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6 month follow up

User
Posted 08 Mar 2019 at 15:06

Just nervous about PC. My husband is followed every 6 months (6 months ago had MRI (clear) for rising PSA it went from 3.2 to 4.0 in less than a year, no biopsy).  His dad died of prostate cancer and 2 brother have been diagnosed. He is scheduled for his 6 month follow up at Mayo in a couple of weeks, it just makes me really nervous. Honestly, my husband is 56 and has been sick a lot lately, he just does not seem like himself. They only do template biopsies at mayo (they do not feel like TRUS biopsies are accurate enough to be worth the risk). It just feels like a ticking time bomb that is more when than if. How have other dealt with these feelings?

User
Posted 08 Mar 2019 at 16:13

Hi Sally,

One thing I was told during diagnosis was that you can think every pain is something to do with the disease when at that stage it almost certainly isn't.   I got a huge pain in my hip during diagnosis, which is a likely symptom, and was convinced it was related until it went about 6 months later.  With a psa of 4 it's very unlikely to be related.

I assume he's under surveillance and from what we read in the US they catch it quicker than they do in the UK and catching it quicker usually has better outcomes.  In general outcomes on early Prostate Cancer are good.   All the best Peter

User
Posted 08 Mar 2019 at 16:46
Hi Sally,

I have just briefly read through your previous posts under a different thread - they should all be consolidated into one heading for continuity and for ease of following your progress.

Am I to understand that your old man has a father and two brothers with PCa, has a rising PSA level, and yet he has yet to have a template biopsy (TRUS biopsies are rubbish unless you have a clearly defined tumour like I had)?

If so, I would be beating a path to my urologist’s door and requesting one, sharpish! Preferably next week!

Best of luck however it turns out.

Cheers, John.

User
Posted 08 Mar 2019 at 18:40

He has not had a biopsy. He did have a multi parametric 3t MRI of the prostate but they did not do a biopsy because they did not see anything on the MRI. There was an indication on his MRI that he possibly had prostatitis, so they scheduled a 6 month follow up to do a PSA, Free PSA, and some other PSA genetic test. He said they would decide on a biopsy at that time. His prostate was large 59cc, so the urologist said even though the PSA was rising it was "technically" normal for the size of his prostate. They do not do TRUS biopsies at all at mayo, so his biopsy would definitely be a template biopsy.

Edited by member 08 Mar 2019 at 18:41  | Reason: Not specified

User
Posted 08 Mar 2019 at 19:43

I can understand your concerns...family history and rising PSA.  I would insist on a biopsy.

A urologist diagnosed me with prostatitis ( no symptoms) after mri and raised PSA. Almost three years later, after biopsy, i was diagnosed with PCA. 

 

User
Posted 08 Mar 2019 at 19:52

Amazon that is my fear. The doctor did say that if the PSA was rising or if the free PSA was not where he wanted it to be this time that he would do a template biopsy. DH is 56, his brother had a prostatectomy at 57. His dad had advanced cancer with bone mets at 64. Hubby is trying to be as proactive as possible given the situation and family history. 

Edited by member 08 Mar 2019 at 19:53  | Reason: Not specified

User
Posted 08 Mar 2019 at 20:00
His mpMRI was clear and his free PSA was okay. He has a biggish prostate with signs of infection which would explain the PSA level. Template biopsy would be an unnecessary risk at this point; if he wasn’t having his free PSA tested it would perhaps be a different matter but he is in the range for free PSA to be reliable.

Anxiety building up to PSA testing time is a fact of life for most members here. Fingers crossed his next results are as good as the last set.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 10 Apr 2019 at 17:22

So just got results from 6 month PSA test. PSA went from 4.0 to 4.4 in 6 months, free PSA is 0.11, so not good. Follow up apt is today but it seems like template biopsy is imminent since MRI was clear 6 months ago. So many of you have been through this, are there some good questions to ask at the apt today? We are just really overwhelmed right now. So far PSA results have been

2014  3.0, Oct 2017 3.2 , Sept 2018 4.0, April 2019  4.4  (prostate volume is 59 CC’s).

 

 

User
Posted 10 Apr 2019 at 19:10
A biopsy seems like the sensible way forward. The only question I’d ask is “How soon can you do it?”. The biopsy itself is nothing at all to be concerned about - a minor procedure.

User
Posted 10 Apr 2019 at 20:06

So biopsy is scheduled for April 24th and it is a trans rectal biopsy. The urologist said that at the rate his PSA is increasing he is concerned but not overly concerned. Since his MRI was clear 6 months ago, if he is clear on the periphery he is most likely ok to monitor??? He said he will most likely have prostate cancer at some point and they are referring him to be tested for the BRCA 2 gene. Also, since his prostate is large his PSA is still in the normal range. So hard to know what the right decisions are.

User
Posted 10 Apr 2019 at 20:28
That’s excellent news, but I am slightly puzzled. Didn’t you say in your initial post in this thread that they only did template biopsies?

Hope the procedure goes well.

Best wishes,

Chris

User
Posted 10 Apr 2019 at 20:48

That is what we were initially told. I think bacause his MRI was clear a few months ago his individual urologist decided to do the other since it was in office and required no sedation (I guess the individual doctor can decide). He said with the size of his prostate it is a needle in a haystack. If nothing shows up and his PSA continues to rise they will do another MRI and go from there. He said the MRI is 89% accurate for the detection of significant cancer and he will do 12 cores. 

 
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