1. < Prostate Cancer

They just found a palpitated nodule on my prostate. I need advice

Posted by grateful11 @grateful11, Dec 6 12:42pm

Hi!
I just saw a nurse in Urology at Sutter in San Carlos, CA. I will be getting an MRI on my prostate and an abdominal MRI to see if anything has spread at Sutter in Burlingame. After that, I am told they will do a biopsy. They will use the MRI and a ultrasound "fusing" I think through the anus.
I have reached out to Stanford. The earliest appointment they have is 3/4/25 to be seen. by a urology nurse. I am reaching out to UCSF and Mayo clinic in AZ for an appt.
1)If you were me, what would you do?
2) Is an anal biopsy the way to go or through the perineum? Would you recommend general anesthesia? I hate pain
3) I am willing to spend money to get the best treatment. I also have Anthem Blue Cross PPO. Where is the best place at this stage?
4) Any other advice? I am 57. My PSA is 0.2. I am healthy. No abnormal white blood cells in my labs.
Thank you so much and God Bless you for taking the time to help me!

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bens1 | @bens1 | Dec 8 8:17am

You might want to get a PSE test before the MRI. Supposedly 94% accurate and you can get your PCP or other doctor to order the test for you. I had the test a few weeks ago to check for biological re-occurrence. It took 3 days to get it after the order and about a week to receive the results. It’s FDA approved but fairly new. Some doctors will be aware of it and some not. If you email Joe.Abdo@oxfordbiodynamics.com, the VP of Clinical Diagnostics at the company that makes the test, he can answer further questions and volunteered to do so.

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1 reply
pdcar4756 | @pdcar4756 | Dec 8 8:32am

My advice would be to calm down and slow down. With a PSA of 0.2, if that is in fact accurate, you have time to address this in a reasonable, calculated way. This cancer is generally slow growing. From time of diagnosis until my treatment was 6 months. That kind of delay has little to no impact on long term survivability. Have the MRI and see what it has to say.........get a second read of the MRI by a center of excellence to make sure the MRI read is consistent with the first read. Then have a targeted fusion biopsy. And get a second opinion of the biopsy slides from a center of excellence. Then decide what to do. In parallel with this you could set up appointments with the urologists you prefer to use or the cancer center you prefer to use. You can always gladly cancel those appointments should you not need them.

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1 reply
grateful11 | @grateful11 | 5 days ago
In reply to @retireditguy "I went to Mayo Phoenix earlier this year and was very happy with the care I..." + (show)
@retireditguy

I went to Mayo Phoenix earlier this year and was very happy with the care I received. I met with a urologist there who ordered a reading of my MRI (done elsewhere) by their radiologist. Based on their radiologist reading of my MRI they then decided a Fusion MRI biopsy was warranted, which they then performed about 6 weeks later. I had the Fusion MRI biopsy through the perineum with general anesthesia and 2 anal biopsies 25 years ago while awake. No comparison. The Fusion MRI biopsy gives you confidence they actually sample the areas of concern and being under anesthesia was way better than being awake for the anal biopsy. I believe UCSF and Stanford are also first rate institutions, so I'd be happy to go to any of those 3. With the holidays I kind of doubt you'll get in anywhere much before 3/4 unless they just happen to have a cancellation, but it never hurts to try. Best wishes.

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Thank you so much!

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grateful11 | @grateful11 | 5 days ago
In reply to @pdcar4756 "My advice would be to calm down and slow down. With a PSA of 0.2, if..." + (show)
@pdcar4756

My advice would be to calm down and slow down. With a PSA of 0.2, if that is in fact accurate, you have time to address this in a reasonable, calculated way. This cancer is generally slow growing. From time of diagnosis until my treatment was 6 months. That kind of delay has little to no impact on long term survivability. Have the MRI and see what it has to say.........get a second read of the MRI by a center of excellence to make sure the MRI read is consistent with the first read. Then have a targeted fusion biopsy. And get a second opinion of the biopsy slides from a center of excellence. Then decide what to do. In parallel with this you could set up appointments with the urologists you prefer to use or the cancer center you prefer to use. You can always gladly cancel those appointments should you not need them.

Jump to this post

I appreciate it!

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grateful11 | @grateful11 | 5 days ago
In reply to @bens1 "You might want to get a PSE test before the MRI. Supposedly 94% accurate and you..." + (show)
@bens1

You might want to get a PSE test before the MRI. Supposedly 94% accurate and you can get your PCP or other doctor to order the test for you. I had the test a few weeks ago to check for biological re-occurrence. It took 3 days to get it after the order and about a week to receive the results. It’s FDA approved but fairly new. Some doctors will be aware of it and some not. If you email Joe.Abdo@oxfordbiodynamics.com, the VP of Clinical Diagnostics at the company that makes the test, he can answer further questions and volunteered to do so.

Jump to this post

WOW! Thanks for letting me know about the PSE test. I emailed my dr to order it. This board is amazing!

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grateful11 | @grateful11 | 4 days ago

I had the MRI and the tumor is believed to be benign. Thank you all for your kindness!

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1 reply
retireditguy | @retireditguy | 3 days ago
In reply to @grateful11 "I had the MRI and the tumor is believed to be benign. Thank you all for..." + (show)
@grateful11

I had the MRI and the tumor is believed to be benign. Thank you all for your kindness!

Jump to this post

Excellent news! Depending on where the MRI was read and your confidence in that reading, you can contact another provider can have a second reading of the MRI. I'm not saying you need to, but rather just making your aware of that option. I got a second reading of my MRI at a cancer center of excellence and it was very little effort and my insurance covered it for me. Also, although it sounds like you don't need it yet, just know that I had a fusion biopsy and it wasn't a big deal at all. They put me out and recovery was quick. So if you ever advance to the point where you need a biopsy, don't be afraid of it. Just be sure to go to a cancer center of excellence with the best technology. Expertise counts. Best wishes.

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grateful11 | @grateful11 | 3 days ago

Thank you so much! I will definitely get a second opinion!

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