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Looking for Guidance Pirad 3 / PSA Scores

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User
Posted 23 Aug 2023 at 17:19

Hello, 

My 51 year old brother had has prostate removed in April after a normal course of elevated PSA scores, active surveillance , MRI, Biopsy, etc.

I'm 48 and started quarterly PSA testing as part of wellness program, scores were 2.1 / 3.6 / 3.0 / 3.4 / 3.3 / 3.94 / 2.96 / 3.82 / 2.69 /2.79 and then in June 4.71 which triggered my primary doctor to recommend seeing a urologist. DRE came back normal , but advised a 3T MRI with and without contrast. 

Results came back with (2) lesions rated PI-RAD 3, lesion 1 (.9 x .6cm) , lesion 2 ( .8 x .5cm), total prostate volume 42.6g

As discussed prior to MRI  based on results next step would be a fusion biopsy. The quickest my doctor can see me is 6 weeks from the MRI date with results review scheduled 3 weeks later. The 9 weeks of the unknown is leading me to look for another urologist that could perform the procedure quicker, my understanding is the biopsy is a relatively simple procedure and that once I have those results could return to my original urologist for a course of action.

Although a slower growth cancer, given my brothers history, does it makes sense to attempt to expedite the results of the biopsy or realistically besides the weight of the unknown it won't really impact anything.

Thanks in advance.

Edited by member 23 Aug 2023 at 17:36  | Reason: Not specified

User
Posted 23 Aug 2023 at 19:19

9 weeks will make no difference. If you were in the UK and tried changing urologists it would almost certainly add about nine weeks of delay. Unless it is really easy to chop and change in the USA I would go with the flow.

Dave

User
Posted 24 Aug 2023 at 11:35
From my original PSA of 6 (08/2021) to seeing the Urologist and getting the scans was 7 months. PSA had risen to 9.6 in that time. It was then just over a year until the RARP surgery in May 2023 (when the PSA was 12.3). Post RARP PSA was < 0.01

So I don't think that 9 weeks will make any difference - you will still need to wait for the MRI results and then schedule a biopsy with results from the lab probably 3-4 weeks later. If surgery is advised then that will take additional time to schedule.

The waiting is the hardest part as we all anticipate the worst but PCa is a slow growing cancer in many cases and you are still very low PSA numbers at the moment.

 
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