I have bph, large prostate and rising psa

Good evening Darren and welcome to the site.  First of all the more I have read up on it the bigger the prostate the higher the PSA but it seam like you have it under control for now.  I had a 12 needle biopsy did 14 years ago.  It all depends what type of cancer you have if you have it.  There are slow growing that doctor say that it would take 10 years to give you a problem.  It's good to know so you can deal with it.  But if you are not having any problem peeing I would leave it alone.  Do you trust your doctor.  Get all the information you can before you do anything.  At 51 your a young man to deal with any other problem.  Do your research please.  Do not let them rush you into any surgery.  Good luck  Ken     

Hi Darren, 

       1. PSA. Could be due to large prostate. Mine has been between 8 and 9 for sometime with prostate size of 98 cc. I've had 3 biopsies, one targeted, all negative.

       2. I wouldn't worry, but having the MRI's is prudent. Are they 3T MRI's?

       3. Not sure what the biopsies are that they are proposing. My third biopsy was based on my 3T MRI which showed one lesion, PIRADS of 4/5. Came back negative. Uro doc said BPH nodules can look like PCa on the MRI.

       4. You didn't mention what your symptoms are. There are many alternatives going forward depending on your symptoms are.

Rich

 

I am not a doc but had a 10.3 with a size of 123 at 65yrs old.  Usually all BPH although uros would love to cut you up.  As you know only allow if aggressive gleason, etc.  I would NOT do more biopsys.  MRI is great tool but again uros don't earn $ on them.  If I were you with the BPH and size I would first do very limited alcohol and caffine.  If it continues to get worse I would look into PAE.  A simple non-invasive clean procedure which was a  miracle in my life.  Use a doc who has done many like a dr at UNC Chapel Hill.  9 days after procedure I felt like a new human being and am still great 18 months later.  Wake up zero or once per night.  Saw Palmetto never did a thing for me except make it worse.  There are some other supposed supplements like Flower Pollen and Pepita seeds or oils.  Try them all and get plenty of sex.  Good luck.

Your PSA fluctuations are normal, not indicative of cancer. Keep monitor it. If it doubles in any 6 months then go for cancer testing.

If your BPH symptoms are acceptable, I wouldn't go for any procedure, yet. Spending some time looking into different procedures now will help you later when you decide to go for it.

Hank

PSA levels can be variable by which lab and lab technician is doing the reading.  ALSO, as the prostate enlarges over time, the PSA level also goes up.  This is not because you may or may not have cancer, it is because the prostate is bigger and giving off more protein, which elevates the PSA level.  This is something I found out by doing my research and asking the urologist that specific question.  I would still get the biopsies, they take it at 4 or 5 spots when they do the procedure just to make sure it is not cancerous........however, they can possibly miss the cancerous spot......

Robert

 

Hi, I had a mp MRI which found a suspect area 20mmx20mmx8mm at pirad 5 with a note saying it was highly suspect but only in 1 way slightly different from cancer, my psa varied from 2.4 to 5.4, I had bph in the form of an enlarged median lobe 6cm highx4cm wide approx 50cc pushing my bladder up making it hard to pee and sleep, I tried sawpalmetto without results and other natural options all to no avail and had to reluctantly search for a surgery to solve the pee and broken sleep struggle then along came the pirad 5 cancer scare, durring all this I am so glad I discovered a Dr Karamanian and sent him my mp MRI results and diagnosis, he said dont sweat the pirad 5 and said in my case it is most likely just inflammation,I then had to decide on what type of biopsy and google explained if you do have cancer a standard 12 needle ultra sound guided biopsy done by a urologist can not only cause prostate injury but has a risk of releasing cancer cells into the body (cancer kept inside the prostate is not so bad since it is often slow compared to cancer in other body parts unless its aggressive prostate cancer) also google said the standard 12 needle ultra sound guided biopsy done through the anus is less likely to spread cancer than done under the scrotum, so I chose to reduce the amount of needles to 3 only through the anus into the pirad 5 suspect area, and I used  a prostate robotic surgeon to do the biopsy as he is more likely to hit the suspect area, the result was just inflammation just as Dr Karamanian said. I also chose FLA to deal to my enlarged median lobe rather than the cheaper option of TURP which has a lot of serious side affects when it comes to a median lobe, it all worked well with no side affects so life for me is now much better,Dr Karamanian did an excellent job, hope this helps.

It's about rate of change when it comes to PSA and I would say yours are figures not to overly worry about. There is evidence over time that yours have gone back down. Mine have been from 4.1 to 7.6 over 10 years. The biopsy and/or MRI should be enough to ensure all OK. The peeing in the night and BPH is a another problem.