Decision Time

Hello, my name is Dennis. I am 69 years old. My PSA started to rise about 6 years ago. Went from .02 to 2.4 in a year. Went to 8 in 2014 and I had my first biopsy in 2017, PSA at 10.5. Results were first told cancer then clarified as just suspect tissue. Went on active surveillance in 2017.

PSA rose to 14.5 in Dec 2020 had a second biopsy resulting in only 1 core as cancer with a Gleason score of 6. Suggested I remain on active surveillance (AS). I then got a referral to OHSU Phil Knight Cancer Institute. Met with surgeon, radiologist, and oncologist in July. The consensus was to have MRI with Endo Probe. If it showed areas of concern then treatment would be needed.

Treatment options and family history

Had MRI Aug 6th, results were an enlarged prostate with 2 tumors, the primary tumor is large 3.0x1x2.3 cm with a PIRADs of 5. In Dec Urologist had said that the prostate was not enlarged and DRE had no areas of concern. Met with OSHU team to discuss options. I am leaning towards surgery.

My father died of PC at 82 and my brother had PC at 68 went through Radiation and Chemo PSA then 0. Brother then was diagnosed with pancreatic cancer and died 5 months later.

Questions for the community

  • Any thoughts on surgery? Or other treatment
  • Should I do another biopsy first to confirm?

My concern is the size and quick growth of the prostate and tumor.

Thanks for your help.

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