1. < Prostate Cancer

PSA & MRI suspicious but biopsy benign

Posted by lyricw @lyricw, Oct 5 10:36pm

I am 66 & asymptomatic but PSA has been rising 2014-2,2, 2017-2.6, 2019-3.8, 2022–3.6, 2023-5.0 with 16% free. DRE negative & MRI revealed pirad 4 0.6 X 0.9 lesion of left posterior apex intracapsular & LN negative. 12 core grid biopsy & 1 core of lesion benign inflammation.

I definitely feel relieved, but wonder if there is any chance PC present. I will see doc & discuss future monitor.

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web265 | @web265 | Oct 6 7:49am

I'm no doctor, but, here's my $0.02
Is there "any chance", unfortunately there's almost always a chance but there's also a good chance you're one of the lucky ones.

Given what I've learned from reading over the last couple years. I'd probably just keep an eye on the PSA. 5 is elevated for a 66 year old but not by a great deal. How fast PSA rises is an indicator but you're showing a 9 year period here. Your "rate of doubling" shown in your numbers is over 10 years. If my math is right, your increases are…the first two numbers are a 2 or 2+ year period, the third year it goes down then has an increase this year. There are a lot of things that can increase your PSA by small amounts.
2014 Baseline
2017 15.38%
2019 31.58%
2022 -5.56%
2023 28.00%

If the biopsy really got a core from the lesion, sounds like you've pretty much identified that as BPH. BPH can raise your PSA levels as well as PCa.

If it was me and I was concerned about it, maybe get a PSA test every three or six months for a year at this point, to see if the rise continues and at what rate it does so if it indeed does rise. Then if it continues to rise, or the rate increases perhaps another biopsy down the road.

For now, I'd take the "win" but just keep an eye on it. "Trust but verify"

Best of Luck to you sir!

REPLY
1 reply
tgood | @tgood | Oct 6 9:04am

One other test that is available at a growing number of cancer centers is the PSMA PET scan. This test specifically identifies prostate cancer cells. This would be another “tool in your bag”.

REPLY
trusam1 | @trusam1 | Oct 7 7:01am

Also before the next PSA, make sure to avoid sex/ejaculation and bicycle riding 48-72 hours prior. Those cam stimulate release of the chemical from the prostate.

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lyricw | @lyricw | Oct 7 12:38pm
In reply to @web265 "I'm no doctor, but, here's my $0.02 Is there "any chance", unfortunately there's almost always a..." + (show)
@web265

I'm no doctor, but, here's my $0.02
Is there "any chance", unfortunately there's almost always a chance but there's also a good chance you're one of the lucky ones.

Given what I've learned from reading over the last couple years. I'd probably just keep an eye on the PSA. 5 is elevated for a 66 year old but not by a great deal. How fast PSA rises is an indicator but you're showing a 9 year period here. Your "rate of doubling" shown in your numbers is over 10 years. If my math is right, your increases are…the first two numbers are a 2 or 2+ year period, the third year it goes down then has an increase this year. There are a lot of things that can increase your PSA by small amounts.
2014 Baseline
2017 15.38%
2019 31.58%
2022 -5.56%
2023 28.00%

If the biopsy really got a core from the lesion, sounds like you've pretty much identified that as BPH. BPH can raise your PSA levels as well as PCa.

If it was me and I was concerned about it, maybe get a PSA test every three or six months for a year at this point, to see if the rise continues and at what rate it does so if it indeed does rise. Then if it continues to rise, or the rate increases perhaps another biopsy down the road.

For now, I'd take the "win" but just keep an eye on it. "Trust but verify"

Best of Luck to you sir!

Jump to this post

I read prostate focal atrophy & inflammation can be a precancerous lesion. I wondered if it was worth sending pathology slides to Mayo.

REPLY
1 reply
mccsjm | @mccsjm | Oct 7 5:44pm

Diagnostic tests are not 100% accurate but I won't be too concerned as long as the biopsy was on the MRI lesion (guided by your MRI data). Good practice to keep monitoring it by PSA and MRI.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 17 2:55pm
In reply to @lyricw "I read prostate focal atrophy & inflammation can be a precancerous lesion. I wondered if it..." + (show)
@lyricw

I read prostate focal atrophy & inflammation can be a precancerous lesion. I wondered if it was worth sending pathology slides to Mayo.

Jump to this post

@lyricw, if you would like to get a second opinion at Mayo Clinic, you can self refer or get your doctor to refer you. Find out more here: http://mayocl.in/1mtmR63

How are you doing?

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