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So is normal protocol if PC is suspected ?

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Posted 7/10/2024 9:54 PM (GMT -5)
I’m getting another PSA next week after seeing a 1.5 jump in a year
3.6 now ..I’m 65 with enlarged ( 55) prostate
Dr said he’s not worried , good for him , I am !
So if it’s still that high or higher is the next step to ask for free PSA and mri before jumping to a biopsy ?
And if God forbid I end up with PC how do I find what the best treatment is ?
My uro is a small town guy,, I live near the fingerlakes ny
Probably Rochester ny ???
How do you go about finding the best second opinion
Posted 7/11/2024 12:46 AM (GMT -5)
Have you ever had a biopsy? If so when and what were the results?

I'd want to get a biopsy rather soon if I were you.
Posted 7/11/2024 6:24 AM (GMT -5)
No and everyone here never suggested that nor did my URO
My prostate is 55 cc
So the density etc doesn’t suggest it
If you look at my prior post a couple weeks ago you can see other members reply’s
One said if still high or higher ask for free PSA and mri first
Posted 7/11/2024 6:46 AM (GMT -5)
Just search for another urologist and get another assessment. Where in the Finger Lakes are you? My son lives in Ithaca. Another member on the board lives near Rochester and may be able to give you some information about urologists there. As I remember you are 65. On traditional Medicare, just call any doc you want to see, no need for a referral or approval. If on Medicare Advantage check to see who is in your network. Just make sure the urologist specializes in prostate work.

Your PSA is within the normal range for your age especially with a 55cc size enlargement. If the doc didn’t feel anything during the DRE, there doesn’t appear to be a reason to get a biopsy. See what your next PSA is.
Posted 7/11/2024 6:59 AM (GMT -5)
I agree with JNF, at this point, with an enlarged prostate, your PSA is not what I’d consider alarming. Certainly not alarming enough to warrant an invasive procedure like a biopsy. But if it’s causing you stress, then it’s worth a second opinion.

I did a Google search and found this, I don’t know anything about it, but if it’s at Universty of Rochester, it’s probably worth a look…

https://www.urmc.rochester.edu/cancer-institute.aspx
Posted 7/11/2024 7:19 AM (GMT -5)
URochester cancer is good. I'll admit to bias: my daughter is a PACU nurse at Highland Hospital in Rochester, and she was treated for ovarian cancer at URochester, and has come out well.

But, given your prostate size, your PSA is not particularly alarming. But, if it will set your mind at ease, call them. They are used to calls and can help you.
Posted 7/11/2024 11:08 AM (GMT -5)
my protocol:

1) elevated PSA

2) DRE (normal)

3) biopsy (all 12 cores positive high volume 3+4)

4) treatment
Posted 7/11/2024 1:29 PM (GMT -5)
cvs, it appears normal protocols are being followed in your case. You have an enlarged prostate, and your PSA is within normal range for your age and taking the enlarged prostate into account. The jumping, not linear PSA is actually an indicator of not cancer. PSA every 6-9 months IS normal protocol.

You suspect you have it. How many doctors will have to tell you that you don't have a problem before you believe it?
Posted 7/11/2024 2:39 PM (GMT -5)

halbert said...
cvs, it appears normal protocols are being followed in your case. You have an enlarged prostate, and your PSA is within normal range for your age and taking the enlarged prostate into account. The jumping, not linear PSA is actually an indicator of not cancer. PSA every 6-9 months IS normal protocol.

You suspect you have it. How many doctors will have to tell you that you don't have a problem before you believe it?

I don’t suspect I have it I’m just trying to educate myself
If my PSA next week is still the same or higher and he says he wants a biopsy , should I ask for free PSA and or MRI first
Providing he doesn’t feel anything
Posted 7/11/2024 2:46 PM (GMT -5)

JNF said...
Just search for another urologist and get another assessment. Where in the Finger Lakes are you? My son lives in Ithaca. Another member on the board lives near Rochester and may be able to give you some information about urologists there. As I remember you are 65. On traditional Medicare, just call any doc you want to see, no need for a referral or approval. If on Medicare Advantage check to see who is in your network. Just make sure the urologist specializes in prostate work.

Your PSA is within the normal range for your age especially with a 55cc size enlargement. If the doc didn’t feel anything during the DRE, there doesn’t appear to be a reason to get a biopsy. See what your next PSA is.


I’m between Syracuse and Rochester
My next PSA is a week from today and I meet with the Dr the next day
Posted 7/11/2024 4:47 PM (GMT -5)
My PSA was high for many years due to a very large prostate but eventually it went a little higher then had the biopsy.
I was low grade around 2018 but a year later I had a second biopsy and it was a slightly higher volume so after slides sent to John's Hopkins I came here for advice and in time had treatment SBRT in my case
Finished going on three years now.
My point is that there's no rush. PCA is usually slow growing.
I understand the concern so yes perhaps a biopsy down the road.
Good luck

Glen
Posted 7/11/2024 5:58 PM (GMT -5)
Nowadays, they do MRI before biopsy, so they have some indication of where to poke for the biopsy samples.

10 years ago, when it was my turn, I had a blind biopsy using Trans Rectal Ultrasound to let them see the prostate as they poked.
Posted 7/12/2024 8:04 AM (GMT -5)
You will find excellent urologists and treatment options, if needed, in your area. Both Rochester and Syracuse will provide what you need if your current urologist doesn’t have your confidence. Just objectively do the required provider research.

As others have said, your situation does not appear, at present, to be out of the ordinary. If your PSA continues to consistently increase and/or the doc feels something different when performing the DRE, then am MRI and potentially a biopsy would be the next steps. I still suggest you have quarterly PSA for a while to better measure any trend.
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