I found a different urologist who was willing to work with me and do nothing unless my PSA started climbing.
In the meantime I learned about Dr Jonathan Epstein, and I got a second opinion from him on the biopsy. He downgraded the Gleason score to 6. When I discussed this with him on the phone he recommended that I “just watch it”.
That is what I have done since with semiannual PSAs and annual MRIs. My PSA has increased to 2.1 but the MRI has not changed at all. I have not had any biopsies during this time agreeing with my urologist that a biopsy would not find anything the previous PSAs couldn’t find.
I intend to continue with this process for the foreseeable future. I may drop the annual MRI but will continue with the semiannual PSA. I undergo semiannual checkups and having the PSA tested at the same time costs me nothing more than a moment of anxiety when I read the results of the blood work.
I am your age (76 in October) and diagnosed in Apri2012 incidentally after a TURP. My Psa score started climbing in 1998 and I had underwent 3 biopsies looking for the cancer without success. By the time I had the TURP my Psa climbed to 9.6. The Gleason score was determined to be 7 (3+4) and in the 2 months I recovered from the TURP procedure I had already scheduled a prostatectomy for the end of July. My first Psa after the TURP was 1.0 and that changed everything. The surgeon who was supposed to do the prostatectomy was determined to continue with the treatment. I resisted and he had me undergo an MRI. When the PRADs was scored 2
Thanks for sharing your story. And Happy '6--that's the spirit.
You have a lot going on.
Your BPH could have been driving up for PSAs.
Dis you get a second opinion from someone like Hopkins or Dr. Ming ZHou on that 3+4? Sometimes the Gleason score is reduced in a second opinion.
Your PI-Rad score sounds OK. Have you had other MRIs?
Are you being treated at a major medical center or maybe a private urology group in a small town?2
Have you had genomic testing of your tumor? Or DNA testing for mutations like BRCA 1 and 2? Do you have a family history of aggressive prostate cancer or even breast cancer?
Ea h of these are individual items that can give you and your doctor a fuller picture of what's going on?
How is your mood or that Spirit of 76? This can be a roller coaster ride. Hang in there.
See my previous comment which followed the first comment. I did get a second opinion from Dr Epstein who downgraded the Gleason score to 6. I also did the DNA testing with color.com for the BRCA 1 and 2 under the PROMISE study, particularly because I have an Ashkenazi Jewish heritage. I have been treated at NYU Langone since 2012.
I have been dealing with my PSA for 25 years now. If there is still cancer there, it has not metastasized during this time. I don’t expect it to do so now.
The first surgeon I consulted after my PCa diagnosis was Dr David Samadi. it was he who wanted to operate even when my PSA dropped to 1.0. It was then that I switched to Dr David Whang at NYU. I have been doing semiannual PSAs and annual MRIs since. I have not undergone a biopsy since my third one in 2009.
Sounds like the path I am following, Dramatic story, Marvin. Thanks for sharing it.
Howard
I found a different urologist who was willing to work with me and do nothing unless my PSA started climbing.
In the meantime I learned about Dr Jonathan Epstein, and I got a second opinion from him on the biopsy. He downgraded the Gleason score to 6. When I discussed this with him on the phone he recommended that I “just watch it”.
That is what I have done since with semiannual PSAs and annual MRIs. My PSA has increased to 2.1 but the MRI has not changed at all. I have not had any biopsies during this time agreeing with my urologist that a biopsy would not find anything the previous PSAs couldn’t find.
I intend to continue with this process for the foreseeable future. I may drop the annual MRI but will continue with the semiannual PSA. I undergo semiannual checkups and having the PSA tested at the same time costs me nothing more than a moment of anxiety when I read the results of the blood work.
I am your age (76 in October) and diagnosed in Apri2012 incidentally after a TURP. My Psa score started climbing in 1998 and I had underwent 3 biopsies looking for the cancer without success. By the time I had the TURP my Psa climbed to 9.6. The Gleason score was determined to be 7 (3+4) and in the 2 months I recovered from the TURP procedure I had already scheduled a prostatectomy for the end of July. My first Psa after the TURP was 1.0 and that changed everything. The surgeon who was supposed to do the prostatectomy was determined to continue with the treatment. I resisted and he had me undergo an MRI. When the PRADs was scored 2
Hi, Marvin.
Thanks for sharing your story. And Happy '6--that's the spirit.
You have a lot going on.
Your BPH could have been driving up for PSAs.
Dis you get a second opinion from someone like Hopkins or Dr. Ming ZHou on that 3+4? Sometimes the Gleason score is reduced in a second opinion.
Your PI-Rad score sounds OK. Have you had other MRIs?
Are you being treated at a major medical center or maybe a private urology group in a small town?2
Have you had genomic testing of your tumor? Or DNA testing for mutations like BRCA 1 and 2? Do you have a family history of aggressive prostate cancer or even breast cancer?
Ea h of these are individual items that can give you and your doctor a fuller picture of what's going on?
How is your mood or that Spirit of 76? This can be a roller coaster ride. Hang in there.
Howard
See my previous comment which followed the first comment. I did get a second opinion from Dr Epstein who downgraded the Gleason score to 6. I also did the DNA testing with color.com for the BRCA 1 and 2 under the PROMISE study, particularly because I have an Ashkenazi Jewish heritage. I have been treated at NYU Langone since 2012.
I have been dealing with my PSA for 25 years now. If there is still cancer there, it has not metastasized during this time. I don’t expect it to do so now.
Thanks, Marvin.
I missed the previous comment. Somehow I didn't see or get a notification.
Thanks for answering the questions.
Sounds like you're making a good choice.
Some guys just produce lots of PSA with low-risk cancers.
Will you continue to monitor with PSAs and MRIs or will just ride off into the sunset? Does your NYU urologist still want to operate?
Howard
Howard
The first surgeon I consulted after my PCa diagnosis was Dr David Samadi. it was he who wanted to operate even when my PSA dropped to 1.0. It was then that I switched to Dr David Whang at NYU. I have been doing semiannual PSAs and annual MRIs since. I have not undergone a biopsy since my third one in 2009.