PAE and other available options

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This forum is nothing short of amazing! I have read almost every post. Thank you all for sharing your experiences! I have a lot of the symptoms of enlarged prostate but not too bad at night. Usually only get up twice/night. But during the day need to pee often and sometimes a greater urgency. I had a PSA done (twice) and both times came back at 18.5. That really scared me. Urologist did DRE and said large prostate but didn't think cancerous because no hard spots and the high score could be from prostate just being so large. He did a cystoscopy and said I have a giant median lobe. His recommendation was PVP Green Light laser but I read the side effects and only want that as an absolute last resort if at all.

I went to get 2nd opinion because, in the back of my mind, the high PSA score still weighs heavy on my mind. 2nd urologist agreed that there are no suspicious areas found from DRE but wants to do 12 core (or more) biopsy. He is willing to do an MRI first to see if that shows any suspicious areas and will use that to determine where to biopsy in addition to the random selection. (I'm not agreeing to the biopsy part yet.). He said he would not recommend the laser because the median is pushing in the bladder and using the laser could accidentally damage the bladder. He wants to do a robotic suprapubic prostatectomy.

I am very interested in the PAE based on what I've read but wonder (because of my high PSA score) if I should do the biopsy or...if the MRI comes back clean just move forward with the PAE. I was also thinking (based on info I found here) of having the pca3 test done (if I can find a lab around here that does it.

Any thoughts regarding if I should do the biopsy because of my high PSA score?

If I don't have cancer, I think the PAE is a reasonable option for me (even with a giant median lobe) but would be interested in some feedback. (The side lobes are also enlarged).

Thanks

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  • Posted

    Hello.  Just look at the video of what the doctor wants to do to you.  No way in hell would I have that done. Don't want a tube in my stomack  High PSA does not been cancer.  There should be a pill to relax your bladder. Or the PAE may help.  There are so many procedure out there that could help.  Don't let them core or burn your prostate to many side effects.  I had a urolift work great for me..  Take care and don't let them talk

    you into anything.  Get all the information you can  Ken   

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    • Posted

      Thanks Ken. I won't let them talk me into anything. If I do anything I'm leaning towards PAE but with such a high PSA I also don't want to be negligent and stick my head in the sand and not do a biopsy if I should. I'm just looking for input from people on this site because I think the people here are looking out for each other. I only listed the urologist recommendations to detail my situation. Thanks for your comments
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    • Posted

      Thats good.  Tell your doctor that you don't want to rush into anything and do another PSA in 6 months.  95% of prostate cancer is slow growing.  Read a story that's called * I what my prostate back *  It';s about a 52 year old man that was talked into having his prostate out after a year he could still not have sex.  Then the doctor told him then that it was slow growing that it would have not cause a problem for 10 to 15 years  Ken  
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    • Posted

      I'm going to take it slow. Just that the PSA is so high. I'm getting a T3 MRI tomorrow to see if anything shows up there. Also, my urologist has agreed to do the PCA3 test. Nothing will be done until I have those results. If no cancer then PAE is the way I will probably go. If I end up with an aggressive cancer then I will have to rethink my situation.

      Thanks for your thoughts.

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  • Posted

    Assuming you are negative for PC, and I strongly suspect you will be negative, I do think PAE is a good choice for you and based on what reading I have done on PAE I do not think the large median lobe will be a problem as it will shrink too. Unfortunately UroLift is not an option for you as a large median lobe is a contraindication for successful outcome with UroLift. Good luck on your MRI assessment. I doubt they will find anything to biopsy but you will soon see. Keep us posted on what happens and what choices you make.
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    • Posted

      Just a quick update. I the Uroligist office called and said there is an abnormality showing on the MRI and the urologist wants to proceed with the biopsy. I am really stressed and a little depressed. I see the urologist this Wednesday for a consultation/review of the MRI. That is also when I am scheduled to have the PCA3 test performed. I really want to wait for those results before I agree to a biopsy. The emotions of sadness are almost overwhelming and yet I haven't even been diagnosed with anything!
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    • Posted

      I would see what the urologist says.  The PCA3 is a urine test to see if there are cancer cells The doctor will do a finger test and then ask you to pee.  It take 10 days for the test to come back.  It could be nothing.  Have it done and see what the test show.  Then you can tell them no or yes to the biopsy.  Most prostate cancers are show growing and take 10 to 15 years to cause a problem.  I had a biopsy done when I was 47  I will be 61.  If I would have had cancer I would have just waited.  My urologist is great.  He knows how I feel.  Had a problem about 3 weeks ago Had 3 blood clogs on my prostate.  Had to have them burned to stop the bleeding.  I also did tell my doctor before sure you can repair it but you do not have my permission to core, laser or remove my prostate.  It is staying right were it is.  That is your organ and your body.  You have the right to do anything you want.  Read up on prostate cancer. Like I said before it will tell you most prostate cancers are slow growing.  Most doctor will not tell you that because they want to remove it which will cause you more problem.  Get the information  That care and let me know what is going on.  Don't let her talk you into anything  Ken       
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    • Posted

      Well, just a quick update. Things have taken a turn for the worst. The MRI leaves almost no doubt I have cancer. The urologist His words were that my MRI was one of the worst he has seen. I told him I was researching cyber knife and proton therapy but he didn't think those options would work because my prostate is so large. Well, next is the biopsy this Monday.

      I'm doing ok mentally for now because I was already anticipating him to confirm my suspicions of having cancer.

      Even though he was not encouraging regarding possible treatments, I will continue to investigate and will seek other opinions for the best treatment.

      You are the only one I'm am telling this to until I have a chance to talk to Cindi. She does not get into Boise until Saturday around 9:00pm.

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    • Posted

      Sorry to here that but jsut because it large does not mean it is cancer.  And were is it and what kind.  Most prostate cancers are slow growing.Sone take 10 to 15 years.    Don't let that doctor talk you into anything Like removing the prostate.  You think you have problems now>  There is another treatment that I have been reading about.  It's called MRI guided laser ablation.  It is were they pin point the cancer and kust get ride of it No removing of the prostate.  Just have the biopsy and see and you can still wait and watch  Take it easy  Ken
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  • Posted

    I'm very sorry that you are having to go through the stress of being told you have PC. I attempted to post a link I wanted you to review but it was edited out by forum managers. The link was to the web site of Sperling Prostate Center. They offer clinics in NJ, NY, and Florida. Sperling is a pioneer in MRI-guided prostate imaging and laser tumor ablation. If I were facing what you now are, Sperling is where I would go. You can find Sperling Prostate Center via Google. I have no association with Sperling Centers. I became aware of their services several years ago when I had to endure a PC scare which turned out to be a false alarm.

     

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    • Posted

      First, let me just say thank you to everyone for your thoughts and suggestions. I did view the Sperling prostate center website and was impressed with what I saw. I'm on the other side of the US so I will reluctantly go ahead with the biopsy tomorrow because of the areas of concern.

      I am taking the "trust but verify" approach with my urologist. He has given me a Valium to help me relax, a pain pill for any discomfort to take before the procedure, and said he will numb the area. He also did a rectal culture last week to make sure I didn't have any unusual bacteria before he prescribed an anabiotic for me to take the day before, during and after the procedure.

      I will post When I have the results. This is such an invaluable forum. To be able to hear from others who have researched and traveled the path I am now on.

      After I know what I'm dealing with, I would greatly welcome everyone's thoughts and will also research and seek several professional cancer centers on the best treatment for my condition.

      FYI, if it comes down to it, I don't think I'm afraid to die. I do feel deep sorrow for the the pain this will cause my loved ones and not being able to be there to support, guide, and encourage my family. That is what I will regret the most. Please don't interpret this last paragraph as I'm giving up. I don't think my condition is Who nearly that bad. But if it is...death itself doesn't seem to be that scary.

      Happy Easter everyone.

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    • Posted

      Life is short and we must live all we call.  Prostate cancer most of them are slow growing.  I hope you read the artical that I told you about.  He had a 13 needle biopsy only 2 showed cancer cell. He had cancer but what the doctor did not tell him was that it would take 10 to 15 years for it to cause him a problem....Just be careful and I will say a prayer for you  Ken
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    • Posted

      Ken thank you for your concern, advice, and prayers. I absolutely will not make any decisions until I have all the information including what type of cancer (slow or aggressive) and then have consulted with several independent cancer centers (if it is cancer) to educate myself on what the best action plan is for me. My goal is to keep as much of my prostate as possible with the least side effects and the highest quality of life possible. Again, thank you.
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    • Posted

      I know your cancerns I have the same thing about my prostate.  I am keeping it till the day I day.  Go on American Cancer Society and read up on it.  The 3 main treatments are removing the prostate ( which you don't want Me either ) Radation and watchful waiting.  That is the one I would go for.  Or the Direct MIR Laser.  Do let the doctor bullt you into anything Some have a way of telling you things without telling you everything.  If you like to talk sometime send me a private message I am here for you.  I can help you research  Relax if you can I had it done 14 years ago.       
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    • Posted

      Hey Buy just checking to see how everything went  Just relax  Tryed to send a private message but could not do it take care  Ken
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    • Posted

      Hey Ken,

      I did do the biopsy today. 22 cores. The procedure went pretty easy for the most part. On a scale of 1 to 10, about half were 1 or a 2 and half were a 3 or 4. I did get dizzy after I got dressed and they brought me a Sprite and gram crackers. After I left, and on the way home, the pain went up to about a 6 and started feeling really bad. Fortunately my wife was driving. I started to mildly shake and feel horrible. Then it settled down again but the pain was still there. We turned around and went back to the urologist and they gave me a prescription for the pain. I laid on the couch the rest of the day and now feel somewhat better but not back to normal. I still get a little lighthead if I stand for more than a few minutes. I have no fever and only took one pain pill about 5 hours ago and right now the pain level is around a 1 so doing much better. Also have been able to pee a little with only a very small trace of blood (almost no blood at all). I hope the worst is over because it was a pretty rough day.

      Thanks for checking on me. Hope all is going well for you.

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    • Posted

      Just take it easy for a few days.  Why did the do so many. I had 13 when  had mine Also I was out when he did it.  Word of warning no messing around.  I did it 2 days after It was intense but mosty blood Take it slow..Ken
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