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Prostate Health Index (PHI) results: Time for a second opinion?
My husband recently had his first PSA test. It came back at 16.01. He was referred to an NP in urology. She did a DRE, which confirmed an enlarged prostate. She ordered additional PSA testing. The next day, his PHI showed 89.2, PSA total was down to 10.56, PSA free was 1.56, and %Free PSA was 14.8, p2PSA is 42.8
The NP sent a message in my chart stating that there is a 50 possibility of prostate cancer. He has an appointment for an MRI end of June. We are unavailable between May 27 and June 17, and no earlier MRI appointment is available. The NP made a video visit appointment for end of August to discuss MRI results and next steps.
After reading about the PHI tests, and my husband’s results, it seems like there is a greater likelihood of prostate cancer than 50%. My husband has CLL, and has had several secondary cancers. Numerous squamous cell carcinomas, and a malignant gist in his duodenum. Would it be prudent to get a second opinion with a urologist? We were not given the option of seeing a urologist at his first appointment. We know that prostate cancer is slow growing, but still want to speak with a urologist before end of June. Any recommendations?
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With that high a PSA (welll some people are MUCH higher) and 3 suspect PIRADS it probably is necessary. I had 3 biopsies 15+ years ago, never noticed it after I left the doctors office. It sounds frightening but it is pretty easy to do.
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2 ReactionsThank you, Jeff. Hubby will be out for the procedure, so I think he will be a lot less nervous. I’m sure I will be more than nervous for us both!!!
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2 ReactionsHi Gentlemen,
Hubby’s biopsy, MRI Fusion transperineal, is tomorrow. After a week or so, we should have results that tell us what we are dealing with.
I thought my husband had the Episwitch test, but it was the IsoPSA. It came back with a level or score of 6.7.
With an IsoPSA level of 6.7, a PHI score of 89.2, three lesions of which two are Pirads 4, and one is Pirads 5, are we likely looking at PCa? Could BPH, with a prostate volume of 157.6 skew results, resulting in false positives?
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2 ReactionsAbsolutely a large prostate, And your husband’s is huge, Can create high PSA levels along with BPH.
Has he been put on antibiotics to try to resolve the BPH? Have they ever said he actually had it?
The thing is, he’s got a Pirads 5 lesion, Which usually means that there is cancer. So in this case, a biopsy is very desirable. Those Pirads 4 lesions could be cancerous as well, They have to be tested to see.
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1 ReactionI have a friend with BPH and his PSA is 10. Urologist ran some blood tests, did digital exam and is not worried that he has PC. I had no idea PSA could be so high with only BPH
I know from research, that BPH ca. cause high PSA and skew results of blood tests. I have also read that Pirads 4 and 5 lesions can be just due to inflammation.
The only niggling thing is the IsoPSA test which was 6.7 and the PHI which was 89.2. Both suggest higher than 50% chance of cancer.
Will be so glad when the biopsy results come back and we have a definitive diagnosis. Oh the waiting is the so nerve wracking!
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2 ReactionsGood to hear that the biopsy has been done, and saying a prayer for good results. I want to add to the other fine comments above that from my experience if you are asking yourself should we seek a second opinion, the answer is yes. This may be a slower growing cancer but growing is the key word, not slow. The medical response must not be slow. The NP giving you an end of August estimate for results and further discussion was unacceptable. Do not let your medical providers delay any action necessary for diagnosis or treatment. God bless you and your husband. He is fortunate to have you as an advocate.
Oh thank you so much for your kind comments.
I am always going to be hubby’s advocate as he tends to be shy. He calls me his bulldog!
I am already checking out urologists in case the biopsy comes back positive. I understand that his urologist at Triangle Urology Associates will be willing to recommend urologist, oncologist, radiologist if needed.
Definitely not going to take the advice of one urologist. As good as he may be.
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3 ReactionsIf positive, include an oncologist in your husband’s health team immediately. Urologists and oncologist are both important, but each has a different approach to the treatment choices. I will be watching for the results. Your husband is fortunate, every PC patient needs a a bulldog advocate!
Thank you so much!
Does the oncologist need to be a urologic oncologist? Is that the doctor I should be researching?