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Continued Monitoring or Biopsy?
My PSA has fluctuated all year:
January: 8.1 and 7.8
March: 5.4
June: 4.4
September: 7.1
Dec: 6
%Free PSA between 15% and 16.6%
First MRI: Pirads 3 with a 95ml prostate.
Second MRI: Pirads 2 with 70 ml prostate. No focal lesions
Some characteristics of BPH/Prostatitis. On Tamsulosin
62 years old. Father had radical prostatectomy in 1992 at my age but lived another 25 years cancer free.
When I look at all the numbers like density, velocity and MRI reports I' m inclined to continue with regular PSA tests every 3 or 6 months and MRI's. My urologist thinks I would benefit from a biopsy but offered a standard office transrectal 12 core, essentially blind since there is nothing to target right now. Anything else I should consider that I'm not? Thanks
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@vincenzo66 did you have a PSE? Did your prostate density factor into decision-making? But I would agree that if it's all borderline.....probably time for a biopsy. With your Pirads 3 is there something to target or is the biopsy sort of blind?
@ezupcic my prostate volume was 56cc so while my psa of 11 was for sure bad from a prostate density perspective, the 6.2 is again borderline. Yea, there’s a specific lesion that’s PI Rads 3 and Im doing the MRI fusion biopsy for best chance of sampling that specific area. I had to get a second opinion since the local uro wanted to biopsy months ago without the fusion tech. No PSE - I guess the ExoDx biomarkers test is USCFs advanced further testing. Best of luck.
@vincenzo66 so your most recent PSA was 6.2? Did the radiologist give you any more information about that lesion in the report?
@ezupcic from what I'm reading a trans perineal targeted fusion biopsy is the way to go. Do you know how many cores they are sampling?
@ezupcic
Most recent PSA 6.2 yep.
Here's the findings from the report.
1. Questionable area of restricted diffusion in the left peripheral zone mid gland with no associated T2 hypointensity or discrete lesion, indeterminant.
2. BPH, with gland volume of 56 cc.
3. No pelvic lymphadenopathy or suspicious pelvic osseous lesions.
Total PI-RADS score: 3 - Intermediate (the presence of clinically significant cancer is equivocal)
@vincenzo66 hopefully the Biopsy comes back with a benign report. all the best.