Family history and rising PSA

Hi Alex

Cancer does not care what age you are, the good thing is it’s being monitored and a PSA in two months is a good thing, sometimes it’s nothing to do with PC but your doctor should be able to tell you that.

Medications in this day and age, get better all the time, so even if you have this disease as I call it, there’s an abundance of help out there waiting to cure you, so keep positive.

Stay safe

Joe

Thank you very much Joe. Really appreciate your response. And yes, it’s good it’s being monitored. I guess I just need to grit my teeth and be patient and hopefully the PSA will go down again.

Thanks again and stay safe you too!

Alex

If a repeat test shots that is still rising, then there comes a point at which a scan should be considered.

With your history, and the level it's reached, I'd have thought that now is the time.

Thank you Heinous. I was supposed to have a check up/cystoscopy tomorrow with my urologist but because I have two children with Covid at home it got postponed for another month. Very frustrating but I will ask him at my next appointment. He’s a bladder cancer “urooncologist”but I presume his expertise covers the prostate too.

I do feel the time has come to do something else but understand that even if it were prostate cancer, it’s a disease that develops slowly. Is that correct or too much of a generalisation?

Last time I had a scan was almost two years ago even though they’re supposed to be done every year for the first 5 years with my BC. 

Relatively speaking, it's a slow moving disease, certainly in the early stages.

I read somewhere that most PCas are about 10 years old before they're diagnosed.

Re-reading your original post, I see you had an MRI and biopsies - when was that?

PSA is a horribly unreliable test - in general, you can trust rises and falls, but not actual values. It may be that it's a false alarm, and 3-monthly PSA will be sufficient for now, but a PET scan is the 'gold standard' for very early recurrence, and my guess is that would apply to early disease too.

One famous US oncologist whose name eludes me, of course, argues against too early intervention, on the ground that while scans are good, they are not perfect, and so it's better to wait until you know what you're looking at.

A lot to think about, and apologies if I'm making muddy water even muddier!

Yes, urologists are all purpose plumbers (but never use that word on front of them  )

Thanks for that Heinous. I had the MRI almost two years ago. It was meant to check my bladder so I was surprised when they said I needed prostate biopsies. I’m a Brit living in Norway where they are very keen on MRI and only targeted biopsies apparently so only 3 biopsies were taken from each lesion (one in the apex, one in the base). One was Pirad 4, the other 5 due to its size I think. 

Interesting what you say about pet. I had a pet ct (too due to BC and unremitting back pain) and it picked up an area of fdg uptake in my spine. They thought it was due to a “loose screw” after an old injury but the orthopedic guy concluded that the screw was not loose and I’m not sure that info has been passed on to my urologist. 

As you might gather, I don’t have the greatest faith in the doctors here. Depending on whether my PSA keeps rising I am tempted to seek help privately in the UK. I wonder if a pet might be a way to reassure me. 

My bladder cancer has a 50-70% change of recurring in which case both bladder and prostate need to go so it might all be academic anyway  

I really appreciate all your information. I am used to working with a lot of facts in my job so the more the better!

Thanks again

Alex