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Rising PSA

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TKM
TKM

I am 71 and have had BPH for about 15 years. I tried Avodart for a year in 2012. I have been doing self cathterization (5/day) since May 2018. When I started catheterization my PSA went from 2.8 Aug 2017 to 5.3 Mar 2019 Which as I understand is somewhat normal due to the irritation caused by catheterization. Then PSA went to:

6.3 July 2019

7.55 Jan 2020.

I had a mp 3T MRI Feb 2019, The report says :

"1 & 2. Prostate size 85g, enlarged median lobe pushing into bladder.

  1. There are no focal areas of restricted diffusion demonstrated. There is a generalized restricted diffusion within the left side of the prostate when compared to the right side . There is a generalized decrease within the ADC map on the left side of the prostate. Following infusion of contrast there is a generalized increase in contrast enhancement within the left side of the prostate.

  2. PIRAD-3"

The place I had the 3T MRI is near a hospital 2 blocks from my home in Fremont California. I think it is a general MRI imaging center and does not specialize in prostate images, so don't know how accurate their report is, or if they did the imaging correctly.

I sent the images to Dr Karamanian in Houston, Tx. He said the quality of the images was not good enough to tell much about prostate cancer. He said the size of the prostate is roughly 85g.

I will see my urologist this week on March 4, 2020 and he will probably want to do a biopsy.

I had originaly wanted the 3T MRI to avoid biopsy.

Should I watch and wait getting another PSA test in 3 months and maybe another 3T MRI in 3 or 6 months, at a reputable institution like Stanford Univ, or University of California San Francisco ? Should I take my present images to Stanford or UCFS to find an expert to read them, for second opinion ? Can I get Medicare and my insurance to pay for another 3T MRI in less than a year?

Any help would be appreciated,

Thanks,

Thomas

0 likes, 17 replies

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  • barney34567
    barney34567 TKM

    Posted

    I agree with you that

    There is no test to categorically rule out PCa

    That the finger test is BS

    Yr comment on the PSA rising slightly and then falling considerably is a good sign IMHO of an unfection rather than PCa. I was thought to have an infection and had 2 courses of antibiotics which did not move the PSA a jot. Had the PSA fallen then an infection would have been the Dx

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