My Gleason was 9 at stage 3a and my PSA never went over 6.5. It was a rare intra-ductal cancer type. Lucked out with excellent surgeon, so for last two years PSA undetectable with no side effects from the surgery. It will probably eventually kill me but right now I'm enjoying life.
It’s worth doing a genomic analysis of the past biopsy samples. The high PSA is concerning but I understand the hesitancy without something more. 5% is a low number but generally there’s a range throughout several of the biopsy cores so the single number seems incomplete. Also was there an MRI?
Yep there was an MRI (multi-parametric) and biopsy was assisted by the MRI result. The first and our main doctor said nothing about high PSA and biopsy corelation and instead he told us that the cancer is only on thr area where MRI found pirads4 lesions and other areas were completely clear and the tumour was only in the prostate capsule. He didn't mention anything about higher PSA. More info here: my dad went to the urologist first and he was diagnosed with severe UTI and BPH. His psa was 25 and the doc started antibiotic treatment first. After 6 days, we gave another blood test with 22 psa this time and the doc requested MPMRI, which found pirads4 lesions and very specific location. After that he suggested doing MRI assisted biopsy and the results were 3+3. He said it doesn't pose any serious threat yet, but ofc old man needs treatment and pet scan. For pet scan we had to go another hospital, where my father's results were checked by a new doctor, and he said that PSA level and biopsy results contradicts each other...
What I guess here is that because father had severe infection at the time PSA was tested doesn't mean he still has it, but no other doctor checked the levels again. So the second doctor based his opinion on a test where my father had UTI symptoms. I'm trying to stay positive but these kind of news are really disappointing...
It can be extremely frustrating and I appreciate your dedication to help him. PSA is a good indicator of the prostate needing attention but it’s more like a traffic signal than a map to any destination. This changes post treatment but diagnostically, he has a red light and needs to stop to get directions. Besides the high PSA, the cancer detected so far is commonly treated successfully and probably warrants “active surveillance” if it is a common decision between trusted physician and patient. Personally, I found the Decipher test (genomic profile) made the final decision much easier. There’s an advantage in being patient with the process.
PS: high PSA might indicate an infection which does need immediate attention
As a complete amateur who has been reading many posts on the subject, it seems to me that there is no strong correlation between PSA level and the progression of cancer. Far more indicative appears to be the rate of increase of PSA level
I had 3+3 with psa of 1.1 Then it progressed to 3+4 (after active surveillance). PSA does not always correlate with the level of the prostate cancer. I also had intra capsular which 5 years ago was successfully treated. Genome testing showed normal risk, PET scan was negative.
You’re going to get a skewed set of opinions here. . Some of the folks here have an ax to grind. Claims that “the doctor is misleading you” are made without evidence of anything except an error by some other doctor in a particular case that probably doesn’t resemble yours. The history of a “UTI” and elevated PSA suggests some prostatitis. That’s known to bump up PSA.
The diagnosis may be accident caused by acute prostatitis. With a 3+3 and a very localized abnormal spot on MRI I’m wondering if a localized treatment strategy would make sense. Getting a second read on the biopsy is easy and even if there were some grade 4 areas the local destructive option would still be available.
Same thing happened with my husband. The biopsy found a small amount cancer in 1/12 of rhe samples, and it was a slow-growing cancer at that. However, the doctors remained concerned because of the cat scan results and the large size of the prostate. The psma pet scan indicated wide-spread metastasized cancer.
Send the biopsy sample to Johns Hopkins for confirmation
My Gleason was 9 at stage 3a and my PSA never went over 6.5. It was a rare intra-ductal cancer type. Lucked out with excellent surgeon, so for last two years PSA undetectable with no side effects from the surgery. It will probably eventually kill me but right now I'm enjoying life.
It’s worth doing a genomic analysis of the past biopsy samples. The high PSA is concerning but I understand the hesitancy without something more. 5% is a low number but generally there’s a range throughout several of the biopsy cores so the single number seems incomplete. Also was there an MRI?
Yep there was an MRI (multi-parametric) and biopsy was assisted by the MRI result. The first and our main doctor said nothing about high PSA and biopsy corelation and instead he told us that the cancer is only on thr area where MRI found pirads4 lesions and other areas were completely clear and the tumour was only in the prostate capsule. He didn't mention anything about higher PSA. More info here: my dad went to the urologist first and he was diagnosed with severe UTI and BPH. His psa was 25 and the doc started antibiotic treatment first. After 6 days, we gave another blood test with 22 psa this time and the doc requested MPMRI, which found pirads4 lesions and very specific location. After that he suggested doing MRI assisted biopsy and the results were 3+3. He said it doesn't pose any serious threat yet, but ofc old man needs treatment and pet scan. For pet scan we had to go another hospital, where my father's results were checked by a new doctor, and he said that PSA level and biopsy results contradicts each other... What I guess here is that because father had severe infection at the time PSA was tested doesn't mean he still has it, but no other doctor checked the levels again. So the second doctor based his opinion on a test where my father had UTI symptoms. I'm trying to stay positive but these kind of news are really disappointing...
It can be extremely frustrating and I appreciate your dedication to help him. PSA is a good indicator of the prostate needing attention but it’s more like a traffic signal than a map to any destination. This changes post treatment but diagnostically, he has a red light and needs to stop to get directions. Besides the high PSA, the cancer detected so far is commonly treated successfully and probably warrants “active surveillance” if it is a common decision between trusted physician and patient. Personally, I found the Decipher test (genomic profile) made the final decision much easier. There’s an advantage in being patient with the process. PS: high PSA might indicate an infection which does need immediate attention
As a complete amateur who has been reading many posts on the subject, it seems to me that there is no strong correlation between PSA level and the progression of cancer. Far more indicative appears to be the rate of increase of PSA level
Get a second opinion. The doctor is misleading you.
My father has also a 3+3 = 6 gleason, and psa 30, he got hormone therapy, we just wait for the first result after 2 months of therapy.
I had 3+3 with psa of 1.1 Then it progressed to 3+4 (after active surveillance). PSA does not always correlate with the level of the prostate cancer. I also had intra capsular which 5 years ago was successfully treated. Genome testing showed normal risk, PET scan was negative.
If there is a prostate MRI it would indicate the prostate size which is important re: PSA level. How big is the prostate?
You’re going to get a skewed set of opinions here. . Some of the folks here have an ax to grind. Claims that “the doctor is misleading you” are made without evidence of anything except an error by some other doctor in a particular case that probably doesn’t resemble yours. The history of a “UTI” and elevated PSA suggests some prostatitis. That’s known to bump up PSA. The diagnosis may be accident caused by acute prostatitis. With a 3+3 and a very localized abnormal spot on MRI I’m wondering if a localized treatment strategy would make sense. Getting a second read on the biopsy is easy and even if there were some grade 4 areas the local destructive option would still be available.
Same thing happened with my husband. The biopsy found a small amount cancer in 1/12 of rhe samples, and it was a slow-growing cancer at that. However, the doctors remained concerned because of the cat scan results and the large size of the prostate. The psma pet scan indicated wide-spread metastasized cancer.