Advice needed

Wifesupport1

https://csn.cancer.org/discussion/comment/1719947#Comment_1719947

Thank you for the words of encouragement, Wheel and CentalPA.

Yes, we are happy with the decision to use the teaching hospital. We are worried but trying to take your advice and work through the process.

Thank you guys so much for answering all of my questions.

I’ll update everyone when we receive the results.

Steve1961

fantastic..step,1 mri go,from there.. worst case scenario and it does happen to be cancer. You caught it extremely early and that’s a very very very very good thing. Your husband has a good doctor when he turned 50 they probably started checking for PSA just think if they didn’t bother to check like with me, I caught it early. but it’s very very early in the game. keep us posted

fishnmaine

First of all don't panic. I'm 64 Mine went from 2.85 to 5.89 in a year and a half I was shocked. I do have an enlarged prostate. My urination is not bad at all. I had the biopsy, 12 cores taken and all was benign. Next few months i am going for more blood work if nothing has changed then an MRI. Not sure what an MRI will see if my biopsy was neg. I Don't have frequent urination at night I get up only once per night. Don't need flowmax. Hope your outcome will be the same

Dirtclods

https://csn.cancer.org/discussion/comment/1719945#Comment_1719945

this amount insignificant? YES ! 4.0 ng/ml or less, So his still ok. His marker is not high. Do you use Hoag My Chart or Quest they have scales to look at on your PSA/Blood work

Rob.Ski

His 3 test results were all over 4.0. For age 52, that's above normal. Regardless, biopsy will say if he does have cancer. If biopsy is negative, keep monitoring PSA. If it keeps rising, they can check again.

Marlon

PSA is a measure of prostate tissue, not specifically cancerous tissue. The number is less significant than the change over time. Mine was 4.2 which I thought was low - just above the normal range for my age, and I did have BPH. Yes, it was cancer. Nevertheless, thats low enough that it helps determine that it's unlikely to have spread.

Josephg

https://csn.cancer.org/discussion/comment/1720113#Comment_1720113

I agree that the change in PSA over time is more important than the actual PSA reading itself. However, I do not necessarily agree that a relatively low PSA number (4.2 in this discussion) is "low enough that it helps determine that it's unlikely to have spread". Over a 5 year period, my PSA increased from 3.2 to 5.3, and when I ultimately had my biopsy after the 5.3 reading, my prostate was almost fully engulfed in 4+3 PCa. Over the next 13 years with surgery, two rounds of radiation, and two rounds of hormone therapies, my PCa still has metastasized.

Aggressive PCa can have a lower PSA reading, compared to less aggressive PCa, so we shouldn't automatically be complacent because the PSA reading is low or aligning favorably with generic PSA/age charts. If you are concerned about your PSA reading, IMO, you should demand a biopsy, so that you know specifically what you are (or are not) dealing with.

mbluth

In my case I was 3.8 in 12/2022. I was 4.4 in 6/2024. After the 4.4 I went for an MRI, I was PI RADS 5. The biopsy in September was a Gleason score of 7=4+3. There was no metastasis. The edges were clean after surgery. A low score does not mean that the cancer is not aggressive.

Marlon

Josephg yes you're right. No guarantees. It's just educated guesswork by the docs.

ly55

https://csn.cancer.org/discussion/328762/advice-needed

I’m glad your husband is moved Fwrd with biopsy and being proactive. My husband was diagnosed with stage 4 Mets prostate cancer 3 yrs ago, hormone suppressant zitiga, his psa has stayed low he is tolerating treatment meds still working. We also shocked to here dr wanted to do a monitoring treatment my husband insisted on a biopsy if he had not he would not be here. I will tell you thus the treatments has advanced considerably, I hope your situation isn’t too dire and his can be treated in a less aggressive manner. The side effects from treatment can be brutal but fight the fight get second opinions on treatment. And pls take care of yourself ! It can get rocky in a relationship your husband will go thru many emotions and it will not be easy for you ….. take care of yourself

JackWest

https://csn.cancer.org/discussion/comment/1719520#Comment_1719520

Very similar for me. Want to compare notes further? I makes me feel better. How about you?

Wifesupport1

Just wanted to let all of you know that my husband got his MRI results today. He has a pirad of 5 in one side and pirad of 3 in the other side. They are scheduling a biopsy. Is this a Gleason score or is that different?

Wheel

The Gleason score will be assigned by the pathologist reviewing the cores from the biopsy after the biopsy if cancer is identified. I am sure the biopsy will be a MRI fusion guided to get extra specific cores from the lesions and then a grid random over the remaining prostate. The PIRADS 4 and 5 lesions are considered clinically significant disease that is likely for cancer but the lesions could still turn out not necessarily cancerous. My PIRADS 4 turned out to be benign but the other cores identified my cancer. The MRI also hold additional important information on size, volume and density of the prostate that are important to know as well as where in the prostate the lesions are .located

Old Salt

https://csn.cancer.org/discussion/comment/1720770#Comment_1720770

Different. As Wheel already pointed out the Gleason score is assigned by the pathologist who examines the cores taken during the biopsy. The PIRADS score is assigned by the MRI specialist. A higher score (like 5) increases the LIKELIHOOD that that site is cancerous. It does give the urologist who will do the biopsy a lead as to where he/she should sample.

Wifesupport1

https://csn.cancer.org/discussion/comment/1720771#Comment_1720771

Thank you for the information. We don’t have a copy of the MRI yet to know the other data on the prostate. We are currently waiting for the biopsy appointment.

Wifesupport1

Thank you for the response. I’ll report back after the biopsy.

Wifesupport1

We now have the biopsy results and more information from the MRI.

The prostate is 32mm in volume and the density is .14 ng-last PSA was 4.57. (Age 52)

The MRI shows cancer in two spots. If I’m reading this correctly, surprisingly not in the two lesions of concern on the MRI.

1st spot is RM - less than 1mm involving less than 5% of tissue 3+3=6 grade 1 group 1

2nd spot is RLA - less than 3mm involving less than 15% of tissue 3+3=6 grade 1 group 1

We have a teleheath with the nurse practitioner on 3/6 and will meet with the doctor shortly after that to discuss treatment options.

Do you guys think the is an active surveillance situation?

Wheel

Definitely I would be considering it. There are views within the medical profession that Gleason 6’s are not considered cancerous yet. I would see if you could get genomic testing of the biopsy such as Decipher that could confirm whether it’s considered non advanced and low risk.

Wifesupport1

https://csn.cancer.org/discussion/comment/1721315#Comment_1721315

Thanks for the suggestion. I’ll ask this question. We are hoping it will be active surveillance.

centralPA

As it stands, AS is absolutely an option. At a minimum, you are not in any rush to act.

Two easy things to do, first get a genome test on the biopsy sample. It helps shape the odds on future progression. Second, get a second opinion on the biopsy. Your hospital can have the slides sent and reviewed. It will give you a warm and fuzzy if the second opinion matches the first.

Lots of research out there on AS. Now is the time to get reading and become an expert. At his age, a young 52, he will likely need to treat at some point I’d guess, but it could be years of side effect-free life. Who knows what treatment they may come with in the interim.

You do have to able to get up each morning and think, “l have cancer” and cope with that. A little bit of a highwire act.