New and Need Guidance: What questions to ask about prostate cancer?

No biopsy yet because there's 2 conflicting MRI reports. One Pi-RADS 4 and another a Pi-RADS 2.

Radiologists are conflicting each other.

I was diagnosed with stage 4 prostate cancer tumor blockage of right kidney have a neutrastphy bag on ! Have had 3 Lupron shots and 4 chemo s ! My prostate is down to a 1 ! I’m happy ! I also have metastasized bone cancer very painful 🙏

I am 73 and in the same boat as your dad. The 3T MRI is really accurate. I had a 7 mm lesion confined to the prostate, but my PSA was only 2.9. I had an MRI fusion biopsy which is where the doctor uses the MRI image with an ultrasound probe in your rectum to find the lesion when he takes the biopsy samples. I had a trans perineal biopsy under a local with no problems and would never have a transrectal due to two factors. One is the chance of infection from the rectum and the second is that the prostate is more assessable from the perineum.. He did a 30 core biopsy as I have a very large prostate and for mostly 3-4 Gleason but I had two cores with 4-3 Gleason which I why I elected for radiation, After the biopsy the doctors at Mayo Phoenix had me do a PSMA PET SCAN which showed that the cancer was confined to the prostate. My PSA had been in the 2.5 to 2.9 range for 5 years on my annual checkups and no one will venture a guess as to how long it was growing. I had my markers inserted last Friday along with Space Oar Gel to protect my rectum from the radiation. I hope this helps.

The PSMA scan came after the biopsy. The reason for the PSMA scan was to see where the cancer was located in my body; the scan showed that it was confined to the prostate gland itself. It had not spread anywhere else.

My Urologist gave me information on a Radiation Oncologist and a Urologist/Surgeon, and included that he had worked with that Surgeon before.

It was my Urologist who told me that radiation did some damage to the tissue, making surgery after radiation moe challenging, while surgery removed tissue/gland and left the area viable for radiation.

Therefore, I opted for the RALP. After a long discussion with my Urologist, who had me as the last appointment of the day to give me all the time I needed. After reviewing my results and some of the articles I had collected into a binder, I told him of my choice. He then said that he would have made the same decision if those were his "numbers."

Having seem my Surgeon at a 6-month checkup, and after an ultrasensitive PSA test, my PSA is less than 0.008.

I feel truly blessed to have been given the outcome that I had. I wish this on everyone.

Ask for PSMA Pet scan. If it is prostate cancer, it will show, anywhere in the body. The cancer may be outside of the prostate or not even in the pelvis. That can account for the high PSA and ambiguous MRI. Also the cancer can be hidden in certain places. Such as the bladder. MRI will also not show.
PSMA Pet Scan is for the whole body. It is the classified as the most accurate test so far. That said, it can miss 10% of the cancer. Talk to your doctor about it. Hope that helps.

Adding Enzalutamide Study
https://www.healthline.com/health-news/advanced-prostate-cancer-experts-say-this-double-therapy-can-help?slot_pos=article_2&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=cancercare&utm_content=2023-04-04&utm_term=s:hl_n:cancercare&apid=&rvid=bb1eae2f35916c1f0f383cc46053ca8a110a0657e125948dea0d990208a5d64d

I feel for you my friend. I'm glad you are happy and I hope you find ways to deal with the pain.

We're still continuing with doctor visits to decide on results of the MRI. There's still no clear answer somehow and the doctor is pushing back on the request from us to have ANOTHER MRI be performed. He is saying that the insurance won't even cover it.

On top of that he continues giving us ridiculous looks everytime that we bring up on transperineal biopsies, and defends transrectal.

Very strange.

He is pushing trans rectal because he does not do transperineal and won't get paid. Google info on the advantages of transperineal. Less chance of infection and it is top to bottom of the prostate so it covers the whole gland while the transrectal is front to back and may miss areas due to bone in the way. He is probably correct about insurance not paying for a 2nd MRI. Don't back down find a doctor who will do a MRI fusion transperineal biopsy. Remember you ARE THE CUSTOMER and the doctors are providing a service. Research and studies are readily available on the net to answer your questions.

Remember they put their pants on one leg at a time just like you and are not perfect. Wait till you get a biopsy and get a 2nd opinion that does not agree with the first one.