Continue PSA surveillance or have a Prostate MRI?

Very helpful info, thanks. It makes sense to me. I'm reading the book "Mayo Clinic on Prostate Health" now, and it addresses active surveillance vs. watchful waiting. I'll be sure to discuss with my Urologist soon. Best wishes to you.

If you have an implanted devise (pacemaker) you may not be able to have a MRI
Seawood2735

I do not. Thanks.

Additional non-invasive oriented MRI only helps you make a more informed decision. My Urologist was very specific about which doctor he chose to read the prostate mri image for me and to some degree, it seems there is an art to it. If they will give you a psma pet scan, then even better. Infections, inflammation, age, bph, sex, bicycle riding, and so on can impact a psa going up or down from one day to another, without having cancer. If something is spotted with the imaging, then you may very well end up getting a biopsy but without the imaging, one might be concerned that things could get worse. Catch what you can as early as you can. I wanted to stay away from any hormone or chemo therapy so early detection is better.

You might also want to look at the Galleri test from Grail. It tests for different types of cancers. It's not perfect but it is being used out there. There is a randomized trial in the UK going on right now. I think you have to pay for that test out of pocket.

Thanks so much, very interesting re: Galleri test, first time I've heard about, and Mayo Clinic has some info on it as well, I just learned. I'll ask my Urologist about it along with the psma pet scan, which others on this forum recommend.

I'm aware of the factors that can influence a PSA test, and I'm going to have a my PSA retested in 2 months, even though, at age 71, my doctor claims my above normal total PSA (7.4 recently vs. 8.2 last year) is due to my BPH (my Free PSA/PSA has been 29-32%), but he still recommends an MRI if my PSA levels remain elevated or increase. I'll do the PSA retest first then get the MRI as needed after I get my PSA results and discuss with my doctor.

Early detection is vital, I get that, and while PSA testing is controversial, it does appear that an MRI "could" save me from having an unnecessary biopsy perhaps. Well see.

Thank you!

I am curious as to why you state that "PSA testing is controversial"

Maybe his saying “controversial” is the wrong word. However, questions about accuracy may be more appropriate. Why? A man can have a high PSA and not have any cancer. A man with a very low PSA could have cancer. Using PSA along with other factors is the best way to determine the risk of cancer. I will also say this: I recently had an MRI which showed nothing. My urologist told me the MRI can only detect cancer in about 80% of the prostate. I then had the biopsy and they found cancer in one of 14 cores. 3+4=7. I decided I’m having it removed in a little over a week. Good luck.

It is the trend line of one's PSA that is critical. In my case, I had several biopsies (3+3) but my PSA was increasing and my urologist ordered the MRI to assist in determining where the samples should be taken in my next biopsy. The MRI indicated that there was some suspicious areas in the anterior zone of the prostate and that allowed the biopsy to focus on that area which resulted in a (3+4) which led to a RP. The subsequent pathology report indicated a Gleason score of (4+3) and a TNM stage classification of pT3a NO. Four years later, with a rising PSA I had a PSMA-PET scan which indicated a cancer cell where the seminal vesicle had been. This led to Salvage Radiation in July 2022 and my subsequent 4 PSA readings have been undetectable < .008.

They now have liquie biopsy that is meant to be more effective than PSA test alone.

I am one of those who got diagnosed with prostrate cancer within a normal PSA. Mine was 3.75. However my primary care doctor did not like the continuing rise in PSA levels. We thought bike riding but staying off bike a week prior did not help.

The MRI with contrast and probe revealed suspicious areas. Biopsie revealed several aras of cancer with worse 3+4=7. However Dechipher test reduce my risk level from intermediate to low risk. PSMA was negative. Bone scan was negative. Underwent proton radiation and first PSA after test was 1.2

PSA is the gold test until something better is found. The rising numbers are more important than a single test. Rising means cancer or inflmation in prostrate and both need attention.

The worse thing in all my testing, treatment was that I was referred to a urologist who did medical exam, DME, MRI/Contrast, and MRI/Fusing biopsies only to tell me could not see him because I had my radiation done at another facility. I did that because the facility he worked at did not offer proton therapy. So was told to see their urologist who I never saw. The facility used the original urologist DME, MRI, and biopsies to set up my treatments.

So I was being asked to see a brand new urologist after treatments who had no knowledge of my cancer, testing, exams, etc. Not in my opinion a good decision or dong what is best for patient.

I have a good radioloigst/oncologist at the faciliyt I had proton radiation done and still think I made right decision on proton verus photon radation. The PSA ongoing test after treatment are still the method of dertermining if treatments were successful and or the returning cancer to prostrate or prostrate cancer has spread to body even it had surgery.

Wellness100, are you talking about a liquie biopsy that is done AFTER treatments to monitor cancer treatment success?