Newly diagnosed

johnlakis

Hi everyone. I was diagnosed 2 weeks ago. My PSA was 4.1 in August. This month it's 11.1. My urologist scheduled an MRI which will be done April 11th and a biopsy following that. I've had kidney cancer on both kidneys. 1 surgery in 2015 on left kidney in 2019 the right kidney. My doctors are awesome since I got to keep both kidneys.

This new diagnosis is very scary. I was scared the first time and I survived. My urologist saw me every 6 months right after CTscans and my psa was good until this time. I'm not sure what to expect. Maybe someone can give some insight.

Thanks

Old Salt

The increase in PSA is worrisome, of course, but very little can be deduced from it right now. A repeat PSA tests seems in order; be sure to take 'precautions' for a few days prior to the test (no cycling, sex, etc.). Inflammation of the prostate (prostatitis) can really raise PSA as well; so that is something to consider.

Once you post the results from the MRI and biopsy we might be able to offer advice.

PS: So glad you survived kidney cancer!

johnlakis

Thank you for your support.

ASAdvocate

How were you diagnosed? A diagnosis of prostate cancer requires a biopsy of prostate tissue followed by an assessment by a pathologist. Have you had that done?

If so, what were your Gleason scores?

johnlakis

April 11th is mri and biopsy

ASAdvocate

A spike in your PSA could be caused by inflammation, prostatitis, trauma, or other non-cancerous issues.

About sixty-five percent of first biopsies for prostate cancer are negative.

You could have prostate cancer, but also could not. Try not to get too far ahead of yourself.

VascodaGama

Sage advice from ASadvocate above.

I wonder how and who diagnosed the PCa. In fact, the increase of the PSA could be related to hyperplasia which by itself could relate to the kidney cancer or its treatment.

Common drugs treating RCC affect mostly any thing related to cholesterol or liver enzymes but all react to steroids disturbing the endocrine system. In partial nephrectomy cases (you say above kidneys were saved) the cause of the initiation of the cancer is untreated meaning that in hereditary cases the typical VHL gene mutations could occur. This is known to be behind the development of benign tumors in other organs.

In other words, you need to research deeper on the influences between the kidneys, the bladder and the prostate gland. Somehow, consequences arise when one of these gets sick. Drugs interactions also exist. Your doctor attending you in the prostate issue should be aware of your full story with the kidneys issue.

https://www.cancer.org/cancer/kidney-cancer/causes-risks-prevention/risk-factors.html

Hopefully the increase is not due to prostate cancer.

Best wishes for complete remission in your kidney cancer case.

VGama

johnlakis

Thank you for the information. The MRI scored a 3 on a scale of 1 to 5.

My biopsy is scheduled for May 9th with a follow-up on the 20th.

Hopefully, everything will be fine. Thank you again for the information. I'll let you all know how it goes.

centralPA

Can you post the full result of the biopsy? I assume you mean you had a PIRADS-3 lesion? Maybe a bunch, or just one?

Will the biopsy be targeted based on the MRI results?

Best of luck, JL!

johnlakis

I will post results when available. Thank you everyone

johnlakis

I just came from doctors office. The Gleason is 3+4 the way he explained it 60% is 3 and 40% is 4.

He gave me the options of radiation or surgery. I opted for surgery

ASAdvocate

You are low intermediate risk, and should not feel pressured to make a treatment choice. A good suggestion is to consult with a surgeon, a radiation oncologist, and a medical oncologist before making a treatment decision.

Due to recent advances in technology, there is no “gold standard” treatment for prostate cancer. Actually, the National Cancer Institute’s huge SEER prostate cancer database shows slightly more men are choosing radiation than surgery.

Studies have shown that men who got multiple opinions had less “treatment regret” later. Now is the time to gather the facts to build confidence in your decision. Best wishes.

VascodaGama

Hi again,

John, I wonder your age.

You are not new to surgeries and naturally have chosen the same route to treat PCa. However the side effects of the treatment will be new so you should be aware of them in advance, comparing the risks entailed in each type of intervention.

Even if you have already committed to surgery, I recommend you to investigate further, get the opinion from other specialists and involve your family in the final decision.

You will feel better in the future.

Best of lucks in this journey.

VG

johnlakis

I'll be 70 next month. I've had 2 partial nephrectomies. One on each kidney. My urologist did the second surgery using robotics. His plan is to use a robot again. He wanted to do surgery on June 1st. I requested a later date so I could have talk to other doctors.

Thank you everyone.

vichardy

johnlakis,

you have a number of options that you should consider before surgery. There are side effects that could be unpleasant, IE incontinence and ED and once the prostate is gone, it's gone. I think the incontinence will likely be with you and worse with the surgery.

I had low risk (3+3) high volume PCi 18 months ago and I just happened to talk with a friend of a friend who elected for SBRT, ala CyberKnife. After researching both heavily I decided on the CK therapy. I've had zero side effects, however the cancer is back, so there is that... But if I had to do it over again I would do the same. Now I'm busy studying secondary, focused therapies such as HDR (high dose brachy), HIFU, cryotherapy and the new kid on the block, IRE (irreversible electroporation, with a product called NanoKnife).

One of the downsides to doing radiation is that if the cancer comes back and you decide to do an RP, it's called a salvage procedure and is very hard to do with worse side effects then if you did it originally because the tissue planes that connect the prostate to surrounding structures have been damaged. But again, for me anyway, I've just decided that I'll likely never agree to RP, robot or not. I'm 73 and don't need that aggravation.

Anyway, I think that was a little long and obviously this is your decision (my urologist, like yours I think wanted to do the RP) . I think you should definitely see a radiation oncologist.

Good luck...

Max Former Hodgkins Stage 3

Welcome to you, John

Very generally, PCa cure or successful control is easier to achieve than beating kidney cancer, if that is any support to you. Seventy years of age is approaching the upper age envelope for proctectomy for many surgeons, but no responsible surgeon would agree to your procedure if they did not reasonably verify that you could handle it (as regards your heart and lungs). I myself had surgical removal, but was 59 at the time, and all went well. But knowing what I know now, I believe that if I were making the same decision at 70, I would go the radiation route. But the decision is yours, and it is a reasonable one. Good luck, and please continue to write,

max

johnlakis

Hello everyone,

I decided to do a follow-up. I was scheduled for prostate surgery and going through the pre-op testing. My cardiologist found a blockage on my left side. I has a stint placed in right side in September 2021. I'm scheduled for catherization on Monday June 27. The 30th is my birthday so this is my birthday present. LOL

When it rains it pours. Anyway I appreciate your advice and hopefully I make the right decisions. Thanks to everyone.