Going for Prostate Biopsy Tomorrow ….Looking for Opinions and Thoughts

@lacraig1
I go for my first biopsy in a few days ( 12-11 ), so I will find out what my situation is after that.
I did have an MRI and have one PIRADS 3 lesions. My prostate is very large as well. I thought about doing a MRI last year, but put it off and finally did it a few months ago.

How have you been doing since your surgery ?

hmm
I have ED and wear diapers. I have been control over my urine, but I often get squirts when lifting something or coughing or something.
They want you to masturbate every day to help rejuvenate the nerves. As much as I like that, I find it tedious, because it took a lot of work and I would get urine all over the place.
They give you a sexual health nurse, but she ended the sessions before we dealt with the ED. I complained about that.
My PSA started rapidly rising, though still tiny (.1 to .18). Sent me to an oncologist, who wants hormone replacement therapy and radiation. I had a Gleason score of 7 (out ot 10). I'll start radiation Wed. They have no pictures of spread, so they'll target the pelvic area. The cancer had spread to the lymph nodes and seminal vescicle.

@lacraig1
Sorry to hear you are going through that now.
I hope things get better for you. I will send good vibes that everything goes smoothly.

thank you

Prayers are always welcome too

@lacraig1
When your PSA hits .2 they want to do salvage radiation. Here’s more information about that.

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.

0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.

0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/

Thank you
This is what they have been telling me without referencing those exact numbers. I am on the ADT and will start radiation Wed.
I am getting the impression from some posts here that this urgency is not so critical here, because there is some new-fangled radiation, is it photon, proton, that can handle any metastatis, even to the bones.

@lacraig1
Will be hoping for you to have good outcome on your treatments.

By the way when I set or lift I have the same squirt and all I had was radiation. Seems these days my prostate and bladder have a brain of their own divulged from my body and a mind of their own.

@indyguy sent a prayer your way. I have to wait til Jan 27 for my biopsy. In the same boat. Hope for best

they told me when I had radiation, that I wouldn't get any better than I was now. I'm not sure he meant forever. but he sounded like it.

@indyguy Hi. Yes, I did end up having a fusion guided transrectal biopsy in the surgery center next door to their office, but they knocked me out for it, which was appreciated! They targeted the pirads-4 lesion from my MRI (which ended up being Gleason 7) and then took several random cores too. I just read that your MRI showed pirads 3 so hopefully that means your biopsy results will be even more favorable.

Several on here strongly recommended transperineal and I tried to talk to my urologists office about that, but they were pretty adamant that they only do transrectal and that it is somehow better. Because it was already scheduled and I didn't want to start over with a new urology group, I proceeded that way, especially since there was just one visible lesion on the MRI and they said they could target it with the transrectal.

The discolored pee still comes and goes, but much better. I thought it was all clear, but not yet. Don't get me started on the color of my semen! It's disgusting. lol. I'm wearing feminine pads that stick to your underwear, so there's that. I think they used to be called "panty liners" back in the day. Thanks for the positive thoughts. Right back at you!