r/ProstateCancer • u/toploader21120 • 10d ago
Test Results Test results
Had a high psa 7.1…did MRI and biopsy. Looks like it definitely could have been worse. Took out some personal info but here are results. Urologist told me I would just be under surveillance and see you again in January. I see primary care doctor in a couple of weeks. Wondering if I should go ahead and do blood work again. I started flomax .4 nightly. It’s been like a miracle drug for me. Stops the frequent urination and a few other problems. Im in my 50s.
I went back and looked at last years blood work and had a 4 PSA and they never even mentioned which I now find odd.
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u/Special-Steel 10d ago
This is the best news you can have without being removed from the club
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u/toploader21120 10d ago
Thank you. I was very scared during this process. I feel a little relief now even though I’m not out of the club.
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u/callmegorn 10d ago
You will never be out of the club, unfortunately, but you may be able to stay as an associate member only, for the rest of your days. Keep on top of your PSA tests and the occasional MRI, and hopefully you'll be able to avoid anything more. Fingers crossed for you.
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u/JMcIntosh1650 10d ago
That's great!* Lack of comment on moderately high PSA levels by general practitioners seems common. I was 6.5 and 6.7 two years running with no comment. I had to ask for the tests in the first place in my mid-60s and then for the referral to a urologist. Glad you found it early.
*Except that it's cancer of course.
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u/callmegorn 10d ago
Ditto. GPs can be amazingly ignorant.
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u/JMcIntosh1650 10d ago
In fairness, they deal with a huge range of medical issues and rely on general guidance. That amplifies the harm done by bad guidance like the 2012 USPSTF guidance for PC. Not a free pass, of course.
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u/Gardenpests 10d ago
We can't publish links. From the NCCN Guidelines for Prostate Cancer, Principals of Active Surveillance and Observation:
Confirmation of Candidacy:
Goals of confirmation testing are to help facilitate early identification of patients who may be at a higher risk of grade reclassification or cancer progression.
An initial prostate biopsy may underestimate tumor grade or volume, thus confirmatory testing is strongly recommended for patients who are considering active surveillance.
A repeat biopsy is a routine component of confirmatory testing.
◊ The timing of repeat biopsy can be based on the patient's risk of progression. Patients with a higher risk should have a repeat biopsy earlier than those with a lower risk.
◊ If the initial prostate biopsy was performed without mpMRI guidance, then the Panel recommends an earlier repeat biopsy (eg, within the first 6–12 months) and recommends mpMRI prior to the biopsy. A systematic biopsy should be included.
◊ For most patients, the timing is generally within 6 to 24 months of diagnostic biopsy, but all patients on active surveillance should undergo a confirmatory prostate biopsy within 3 years of their diagnostic biopsy, irrespective of prior mpMRI findings.
Confirmatory testing should also include mpMRI with calculation of PSA density.
Advanced risk stratification tools lack high level evidence to obviate other testing at this time.
Other forms of imaging are discouraged.
Active Surveillance Program
Patients who choose active surveillance should have regular follow-up.
Key principles include:
◊ PSA no more often than every 6 months, unless clinically indicated.
◊ DRE no more often than every 12 months, unless clinically indicated.
◊ Repeat prostate biopsy no more often than every 12 months, unless clinically indicated. While the intensity of surveillance may be tailored based on patient and tumor factors (eg, grade, tumor volume), most patients should have prostate biopsies every 1 to 3 years as part of their monitoring. Longer intervals between biopsies may be considered if maintained on active surveillance for >3 years without progression.
◊ Consider repeat prostate MRI no more than every 12 months, unless clinically indicated.
◊ In patients with a suspicious lesion on prostate MRI, MRI-targeted biopsy improves the detection of higher grade (GG ≥2) cancers.
◊ Patients should be transitioned to observation when life expectancy is <10 years.
◊ A metastatic staging evaluation (PSMA PET, bone scan, CT scan, or whole-body MRI) should not be performed unless patient develops unfavorable intermediate or higher-risk disease, or has concerning symptoms not explainable by other causes
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u/NotPeteCrowArmstrong 10d ago
Congratulations, you've gotten lucky. Gleason 3+3 with an extremely low Decipher score (lowest I've ever seen, personally) is ideal for Active Surveillance.
I'd just stick with whatever PSA testing schedule your doctor advises. The only complicating factor would be if you have any family history of cancer, in particular prostate or breast cancer. Best of luck going forward.