I have questions... new member

Wheel

That is a good Free PSA level. You are in good hands. Don’t worry about crossing the bridge yet, wait the time until your next PSA. Nothing regardless like other cancers need to usually happen quickly.

Old Salt

Good news for you!

tonkinese88

getting my next PSA lab this morning and will talk to urologist on Wednesday. My anxiety is kicking in again and bad. I always think the worst. I spoke with my GI the other day and he stated that they did a study in 2018 on prostate enlargement with men with a jpouch and he stated it was fairly common to have enlargement with a jpouch and urologist noticed enlargement when he did cystoscopy on bladder years ago. I’m thinking regardless of the lab I may just get the MRI to settle my mind.

tonkinese88

these are all my results

9/8/22. 1.97

2/6/24. 2.74

3/19/24. 2.38. 25% Free PSA

7/8/24. 2.5. 31% Free PSA.

Clevelandguy

Hi,

Your PSA seams fairly stable, jumping around a little bit, but not going exponential. If you trust your doctor then just monitor over several PSA tests. If you do have BPH, that it will elevate your numbers . Good luck……..

Dave 3+4

Old Salt

Full concurrence with Dave.

I hate to tell you this, but even an MRI won't tell you if you do have prostate cancer or not.

Wheel

Your free PSA level percent has gone up. The higher over 25% is less likely for prostate cancer. Your free percentage went up. I would agree with your Doctor to monitor. If it rises again at your next test then I might get more pro active and ask to have the ExDxo urine marker test. This is non invasive test the Doctor puts in to have the kit arrive at your house. It measures cancer specific bio markers . It is for patients over 50.

tonkinese88

https://csn.cancer.org/discussion/comment/1720333#Comment_1720333

biopsies are very tricky for me due to my several intestinal surgeries and jpouch. My urologist at Cleveland Clinic seems to be ok with the MRI due to this. He’s one of the top guys. Have not been diagnosed with cancer but we know my prostate is enlarged. Several years ago.

tonkinese88

https://csn.cancer.org/discussion/comment/1720333#Comment_1720333

but won’t an MRI tell you if anything looks suspicious and then if biopsy is needed they know exactly where to biopsy. ? Otherwise isn’t a biopsy without just a blind poke into prostate?

Wheel

Know that you are in good hands at Cleveland Clinic

Clevelandguy

https://csn.cancer.org/discussion/comment/1720336#Comment_1720336

Hi,

Yes you are correct with your questions.

Dave 3+4

Marlon

Did they do a digital exam, or can that not be done due to your surgery?

tonkinese88

https://csn.cancer.org/discussion/comment/1720347#Comment_1720347

cannot do DRE per my GI and surgeon. Not to mention too much scar tissue so would not get accuracy most likely anyways.
urologist doesn’t seem overly concerned but I am terrified, and maybe for nothing. My anxiety just takes me scary places. I have Medical PTSD my surgeon said.

tonkinese88

Here is where i am at after getting another PSA and MRI of prostate. prior to the psa and mri my urologist at Cleveland Clinic had me start BACTRIM DS to rule out prostatitis. Day 10 of 14 i broke out in a nasty full body rash from a sulfa allergy to the Bactrim. This was a few days prior to my tests. And a week prior to this i had the flu pretty bad . Anyways my PSA went up to 8 and the MRI did show BPH and stated no lesions were present. Peripheral Zone: Linear and/or wedge shaped T2/ADC map hypointensities PI-RADS 2. Transition zone: hypertrophy with mildly enlarged median lobe extending into bladder base .No focal abnormalities suspicious for clinically significant disease PI-RADS 1. Urologist stated the wedge shaped is almost always caused from inflammation and typically benign. He stated no biopsy suggested at this time but to do another PSA in 3-4 months. said that could of went up for several reasons… BPH, full body rash, flu, and crazy intense stress i had for several weeks prior to tests where i was barely eating or sleeping. Stated i could get the IsoPSA lab which is alot more accurate than PSA but insurance wont cover and it would be $300 out of pocket.. I feel better about all of this especially being at Cleveland Clinic and them being #1 in urology. but still a slight worry in back of my head..

Old Salt

Glad to read that you got good news.

tonkinese88

https://csn.cancer.org/discussion/comment/1721660#Comment_1721660

Surprised you said this as your previous post said MRI wont detect cancer..?

Buff1977

"Urologist stated the wedge shaped is almost always caused from inflammation and typically benign. "……the MRI showed you the Wedge shape but only a biopsy will tell you for sure if its cancerous or benign. I think that is what Old Salt is saying. Hey please let us know what you get on your next PSA test. Interested to see what it is. I am dealing with a similar thing.

Buff

Old Salt

Yes, that is what I tried to convey; thanks Buff1977.

An MRI may identify areas that need to be biopsied. Suspicious areas are given a PI-RADS score. PI-RADS 5 is the highest (very high likelihood of clinically significant cancer) and a PI-RADS 1 score indicates a a site with very low likelihood of cancer.

A 'negative' MRI doesn't prove there's no cancer but is a good sign, obviously.

tonkinese88

Thanks, i asked my urologist at Cleveland Clinic to elaborate on the wedge shaped hypointensities, and he responded… "I have never biopsied a wedge shaped hypointensity that demonstrates no other suspicious findings but is then found to be prostate cancer on biopsy. ".

tonkinese88

I’m a mess right now. So I ended up getting the isoPSA lab and it’s elevated at 15. Guess the cutoff is 6. My urologist is scheduling a biopsy now. My PSA went from 8 in March down to 4 last week. I’ve read the IsoPsa lab can still be elevated due to inflammation which the MRI showed the wedge shaped hyperintensity and every medical report I’ve read states wedge shaped is almost always from inflammation/prostatitis. But if IsoPSA went up from inflammation why did PSA go down from 8 to 4 , wouldn’t that have not gone down ?? I’m convinced I have cancer now and since Friday I’ve been on edge and have had several panic attacks.