Very Anxious and looking for support

DR_MARTY
DR_MARTY Member Posts: 3 Member
edited September 27 in Prostate Cancer #1

The distilled version of my current situation:

Age 72

-physical exam past June 2022 with PSA at 6.3 [usually runs 3.2-3.8 since age 40] DRE negative

-ASYMPTOMATIC other than getting up 2-3X in PM to void.

-repeat PSA August [6 weeks later] PSA and Free PSA / tPSA at 9.6 and fPSA 23.3

-Urology consult August - DRE Neg after blood draw for 4K assay

4K score 48.6 and now total PSA 11.3

-Scheduling a mpMRI asap [Hopefully with next 7 days]

  • consulting with another Urologist for probably Biopsy after receipt of mpMRI ANY THOUGHTS OR EXPERIENCES?
  • MY PRIMARY FEAR IS NOT SO MUCH FINDING PROSTATE CANCER BUT AGGRESSIVE CELLS THAT HAVE MOVED BEYOND THE PROSTATE .... ANY CHANCE I MAY DODGE A BULLET IN ONE OR BOTH CASES?

Comments

  • eonore
    eonore Member Posts: 131 Member

    Hey Dr. Marty,

    Welcome to the board. The first and best advice I can give you is not to get ahead of yourself and let your mind go wild. You have been diligent in monitoring your Psa and you are jumping on this thing right away. There is every reason to expect that even if your cancer is aggressive, it will still be prostate contained and susceptible to treatment. The program you are following, MRI followed by fusion biopsy is standard operating procedure. Stay cool and make sure that the doctors you are dealing with specialize in prostate cancer.

    Eric

  • DR_MARTY
    DR_MARTY Member Posts: 3 Member

    Thank you. Certainly a challenge to “reel my mind in”from making assumptions I have into facts.

  • Clevelandguy
    Clevelandguy Member Posts: 783 Member

    Hi,

    The biopsy will determine if you have cancer and also give you a Gleason score. Depending on the aggressiveness of the cancer(if they find any) the next steps would be more diagnostic scans(bone and PET) to determine where the cancer is located. Like eonore said take it one step at a time, sound like your following a good path of discovery.

    Dave 3+4

  • DR_MARTY
    DR_MARTY Member Posts: 3 Member

    So an update: Had an EPI urine test {EXODX] to compare and update to 4K test. The results directly contradict the 4K WHICH PUT ME AT THE 48% PROBABLE HIGH GRADE -

    Score on the EPI [which does NOT consider PSA, Free PSA, age, etc] but is a genetic assay] was 15.78 [less than 1% above the cutoff of 15.6 % - which suggests no need for biopsy and less than 10% change of high grade PAc

    So much contradiction:

    PSA total 11.2



    Free PSA 19.2

    4K 48.2

    EPI score 15.78

    Having mpMRI with contrast tomorrow [Wed 9/28]

    Any feedback or experience to share?

  • Old Salt
    Old Salt Member Posts: 952 Member
    edited September 27 #6

    These 'newer' tests (like 4K) aren't all that reliable; that appears clear from your experiences. The MRI should be informative, but open to interpretation by the person reading the image. As Clevelandguy already pointed out, the biopsy will give more definitive results, although cancerous lesions can still be missed.