Advice on PSAM-PET/MR 3+4=7

A PSMA pet test really is the next step. If a pet test comes up clean, then you can have a choice of surgery or radiation or even one of the other techniques available today. If the pet test shows that the cancer has already spread, Then different choices will be made.

With the biopsy showing 3+4 it is surprising that your PSA is so low. You might have your biopsy slides reviewed by somebody else to see if they come up with a different answer.

Thanks for your response, Clarification is due here, my PSA (ultrasensitive) was done in Dec 24,(2.03) and my HoLEP in March 25, the oncology urologist is taking an approach Decipher, PSMA PET/MRI, and MR pelvis with and without contrast with a follow-up with PSA before mid-June for 6 weeks follow-up. Any suggestions will be greatly appreciated.
Anyone know how the urology staff is at UCSF?

@mauk the Decipher test seems like a good choice and will give you a feel for the aggressiveness level and it is used by doctors to adjust treatment decisions.

After that, come back and discuss doctor recommendations. Hopefully, you will get more than one doctors opinion as to treatment. Doctors are dedicated but not infallible and quality of life and toxicity from any treatment are important issues that may or may not be addressed thoroughly by any given doctor, even those from a center of excellence.

"Anyone know how the urology staff is at UCSF?"

UCSF - so far SLOW, unresponsive and ambiguous. Had to call about 20 times and still no "second opinion" on pathology or PSMA !!! It has been about 5 weeks since we sent slides for second opinion *eye roll
We called Stanford yesterday just to "ask" about TULSA (probably we are not good candidates but just had enough of being sitting duck ), lady that answered immediately accessed all results and told us that she will present those to comity of 4 or 5 doctors ( I forgot number) and that they will do evaluation and CALL US !?! I was floored ! Like day and night .
Anyhow, maybe you will have more luck. If we were not soooo focused on RP and success rate there for that procedure , we would probably pick up and fold out tent long time ago.

I am especially upset since our slides are now "stuck there" and we wanted to hear third opinion - but we have consultations soon so we will endure *sigh They promised to "digitalize them" and nothing happened in that regard either.

Sorry to hear that, so far I have not had any issues! But I do have a couple of questions, how do find out who is a good surgeon and 2nd how do you get a second opinion from him?

If you want a third opinion, you should do it with Dr. Epstein in New York. He really is considered the best of breed when it comes to analyzing prostate cancer.

Dr. Jonathan Epstein pathologist for biopsy review
https://advanceduropathology.com/consultation/

Thanks Jeff < 3. Yes, that was the idea, I watched one of episodes of AnCan where that was suggested and it took me about 2 weeks to find out how to send slides there ( it was at the time when I could not send PMs and wanted to ask you ) and at the same time we contacted UCSF . At first they responded fast and organized transfer of slides efficiently but since than we could not get any access to them or the results. They were looked at finally YESTERDAY (at least that is what we were told after calling for 20th time) by their pathologist but we were told this morning that we can not see the report until we talk to their doctor (?????) . Now we are calling radiology to see if anybody looked at PSMA/CT results ! This is just very unorganized for such big center and I am now doubting the choice we made :(. I am doubting it even before we had a consult and it is not a good feeling and we maybe wasted 6 weeks for nothing. I feel were we held hostage, to be honest. I feel sick to my stomach this morning because I have sudden burst of anxiety over all of this useless waiting and not seeing the exit out of this absurd situation .

Thanks Jeff-Really appreciate your assistance, Any trustworthy contacts Solan-Kettering?

Thank you very much, Jeff. Any trustworthy contacts at solan-Kettering?

I had a 3+4 I sent it to Epstein and it cam back 3+3. I transferred to the Nebraska med center they said it was 3+4 then I had a second biopsy and that one came back 3+ 4 so I really don’t know who too believe