Do you still have your prostate? I don’t, so my number should be zero. And yes, this is a “high sensitivity” PSA test.
Not sure if joining the club was what I wanted to do, but at 48, I have prostate cancer as well. Last year in July I got a high PSA at 4.8. A follow-up test at the urologist dropped it to 3.9, but still borderline. I ended up getting and MRI and then a biopsy in November. It’s a very small (5mm) lesion with a Gleason score of 7. They were ready to do a prostatectomy, but I requested the decipher score (which classifies the cancer in various risk categories on a scale of 0 - 1, with 0 being no risk and 1 being highest risk.) Mine came back 0.13, so the doctor said I’m a good candidate for active surveillance.
For the time being, I decided on watchful waiting. I assume somewhere in my future there is a prostatectomy, and I know I’m balancing doing it younger and with possible better recovery outcomes vs doing it later and have all my bits and function in place. My father and his twin both had prostate cancer in their early 60s. I did a genetic panel, and there doesn’t seem to be anything in my genetics that predisposes me to prostate cancer. I know my uncle had the same test with the same results, but ten years ago. (He died eventually of bone cancer; my father is still alive and lives cancer-free.)
Very sorry to hear that.
Interesting. I hadn’t heard of decipher scores before. I also had Gleason 7 (3+4) but my PSA was IIRC 13, which pushed me toward surgery. I’ve always wondered if I could have waited instead.
Best of luck with the watching & waiting!
Speedy recovery and the best of outcomes for everyone
I appreciate your kind words. It’s a lot less scary now that it was in the first couple of months. Thankfully, I have a radiologist friend who has a lot of experience with prostate cancer that could guide me through my charts and stuff, and what everything means, well before I have a follow-up with my urologist. Modern medicine has this way of just dropping a chart or batch of test results on you without any comment from your doctor or nurse, so you have this diagnosis that says CANCER! sitting in the MyChart before anyone can interpret it for you.
To be honest, this only came up in the follow up with my doctor. I asked him a number of questions, about watchful waiting and the such, given my young age, or whether this is a stupid thing to consider, and only then did he mention that the biopsied material can be sent for a genetic test to determine the agressiveness of the cancer. And it only cost like a a hundred or two extra bucks out-of-pocket, so I’m not sure why it just wasn’t done as a matter of course for somebody in my risk group. But, unlike you, my PSA was in the 4-5 range, not 10+, so I’m guessing for your risk profile it wasn’t useful and why it didn’t come up. I also had a PHI score follow-up, as PSAs are a bit incomplete these days.
Incidentally, the doctor who came up with the PSA test, Dr. William Catalona, is the guy who was my father’s urologist, and why I ended up at Northwestern Medicine for treatment. I haven’t the faintest clue how my Polish immigrant father with no connections got hooked up with him personally. I’m with a doctor at the same hospital, figuring that was a good urology department to work with, even given some criticisms and weaknesses of routine PSA testing.
OK, another term I hadn’t heard of, but I see PHI only was proposed in 2013, and I was diagnosed in 2017, so probably not in wide use at that time (and I bet my PHI would have been a poor result anyway).
I’m impressed you got a diagnosis in just four months, especially for such a small lesion. It took me four years of biopsies to get a diagnosis.
Yeah, my radiologist friend initially said that they probably won’t even try to biopsy something that small, but it turns out they have MRI-guided biopsy so are able to pin-point targets much more finely than standard methods.
For my MRI-ultrasound fusion biopsy, they took the standard 12 samples, plus 5 targeted samples based on lesions detected in the MRI. Cancer was found in the targeted samples, and the standard samples were all clear. It could have taken a long time to diagnose with only standard biopsies.
Fusion. That’s the word I was missing. Yes, that’s what I had, same range and targeting of samples, though I had two regions of interest. Only the smaller ROI showed Gleason 7. The bigger one was a 6.
My MRI guided biopsy was done very quickly, and, since the brachytherapy seems to have killed all the cancer, must have been pretty accurate. That was done only a few months after the diagnosis, and some of that was from me figuring out what to do.
Sorry you had to join us.
But there’s lots of good monitoring and advances in treatment available these days. My PSA had peaked at only 5.4 but my gleason score was 9 (which had me thinking I was a goner as 9 is quite an aggressive cancer). Fortunately it seems it was caught very early, with no evidence of spread outside the prostate. Decipher score showed intermediate risk. Overall 15 year mortality from this cancer is 12.5% after radiation, not bad for an older guy like me. I’m now post radiation and hormonal treatment with my last PSA being undetectable. I’m getting another PSA level this week, so am keeping my fingers crossed.
I could have opted for surgery, but survival rate for that was no better than that for rad/hormonal tx, with worse risk of complications in my case.
4 more months and my androgen blocker shot should wear off (18 months total androgen blockade) so maybe I’ll get some energy and motivation and body hair back after that. The weird thing about androgen blockers is that while they reduce body hair, they do tend to reverse male pattern baldness. I’ve now got enough hair to actually comb on the top of my head for the first time in 2 decades.
@Qadgop_the_Mercotan
Your post gives me a little hope.
I had my PSMA PET scan two days ago and now the scans and tests are complete. I meet with my urologist Monday morning at 0900 to talk about the results and the plan forward. I have had a notepad next to my iMac and have been writing down questions. My mindset is pretty good most of the time but I admit occasional anxiety attacks…
As a fellow “niner” (4/5), I know just how feel. But there’s more than a little hope.
Have you had a Decipher score done? If not, I’d ask about it. Mine was covered by Medicare. Feel free to PM me with any concerns or questions.
Just got my latest PSA results in this AM. It’s still undetectable!! Hurrah, can breathe easier for another 6 months.
Thank you very much. Coming on the heels of my heart bypass surgery a few months ago, this has all been pretty overwhelming
Yay! Yay!
(Said twice so Discourse approves)
Heh. I’ve got 7 stents in my coronary arteries. It seems we’re both walking very similar paths to happy destiny! ¯_(° ͜ʖ °)_/¯
I have had the tests and the scans and in a couple of hours I will sit down with my urologist to get the results and chart out how things will be done. Not knowing has been disconcerting but as the time draws nearer I am very uneasy…
If I may make a somewhat tortured analogy based on my own experience, your present situation is near-complete darkness. Your urologist will light a candle, which won’t turn the darkness into day, but will push it back a little and likely show the beginning of one or more paths. For me, the difference was significant.
Hang in there.
I had the consultation with my Urologist this morning. I do not need surgery. My treatment will consist of external beam radiation and hormone therapy, This is the least invasive treatment available. This is terrific news. I was really afraid of the side effects of the prostate removal