New Diagnosis: Prostate Cancer

Posted by ranger44 @ranger44, Dec 31, 2023

PSA had gone from 4.24 to 6.62 in a couple months, had a mpMRI PIRADS 4 with 12mm lesion, then had a 4K Score blood test score was 95, ( the highest possible for aggressive PC. I am 70 years old, have had BPH symptoms for several years, my prostate is 44.1CC so enlarged, getting ready to meet with Urologist / Oncologist, so I assume needle biopsy to confirm, any thoughts on preferred treatment. My Dad had PC and Radical Prostectomy at age 64, lived until 90 when it finally went to the bone, was treated 25 years at Mayo

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Dr eugene know of Mayo Rochester recommends to treat PC aggressively like they treat breast cancer ( he has a video on u tube . A triple therapy with ADT , radiation and chemo as an initial treatment and if you are healthy enough try for a cure. I wished that I had tried that when I was diagnosed 30 months ago , but I am presently in remission and if it comes back I will ask about the triple therapy for me. You may have 15 good years ahead of you. I am gleason 9 CR aggressive, advanced PC 76 years hoping for a long run!!

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At this point you have not been diagnosed with PC. Get the biopsy, get a second opinion on the biopsy, if diagnosed have a Decipher test on it, get a PSMA PET scan........then you can discuss treatment modalities with urologists and radiation oncologists.
We would rather not have you join this "club" of ours, but if you do end up qualifying, please know we will all be here for you. Stay strong brother

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@ranger44 ,
I agree with the advise you got from toolbelt.
Wait until you get confirmation from a biopsy before deciding on treatments.
Then with the biopsies get a Decipher test (uses the biopsies already taken) which will give you a better test to determing risk level of metassising.

Also asked for a PSMA (Pet Scan) which will help determine if spread outside of prostrate.
Also get a bone scan which will also help determine if cancer has spread to bones.

With all that information do research and then asked questions of your urologist, oncologist/radiologist.
Don't be afraid to asked questions, cite different treatments, and most of all the pros and cons of each.
Then get a second opinion. With all this you will have a better understanding of your specific cancer and trestments for you cancer and the pros and cons of each.

But like toolbelt said, WE HOPE YOU DON'T JOIN OUR CLUB. There are many reasons for elevated PSAs and hopefully yours is a benign reason and not cancer. That is why the biopsies are so important.
Good luck!!!

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My MRI at age 72 indicated a Prads 4 lesion and an area of Prads 3. PSA 7.5.
Next was a fusion guided biopsy utilizing the MRI for better guidance. The Urological Surgeon at Hershey Medical Center (HMC) took 18 samples (std 12 plus additional 6 targeted by MRI).
Biopsy resulted in a number of positive "hits"; including 8s and one 9.
PSMA PET scan followed to rule in/out disease spread (negative). PSMA is a newer radioactive isotope that targets prostate cancer (PCa) cells specifically.
My scan was negative for spread or metastases; positive for cancer in the prostate.
I consulted with Surgeon at HMC, and I had a 2d opinion from Surgeon at Johns Hopkins (JH).
I chose Robotic Prostatectomy at JH Aug 2022.
Excellent resources include Patrick Walsh MD's book " Surviving Prostate Cancer" (5th ed released Oct 2023), which is very readable and informative in many ways.
Also, Patient Guide by Prostate Cancer Foundation (PCF.org) free as download or hard copy.
Any next steps will be dependent upon Biopsy results.
Here is hoping that you will receive good news.

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@toolbelt

At this point you have not been diagnosed with PC. Get the biopsy, get a second opinion on the biopsy, if diagnosed have a Decipher test on it, get a PSMA PET scan........then you can discuss treatment modalities with urologists and radiation oncologists.
We would rather not have you join this "club" of ours, but if you do end up qualifying, please know we will all be here for you. Stay strong brother

Jump to this post

Thanks for all the info, I had never heard of a Decipher test. I also haven't seen anyone post about the 4K Score, but I agree with all regarding getting the needle biopsy before even thinking about treatment options

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