which looked good.
The doctor ordered a Fusion Biopsy, which they will call us in the next 2 weeks to schedule a date for.
We were all caught off guard and uneducated in the matter leading to no real questions asked and following whatever the doctor says to do.
I wanted to join the forum and ask this kind group of individuals for guidance through this process.
-What questions to ask the doctor?
-What specific types of biopsies are most accurate and useful?
-Is the "Fusion Biopsy" that the doctor ordered the proper one?
-Is there other types of biopsies that we should ask for?
-Is doing a biopsy risky in any way, and can it worsen a situation?
-Is there ANY reason to avoid doing a biopsy?
-In case of bad biopsy results, what treatment options are there? (I would assume you're going to say that this completely varies until a pathology report)
-What hospitals/clinics/locations would be best to go to for the best treatment?
-Is a biopsy very likely to show cancer with a Pi-RADS 4 and lession of 8mm?
-What words of encouragement would you have for myself/my family/my father in this situation?
-Is this something to be absolutely worried sick over?
-Is this something where life goes on with manageable treatments and major or minor life altering events?
-Is this something that we should not worry too much about at all?
IF I am asking ANY dumb questions, please forgive me for my ignorance and uneducated questions. This is obviously a world that nobody wants to go into but unfortunately a lot of us are in.
Current treatment location is at:
Michigan Institute of Urology
St. Clair Shores, Michigan
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Hoping your father does well throughout this ordeal.
My Urologist told me the PSMA scan, done after the Biopsy, showed where the cancer was; simply within the prostate gland and NOT anywhere else. Fusion Biopsy was not mentioned during my treatment.
He DID send my biopsy tissue for a Decipher test, which took a few agonizing weeks, showing the biopsy results from different sections of the gland. This provided the Gleason scores where the latter number shows the aggressiveness of that "snip;" while the first number indicates the most predominant pattern. I had several 3+4 scores, prompting my Urologist to go further and I had the PSMA test.
On the issue of the experience of the doctor, I would tell him that I am concerned about your short length of experience and, this is MY FATHER whom I am very worried about. I hope you are not offended but I would like someone more experienced to handle his case. Just be honest.
There are a LOT of questions to ask. But some cannot be answered until more steps are taken. With a high PSA, I expect a biopsy would be scheduled, and the snips would/should be sent off for a Decipher test. That takes a few weeks, agonizingly slow when one is very anxious to get results.
Wishing the best for all.
My PSA 's are the same as yours. At this point I am scheduled for radical removal in very early May. My Urologist advises this is my best option . Im 60 no other real health issues. I have PSA #s in 2021 22 a year later 32. Alot of info to take in, and get processed in a very short time . I wonder , should an Oncologist be involved. at this point ??
My urologist made me talk to an Oncologist before I decided to go with the RALP. The Oncologist I spoke to was very thorough. I would definitely recommend this. I got into see one within a couple of weeks. Seems like both approaches have same level of success (very very high) with overall survival. Both have risks with regards to incontinence. RALP more risk of ED, but Radiation carries risk of bowel movement issues. The other thing I did not like about radiation is that if PCa reoccurs it is harder to have Prostate removed. If you go with surgery you can still have external radiation treatments. I am not clear if there is a higher chance of BCR associated with radiation or surgery. I would ask this of your surgeon and the Oncologist. I did not ask this and should have. I also had nerve sparing RALP so everything is working decent with regards to erections. Not 100% yet, but I am 7 months out from my surgery only. It's a lot of decision making I know....
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2 Reactionsjust a comment about a prostate biopsy. I had one 2 1/2 years ago when PC was first suspected with a PSA of over 2000. It was the most painful thing I have ever experienced in my 74 years of living. If you have the option of being put under DO IT!
Good luck
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1 ReactionVulcan, great to hear your father is having a fusion biopsy. You will want to ask your doctor on number of samples that will be taken. The fusion biopsy will gather multiple samples from areas of concern (lesions), but should also gather samples randomly around the peripheral region of the prostate (prostate cancer normally forms in the peripheral regions of the prostate). In may case, additional areas of cancer were found. Please note, I am not a doctor, all of my comments are based on conversations with my doctors and online research.
I went with a radical prostatectomy - 56 years old (Gleason 7 - 4/3) and wanted to ensure most options open for future.
FYI - Johns Hopkins has a great article - 30,000+ radical prostatectomies for men with Gleason 6 (3/3) and no BCR's recorded, pretty much a "cure for those men. If your father gets pathology feedback from the biopsy that he has prostate cancer, I pray it is Gleason 6 or less. Even if it is not, there are a lot of treatments available now, as you have heard from others on this site.
Good luck,
Jim
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1 ReactionYes. Definitely consult an Oncologist
Are you on any Hormone therapy?
I take Zytiga and Lupron injections every 3 months
From August to present my PSA has decreased from 74 to 10.7
Upcoming appointment with Radiologist/Oncologist to determine
if I will start radiation treatments/
Good Luck
Do you have a link or name of the study? I have not found it yet. Thanks.
Perrychristopher - Sorry, I read this article just after my initial MRI last fall and did not save a shortcut. I looked for about an hour without any luck.
Jim
No problem. Thanks for looking.
Do 40 days of radiation last 5 rapid arch for margins then get on Zolodex injections