Decision Time

By Dnsyoung52

1 min read

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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MattI Member
I went to OHSU after having problems with a clinic here is Eugene, OR. The team at OHSU is excellent and caring. The first clinic graded me as a 7 (3+4) but OHSU gave me the same MRI and found another area that needed to be checked and my outcome was more aggressive 7 (4+3.) I opted for the Calypso image-guided radiation therapy; a 10 day (5 treatments) program. Since my cancer turned out to be more progressive I am also on ADT and had my last injection a month ago. Things were looking very good at 3 months and I go in next month for my 6-month checkup.
1. MattI Member
 <inline-mention username="Dennis Golden" user-id="3259730"/> , I did gain about 10 pounds and right in the belly. I made some diet changes and I am pretty active so I am staying in my "normal" pant sizes. I am almost 6 months into it and look forward to getting my T back. I am surprised on how much body hair I have lost plus I really suffer from hot flashes at night and with our heat waves have made it miserable at times. I'm glad things have cooled off here in Oregon.
2. Dennis E. Golden Moderator & Contributor
 <inline-mention username="MattI" user-id="3266891"/> The hair loss was unexpected for me as well . In fact it was rather shocking . I had on heck of a hard time with hot flashes and night sweats and resorted to keeping a ceiling fan on in my bedroom. I also carried a small hand held fan - Laugh all you want - it really helped One hidden benefit with ADT is since my male hormones were turned off was I could skip using underarm deodorant every day - I know its not much of a bell ringer benefit ...but I will take every small benefit that comes along lol
Dennis E. Golden Moderator & Contributor
I had a second opinion and did the surgery. It was the right design for me as my cancer did return 5 years later -I was able to treat it with radiation and ADT. Even though I had an aggressive cancer PCa is slow growing so you have some time to make a decision
wrussell06 Member
hello, I am 53 years old and was diagnose with PC three years ago. biopsy display Gleason(6) four areas all were 3+3.. My PSA was 7.1 and went up to 13.1 over 2 years. My treatment was external radiation. My doctor want me to do surgery cause he had a friend does the procedure. Its not funny lol.. I did some research and i didn't heard any men died from Gleason 6.. over the last two years my PSA went down to 1.1. next PSA test is in two months. 3.4 and 4.3 are difference grades.. the higher the number the more aggressive is the cancer. 3.4 is boarder line whereas 4.3 is very aggressive. first number is very important. again early stage is good to prevent the tumor from spreading though the body.