Got Some Good News

OK, so my 3 month post-TURP recovery is over and had my follow up with my urologist and thought I would pass on some good news.

For starters, I had my slides sent to Dr Epstien and they reviewed them and concurred with G6 score.

Then, my doc did the physical exam and noted no nodules and that prostate, post surgery, is back to normal size. I would hope so! He took 45g of an 80g organ, so there's that! But I can pee like a race horse now so that is also great news.

Lastly, my PSA came back - pre-surgery it was 3.0. Post-surgery it is 0.57. My doc was elated. I guess I am too. The one caveat is it may be higher than it could be because the day before the blood test (I didn't realize they were doing PSA test during follow up) we went on a long motorcycle ride and that is a no no. So, I am hoping in 3 months it comes back even lower. I see some guys having untraceable or super low PSA like 0.05. Mine seems very high compared to that but I am happy so far.

Now, we talked about options and it seems he wants to just maintain AS as he is concerned after TURP where he took so much of my prostate, that removal would be risky due to incontinence and ED. He said he didn't think radiation was necessary, at least not at this point. Even with high-risk Decipher score, he still thinks AS is the right way ahead. At least for now. I have an MRI in a week and if it shows anything, then I am getting biopsies.

For now, all is well. And I am back at the gym and working out regularly so post-op weight gain is slowly coming off! ;-)

Hope you all are doing well!

Chip

Great stuff, Chip. I'm sorry there was stuff in your chips but you have the ultimate entry level T1 G6 so for now you can take a relaxed (but vigilant) view. A lot of your PZ is still there, and plenty of time for it to misbehave. But I would leave the whole thing well alone until my PSA was a lot higher. I would keep up the MRIs though. Good luck.

Chip,

I was in the same situation as you almost 10 years ago in April, 2012: after steadily increasing PSA scores and 3 negative biopsies over a 10 year period, my PCa was detected during a TURP. The initial Gleason reading was GS7. However, after several months, my PSA dropped from a pre-TURP reading of 9.6 to 1.0. I then had my biopsy chips sent to Epstein at JHU who scored them as GS6. I had a chance to speak to Dr. Epstein directly who advised me to "Just watch it". I asked Dr. Epstein whether it is possible that the TURP removed all the cancer. He said that it didn't matter since I had a small level of GS6 in the half of the prostate that was removed.

Since then my PSA score has gone up gradually to 1.7 as my prostate has been growing back. I have been tracking my prostate both with semi-annual PSA and annual 3T- multiparametric MRI. The MRIs have been remarkably steady showing no difference (except for the growth of the prostate) from year to year. I have not had a biopsy since before the TURP because I and my urologist don't think that a biopsy would show anything not found on the MRI by sampling the peripheral zone as is usually done in TRUS biopsy. After all, three different biopsies over a 10 year period found nothing, while the PCa was found in the transition zone which was mostly removed by the TURP. Of course if the PSA jumped up or the MRI indicated anything suspicious I intend to get another biopsy.

So far so good. I intend to continue with this version of AS following Dr. Epstein's advice to "just watch it".

By the way, I was able to find only two other people (both on the YANANOW website) who had their PCa detected incidentally via a TURP and whose PSA dropped precipitately. They also have been "watching" their situation for more than 10 years. All three of us believe that that the PCa was removed entirely by the TURP, but continue to be vigilant.

Good luck to you

Marvin