Upcoming Appointment - Nervous

He should immediately order MpMRI, get that before Biopsy. This way the biopsy can be guided by the scan results called a MRI fusion guided biopsy. Then await Pathology results after biopsy and learn what each biopsy core holds in Gleason score. Then a genomic Decipher test depending on Pathology and PSMA Pet.

He can also order ExDxo urine marker test that can be done at home. This test also identifies markers to identify whether a cancers gene are likely to be of a more advanced or intermediate grade versus lower grade or Gleason 6.

Don’t worry about the biopsy there are two schools of thought, the perineum entry or rectum entry. The perineum entry according to studies has less infection rate compared to the rectum rate but these are statistical numbers that are low either way and the likelihood small. You will certainly have people swear by one or the other and discuss they had an infection. This group being small will likely have members in that group. Also you have members under active surveillance and have had three rectum biopsies with no adverse effects. Some Urologists put you on an antibiotic for 10 days afterwards, my urologist put me on two antibiotics. I never had an issue. I think it’s also the Doctors care. The perineum entry although not new is still not done as often as the rectum entry. The Doctors must also be trained in that fashion and in certain hospital settings some major hospitals have opted to have their urologist’s only do the newer entry because of lower infection rate. My urologist part of a major hospital urology dept that did not have any urologist’s doing the perineum, only rectum. He told me in their practice he could not even recall the last time any patient had an infection.. He thinks when it happens they are not necessarily following their after care( his belief). I clearly was not going to a different urologist and went with the rectum. Quick, no real pain. In two weeks I was off to Switzerland.

Wheel

Marlon is so right about timing. Everything seems in a orderly fashion that takes weeks.
Don’t let the Doctor say, oh your PSA went down, that means you don’t have cancer. Mine went like from 1.9 for years to 3.0, dropped 2.6, then 2.4 then back up. My oncologist for non Hodgkin’s lymphoma I have seen for 15 years said exactly what I said above. Oh you don’t have cancer because your PSA went down. In his benefit he only treats Prostate cancer patients whose cancer has spread and is involved in chemotherapy where these prostate patients their PSA is only going up. My urologist though fortunately was concerned about my fluctuating PSA and was willing to get me an early MpMRI.

Timeline for me

April 2022 through now. PSA jumping around. Never really high

Nov. 2023 ExoDx Urine marker test

Jan 19th, 2024 MpMri

Feb 7th, 2024 Biopsy (he added me to his booked biopsy schedule due to 2 trips to Switzerland and biopsy might not be then until Mid March

Feb 16, 2024, Pathology results and requested Pathology send tissue to Decipher for Genomic testing.

March 1, 2024 PSMA Pet Scan

April 19th, first consultation with Surgical oncologist

April 26th first consultation with Radiation oncologist

June 5, 2024 second opinion with another Radiation Oncologist (different facility)

June 5, 2024 second opinion with another Surgical Oncologist (who I decided on) (different facility)

Surgeon had 4 to 6 week time on his calendar which kind of meant earliest around mid July. With summer here and daughter home I picked August, 15, after returning our daughter to college.

Basically from diagnosis in mid Feb with Pathology to surgery was 6 months. They say 6 months is a fine window.

last thing, don’t let this consume you. Now that you are aware and hopefully its just a large prostate with BPH. Knowing that typically most prostate cancers are slow growing , following a PSA for awhile is no problem and even then if it does turn more aggressive it’s caught early. I am now 6 days post my surgery doing well now. If not for the catheter you would not know I had surgery. My wife is driving but I go to stores with her, and walking a mile a day.