Posted , 11 users are following.
My uro wants to do a repeat biopsy on me. Although my total PSA has come down from 11 to 6 in the past 15 months, my phi (prostate health index) score has gone up. The phi says I have a 33% chance of cancer on biopsy.
I also have a 4KScore from last summer. It was 3%. 4K predicts likelihood of Gleason 7+ cancer and metastatic disease over 20 years.
I also have three 3T mpMRIs that were negative over the past 30 months. None of the MRIs assigned a PIRADS score because no lesions were seen - only mention of BPH nodules and inflammation-prostatitis.
I was considering HoLEP. My PVR is now close to 300 cc. It was 120 cc last week, 280 cc today, and 370 cc four weeks ago. I had one odd reading of 5 cc two weeks ago, but I didn't have anything to drink that morning and voided 900 cc the night before.
My most recent ultrasound measured a prostate volume of 200 cc, up from 175 cc 13 months ago. My last MRI measured 130 cc. I believe MRI is more accurate, but in any case, my prostate is pushing up into the bladder, and my MRI measurement, it would probably still be 140-150 cc.
My PSA density is around 0.035 and my free PSA is around 31-32%.
Four years ago I had a negative 16 core MRI-guided biopsy that was negative for cancer and negative for PIN (pre-cancerous cells).
I did a Michigan Prostate Score (MiPS) urine test in 2015 and it showed 11% chance of aggressive cancer. My PCA3 was 20 and my TMPRSS2:ERG = 0, for an overall risk of 24%.
My doc wants to repeat biopsy to make sure I don't have cancer. If I had HoLEP and later discovered cancer in the peripheral zone, he said it would make radical prostatectomy difficult.
I think he wants to do a saturation biopsy under sedation.
That can cause me to go into urinary retention as the prostate swells further.
Now, I don't know what to do.
Maybe repeat the 4Kscore? Maybe another type of test?
I've had three straight negative MRIs and a low 4K. I just want to pee normally and get HoLEP.
Not sure what to do now, and my life has not been the same since my 2015 biopsy. My PSA has never come down since that. And I bled like a pig - and had rust colored, blood-tinged semen for 3.5 years after the biopsy!
Need to bounce this off you guys.
I have utmost respect for my doctor but I am scared.
Thank you all.
0 likes, 25 replies