What an excellent video! I was diagnosed with 3+3 prostate cancer in 2017 . I went on active surveillance for several years until my PSA went to 18.7 and a3+4 gleason score. I chose HDR brachy therapy as my first form of treatment with 5 weeks of external beam radiation. My PSA decreased to a nadir of 1.1. However my PSA started creeping up to 3,5 at which point I took a PSMA Pet Scan which showed some recurrent cancer,,,still localized. At that point I contacted UCLA and Dr. Leonard Marks for a second opinion. He informed me I was not a good candidate for HIFU but was better suited for whole gland cryo therapy. That was 7 months ago and now my PSA is at 0.67. If not for PCRI and their informative videos I probably would have had an unnecessary prostatectomy years ago. Thank you PCRI.
Great discussion. My doctors- Atlanta and Charleston disagree with my decision to "watch" my prostate cancer. Prostate cancer is still big business. This probably effects medical decisions and medical advice. I have modified my diet, increased my exercise, dropped alcohol, meat, trying hard to do my part. Age 77, do not need all those side effects of hormone therapy. JLH
If your Gleason scores are less than 8, probably you made the right choice. Life expectancy for a 77 year old male in NY, USA is 8.77 years. Take that into account when making decisions.
I’m not sure how long I have had Prostate cancer (pc) but think it’s about 12 years and found out that I had just a little pc. A Dr in training didn’t think I did but my Dr said I did but from this I gathered it was very little. Any way it became a journey of pca checks about every 6 months including a biopsy and at 94 still here . Dr did tell me something other than pc would kill me so I gathered mine was pretty small and still pca route!
Thanks for the information. I sensed that the Urologist was strongly steering me to surgery while downplaying any other options. As I learned more about my Gleason 4+3; 3+4; and 3+3 in 3 of the 12 random biopsy cores; I became less and less inclined to have surgery. I have found that it is better not to let anyone rush you into a particular treatment. At this point I am more concerned about the treatments than the cancer!
IMO, with 3 out of 12 cores have cancer with one 4+3 and one 3+4 you are definitely not a good candidate for AS unless you are over 70 yo. Listen to your docs and go for treatment asap.
@@hn5460 I'm in my mid sixties and other than the prostate issue, I am in excellent health. I have had MRIs; PSMA/PET scans; X-Rays, Bone scans, CT scans, etc., all came back showing no spread outside the prostate. I have seen four doctors and unfortunately there is a financial incentive for doctors to rush patients into treatment. From everything that I have read from the leading cancer institutes (and my doctors), prostate cancer does not spread quickly like other cancers. We are talking 5 to 8 years in my case. I also had the Decipher genomic test done on my biopsy sample and the test reported that my cancer is not likely to spread quickly. I am concerned about having a doctor rush me into treatment until I am confident that I am getting the right treatment and that the side effects are not life altering. I understand you advice and I appreciate it. I wrote this long explanation to let you know why I am taking the approach that I am...at least for now.
@raulvaldes270 Hi, Your case is an easy and clear cut one: Be on active surveillance. Do not let the fear of haboring cancerous cells in your prostate makes you make irrational decision. I am pretty sure any good urologist will advise you just that. Some men with Gleason scores of 3+4 can be good candidates for active surveillance as well, let alone you. Your biggest enemy right now is not the indolent Gleason 6 cancer, but the uneasy feeling of having prostate cancer. A Gleason 6 cancer can stay in its laziness indefinitely. My second suggestion is to change your diet to a plant based diet (whole grains, leafy vegetables, nuts, tofu, beans, lentil, legumes, fruits...) with minimum processing. You can incorporate fish and other seafood to make your meals enjoyable. And remember to stay away from saturated fat (coconut oil, palm oil, animal fats). Olive oil and canola oil are 2 good oils you can use daily (ignore all the talks about the untrue pro-inflammation of canola oil).
I have been going to Sloan Kettering in New York City for almost ten years. I am now 62. I have Gleason 6 and am a patient in the active surveillance department at Sloan. I have a bi-annual appointments with a PSA and digital exam. Every 1.5 years I have an MRI and every 3 years a biopsy. I just had my 3 year biopsy with ten random cores and all were benign. The MRI was clean and PSA was 2.2. The doctors at Sloan do a great job of educating the patients. I would have had surgery ten years ago. However, Dr. Ehdaie, was amazing. He took the time to educate me, explained how Gleason 6 behaves and had a lot of data to back up his arguments. I was sold after that, and remain grateful to Dr. Ehdaie for guidance to be an active surveillance patient.
Looks like a biopsy was unnecessary in your case. Can't believe you agreed to have that done, with a low PSA. Biopsies can have potential lifelong consequences....
Good to hear I live in Astoria right over the bridge from Sloan; I just had my PSA jump from 2.1 to 3.2 after two years at 2.1, been on Avodart so double those numbers. My first MRI 2 years ago showed PRAD 1, the one from last week is PROD 4 but in the APEX with only one small 1.0x0.8 suspicious lesion. I need a biopsy to see my Gleason score but could still be negative. Let's see my urologist is not worried, all contained no protrutions, all else unremarkable. He told me get the biopsy and you can go wherever you want.....Yikes
PSA are not enough evidence by themselves. I had my first biopsy with a 4.4 PSA. As explained at Sloan, they do find Gleason 7 at times with a low PSA.@@AnthonyShaw-ty9pi
A biopsy seems like the right approach. Don't panic, worst case you are treatable. I highly recommend you go to Sloan if the biopsy is not benign. Wishing you the best!@@johnmchale8308
Thank you so much for sharing this man's incredible journey. I was diagnosed in 2014 and have fought with every urologist I have encountered in my moves around the country due to employment. Thankfully, I met a general practitioner whose father had advanced prostate cancer and who did research, especially in European journals, that led to alternatives. I am still waiting to meet a urologist who is adequately informed and possesses the humility necessary to learn something new.
Can I ask what alternatives have you done or doing? I'm currently doing JT protocol with Fenbendazole also doing ivermectin & quite a few supplements. I have an enlarged prostate and had PAE done a year ago after wearing a catheter for 6 months (No fun).1 yr later my PSA went to 13 and had an MRI which came back with abnormalities & a PI-RAD score of 4.Doc wants me to do a biopsy ASAP. I prefer not to & want to continue my protocol for a few months then have another MRI.
@@DerekTaylor88 Seen your post, I had a scare back in 2008 have been on active surveillance ever since. I recommend a book "Anti Cancer a New Way of Life ". I went by recommendations there ,turmeric with black pepper , also lycopene from tomatoes is beneficial , I eat cans of baked beans etc . Haven't had a sign of anything despite annual psa checks and MRI scans ,even though my psa is high I don't think that's always relevant
@@DerekTaylor88 sorry it took me so long to reply. I didn't see this. He put me on metformin, a statin, and an anti-inflammatory. The statin is crestor and the anti-inflammatory is turmeric boswellia. My PSA went from 8 to 2 and my MRI was clear. If I were in your shoes, I would get a targeted biopsy. I also got PAE.
Same here I'm 3+3 fluctuating PSA from 15.4, 12, 19, 17, 15.4, 15 cycling shoots PSA up what i was never told. Active surveillance since June 2020 living in UK
They do thats what i was told, straight away but i have educated myself more about my diagnosis and its 3+4 pi rads2, so iam looking into alternatives, rather than surgery and this channel has been a complete eye opener
Yes they do. I’m so over doctors appointments and ridiculous charges out of my pocket plus I have insurance. It has turned into an absolute money grabbing nightmare. Just like everything else.
This was a GREAT video, and very helpful. I went thru my 50's and 60's with a PSA of 2. At age 68 it jumped to 4.5 in one year, then 7.03 at age 70. At this point my urologist wanted to do a trans-rectal biopsy on me. He said no prior PHI or MRI testing allowed beforehand. This did not sit well with me since, I had no family history, normal DRE, no urinary symptoms, and a normal ultrasound. I got a new urologist who allowed my requests. My PHI came back at 60 (bad), and my MRI came back PIRADS-5 (bad). I have a 17mm lesion on the entire left side of prostate in all three areas, and the right side is clear. I have a trans-perineal targeted biopsy scheduled in March 2024, 2 months from now. The lesion has not broken thru the capsule. At age 70, with no urinary systems, I'm still a bit hesitate about getting the biopsy, with some fear of needle seeding spread to outside the prostate. Mom and Dad lived to 93 and 98 years old. After watching all of PCRI's great videos, I would go with radiation for sure before surgery. Prostate volume is 58cc. Would like viewers to comment of whether Active Surveillance might be an option for me, for a while before submitting to that biopsy. I have read that even PIRAD-5 MRI's can come back negative, or Gleason 6 at times. I appreciate all comments from everyone. Thanks. Keith
Like my story bro. I have a Pi-Rad five lesion. Get the PSMA PET t scan. No biopsy! Absolutely not! I got one and I truly regret it. I am not the same person. I PEE more at night!!. And when I have an orgasm I bleed and it's very uncomfortable almost hurts. With the MRI and PSMA PET scan. You don't need a BIOPSY ! You have a pretty severe case brother. I am going with BRACHYTHEREPY and target ONLY THE LESION !!!
Hi Keith, With a MRI PI-RADS-5 you are very likely to have PCa. You can go for a PSMA PET CT scan but I am confident that it will be positive too, and it is a waste of money. It will only make sense to take it before the biopsy if the MRI was negative or returned a PI-RADS < 3. Now with a certainty of a clinical significant PCa (Gleason scores > 6), what should you do at age 70? You are probably healthy atm, and expected to live an extra 5 years compared to the typical male at your age, so roughly for another 17 years. Back to the tumor itself, my guess is, it is a Gleason 4+3 or 4+4, not the 3+4 or 3+3 you are hoping for. The PSA doubling time probably is about 2-3 years at the moment and that is good news. You can take time to think about all of this before deciding on your options. Having say so, I think you should still go ahead with the TP biopsy in March to have your PCa categorized properly. I have done it with local anesthesia and it was not painful at all. If the tumor turned out to be Gleason 4+3 or higher you should go for treatment asap, if it is 3+4 or 6 you should go for AS if your urologist does not oppose AS in your particular case. Your PSA density is 0.12 ng/mL but it does not mean much in your case bc it just helps to decide whether you should go for an biopsy or not. If your MRI was negative then you can forgo the biopsy atm, but it was a PI-RADS 5 so you gotta take the biopsy to know for sure how lazy your PCa is. You have BPH and that contributes about 1-2 ng/ml increase in PSA level, the rest is from PCa activity.
@@keithcolegrove2924 I believe patients can only be treated without an biopsy if PSA levels are higher than 40 ng/ml. At that level, almost all of the patients have PCa. If your PSMA PET CT scan came back positive with very high PSMA uptake in your prostate and if you want to treat without going for an biopsy, and your urologist agreed to do so (I doubt it), IMO it is not a bad idea too, given the PI-RADS 5 category in the MRI scan result.
Just this past fall of 2023 I had a 12 needle biopsy, 2 cores Gleason 6 @ 15% of tissue and 1 core Gleason 7 also 15% of tissue. The urologist that did the biopsy took 2 weeks to get results back and is located 3 hours from my home. I told him I didn’t want to keep going back to him and wanted someone closer. He responded that he makes his living operating on prostates! I spent 2 months waiting for an appointment with a urologist closer to home and when I finally saw him, he spent probably less than 5 minutes with me and didn’t explain my pathology report but did give me a copy of it, which is how I know what I have. Here again he’s all about surgery. I’ve had a CT scan and a bone scan both negative for any spread. I’m considering SBRT, but I’m really annoyed with our medical community.
Find out if you’re positive for BRCA 1 and BRCA 2. Get a genomic test done to see if you have aggressive cancer. If these come out favorable, and you only have one core of Gleason 7, at 15%: In my opinion you could be on active surveillance. I am.
I second the recommendation on getting a genomic test. I had one and it showed that my cancer had a very, very, low likelihood of spreading despite my Gleason 7 diagnosis.
@@suggarface1 I had the Decipher genomic testing. It is the most pessimistic of the two or three major genomic tests. If you get a favorable result on their test, then you can be a lot more confident about the results. Good luck.
This is one awesome video for men newly diagnosed with pc with tons of info and showing there are many options, with active surveillance being available to lots of men with small amounts of prostate cancer! Its the the mental thing that is so hard to handle! Thanks Alex and what a lovely jacket!
I am a 3+4 with 40% in one core. If I were 3+3 I would never do treatment ever I would get my PSA monitored and work on all the other lifestyle changes.
Very good informative story. I know what he's talking about regarding a busy urologist. Mine ordered a bone scan to see if my lesion spread to my bones and I was waiting in the room for her and I heard her calling the hospital to get the report of my scan that was done 2 wks ago so she could talk to me about it for 2 min. My insurance did not want to pay for the scan, but was OK with me getting a biopsy. Anyway I paid $325 for the scan and my ins paid $25, so I was pissed about that on top of my urologist could hardly be bothered with the results. So I'm off to a great start with my dr and my medicare advantage plan in rural America.
My urologist immediately jumped to prostate removal and did not explain any other options to me at all. He said let’s schedule the surgery and if you have questions, we could talk before the surgery but let’s get it on the books
I'm in the UK and was diagnosed with prostate cancer in late 2010. I was given the option of surgery or active surveillance but the urologist did not push one way or the other. I chose active surveillance, which continues. I've had three biopsies, the last of which was a template version where 36 cores were taken and one core was found, length 1mm. The grading has remained at 3+3 throughout. I've had two MRIs with the latest PI-RADS score in 2021 of 2. As part of my active surveillance I have 6 monthly PSA tests. The main issue that I have had with my prostate is poor flow and urgency which is down to prostate size. (My prostate volume in 2021 was 156ml). This is now under control with medication. I take Tamsulosin and Finasteride and my PSA score is back to the same level as 2010.
This diagnosis echoes my experience with my urologist. I had a 12 core biopsy with cancer in one core at 2%. I had a Gleason 6. I was strongly being directed into surgery immediately. My urologist told me, “I am a surgeon.”
Just had mpMRI and have PIRADS 4. Waiting to schedule a biopsy. My urologist is on top of things. This channel is very helpful. Plan to give a donation to you and my company will match.
Same with me. Same score. Doc wants biopsy right away.I want to wait & see. I read about 4k score & prefer doing that 1st.Not big on the biopsy myself. I'm currently doing the JT protocol with fenbendazole with quite a few other supplements , modifying my diet big time..Lots of research out there supporting this protocol even as preventative.
@@DerekTaylor88 Yes PIRAD4 , thinking I want the 4K score first myself. There is another blood test more specific to prostate cancer PSE-EpiSwitch an accurate test up to 94% probability....just released late 2023...not widely available yet.
Excellent video!! Very much needed, and educational for men. I had a similar situation as his, at 65. Men must realize, that you have to do your research. And lots of it. Or you will end up on the conveyor belt, when it wasnt necessary🤔👍😅
I have low risk PC, and is on active surveillance. I must be crazy because it doesn't bother me,and in fact I am grateful that what I have is not aggressive PC. I had been educating myself on PC long before my diagnosis so I was prepared for any scenario.
Bill Manning is right, you have to be your own "case manager". Doctors don't have the time to do it. I feel like the information I get from following Dr Scholz, Dr Morgantaler, Dr Ahlering, and Dr Kwon's, combined knowledge is a better guide of what to do than the advice from any PGY3 Urology Fellow or Endocrinologist I encounter at the VA hospital. If I bet wrong, well, whose life is it anyway? Not theirs.
What a great video. Yet another. Looks like I've been bitten, and your site is the best I've found so far to help me navigate. Oh, and what a fabulous host.
Was on Active Surveillance myself for 5 yr. or so with an excellent urologist; however, last year I underwent TURP surgery to deal with my BPH. My PSA few months pre-surgery was 12.5 (with Flomax and Avodart). 5 months post surgery, and off the pills the result was 18.6 which raised some concerns with my urologist. Have had a bone scan that shows an issue in the lower lumbar (L2-4) region, , but this could easily be from a climbing accident in the 80's; Actually had a prostate biopsy this morning, so will be interesting to see the results and another PSA test scheduled for early Feb. Categorized as Gleason 3+3, Pirads-3 at the moment.
I had PAE done a yr ago. prostate went from 110cm to 65cm but has since grown to 84cm. PSA 13 MRI PIRAD4 doc wants biopsy asap. I'm hesitant..Trying alternatives even as preventative if I dont have C
@@DerekTaylor88 With PSA 13 and MRI PIRADS 4 you SHOULD go for a biopsy, do NOT hesitate nor try the alternatives. The odd that you are habouring a clinical significant cancer is VERY HIGH (> 60%).
Not to disparage urologists, this man's story supports the concept that urologists make more money scheduling tests and surgeries. To be fair, this gentleman isn't a typical patient. He took charge of his health, unlike most people, who just want to be directed. It's MY HEALTH, thank you, and I'll be in charge. If that's a problem for my urologist, I'll fire him. If I can't find a urologist who will allow me to manage my health, I'll do without. The downside of letting "health professionals" run my life is, in my opinion, just as bad as the alternative.
I really like this channel. Back in January 25, 2022 my PSA was 2.93. August 10, 2022 psa was 3.99. February 19,2023 psa was 3.19. Now July 19 2024 its down to 2.48. So much anxiety came off me today. Thanks to God. And changing my diet.
Great insight. I have also participated in a longer surveillance before treatment and I have a very good urologist who taught and coached and discussed treatment options. We should work to be self care case managers and help others help us.
I had quickly raising PSA in 2015. Had 12 needle biopsy. Urologist said less than 5% cancer in one sample. Gleason score of 6 Radiation oncologist ordered a prostate MRI. Found out Cancer spread to Seminole vessels. Had 25 days external radiation then internal radiation. PSA went to 0. 8 years later PSA was rapidly raising again. Had ct scan and bone scan. Cancer spread to lymph nodes in pelvis. Referred to medical oncologist. Been on casodex and lupron Depot 22.5 for the past year. Last PSA was just a little over 3. So have to stay on same treatment till hopefully PSA goes back to 0. Next PSA test and treatment in few weeks.
This is TRUE when combining with an MRI scan. The positivity and specificity rates are over 90% for the combined tests. Myself, I have gone through that combo recently to rule out PCa. I have a persistent high level of PSA around 20, and the MRI+PSMA scans indicated that I have no prostate cancer, which was later "confirmed" by biopsy as correct.
@@hn5460 I now have a PSA of 20 ... which I was told made me high risk. My other diagnostics; are stable but surgery is being strongly recommended. I am curious - what did your providers tell you was causing the elevated PSA?
@@michaelboyle1426 - Risks of finding Gleason 7+ prostate cancer for patients with PSA 20+ are high, around 70%. But once the biopsy samples were taken and the results were known, there is no more risk of prostate cancer involved, except for the future risk of recurrences. So what were the biopsy results? Why did the doctors recommend surgery, based on the scan and biopsy results? - What do you mean your "other diagnostics are stable"? Give more details if you can. - The main causes of elevated PSA at 20+ levels are prostate cancer and prostatitis. In my case it was prostatitis caused it.
I am 69 yrs old and have Gleason 6 prostate cancer diagnosed 5 years ago. Watching and waiting. Educating myself. I now know everything affects PSA. Bowel movements, bicycle riding, UTI's, biopsies, ejeculation, thinking about sex, etc. My PSA now is 6.7 which is LOWER than it was 5 yrs ago. I do have a question: why is it that once a diagnosis of cancer is stated that other BPH options are unavailable?
Interesting great level of information. It is good to be educated. Particularly noting that in Australia I am shocked that any reference we make to specific focus therapy methods both myself and two other friends has been responded to by our specialists with "I don't know what that is". "If we treat, we treat with surgery or radio therapy and treat the whole prostate". It should also be noted that none of us know what type of prostate cancer we have. One was advised that they "in relation to treatment options they would benefit from an appointment with a prostate specialising nurse". At the appointment the nurse advised that they can only talk about the basics and no options apart from their standard treatments (full surgery, full radiotherapy). The patient also did not know he was expected to choose one at the meeting. This all seems pretty shocking to me.
Man this guy’s story is exactly the same as mine. Glad I didn’t listen to urologist who insisted on removing my prostate. The after effects of surgery are absolutely horrific for most men. Animal protein is like meth to prostate cancer. Cut that out of your diet and live a long healthy life if you have low or intermediate grade prostate cancer.
Not so sure about the meat diet affecting the prostate cancer. Talks on this channel are showing studies finding no correlation on prostate cancer and diet. I'm not a meat myself, but just want to say.
Yes, I have seen and read of many folks who really want to connect diet and Prostate cancer but the rigorous scientific studies don’t seem to back up that idea. (Of course, diet and exercise are important in general.)
Yes, I have seen and read of many folks who really want to connect diet and Prostate cancer but the rigorous scientific studies don’t seem to back up that idea. (Of course, diet and exercise are important in general.)
@@glenrose7925 yes i agree with u, I eat and drink whatever i want lots of meat every day, i have gone to 3 urologists and none have mentioned anything about diet, my pc is hereditary
Great video. I live in San Diego. I would like to know what Dr did the 3T MRI. I had MRI done JAn 2023 Had Pirad 4. Did biopsy Mar 1. Within a week I got a nasty infection. Negative biopsy-but still lingering effects from infection
Bottom line is Active surveillance is just waiting for the inactive tumor to get active...and it always does.Biopcy is good only to attablissh the Glysome Score and no point doing second or third on the same tumor as it prove nothing.MRI does the same without the hustle. I did active surveylence 20 years from the time the tumor was inactive but sure in 15 years it was active . With the choice of treatments today there is no justification for surgery if the tumors are still in the prostate ....Just remove the tumors. Most clinics will advice otherwise but now I monitor it myself and if another tumor is detected it will be removed whilst it is small because the aftereffects are worse if it is allowed to grow into active tumor.
Thank you for your insights Sir! Your info makes us think about this which is really good to try and get information on different levels. I am 3+4 =7 with a 5.3 psa this is all new to me and I want to ...have to think before I make ANY decisions from here on out! Thanks man!
You look young and with a PSA of 13, it doesn't look good unless you have prostatitis. You should go for another biopsy if the first 2 ones found no cancers nor inflammation. Prostate cancers in younger men tend to be more aggressive.
I was on watchful waiting for about the same anount of time. Had a PSA of 4.1. My problem was l quit testing after 5 years. After about 14 years finally got a PSA test. Unfortunately all bad news, 87.1 PSA, immediately got biopsy. Gleason of 8. Cancer in 7 of 12 cores. PSMA test Wednesday, most likely metastatic. Don't make my mistake. Get checked.
@spitfirekid1 PMSA test showed it was contained. Had RP on October 23. It did spread to lymph nodes. 3 of 9 were cancerous. Initial PSA was 1.6. Doing new test Thursday.
No. The appearances are very different and all the BPH "lumps" are in the transition zone where there are much less chances for having cancers compared to the peripheral zone.
My husband was diagnosed with Gleason 8 prostate cancer and just had a psma test that showed no metastasis to bones or anywhere else, is he a good candidate for active surveillance? , he will be going to the dr next week and is inclined to want to do that, he is 76 yrs old in good health
Alonzo Mourning the basketball player recently had his prostate removed. Wonder was it that serious. Well i just read in 2022 stage 3 and 2023 he had Glesson score of 8
In the same boat, had problems getting mri. And doctors have no time for me. Fighting to get a reason for surgery. Do not get straight up answers. 4 doctors so far
Excellent video and great info. He also mentioned diet and exercise, and it would have been interesting to hear how he specifically modified his diet. Also, did he start any supplements, like saw palmetto, etc.? While I'm low risk also, those are a couple areas that of interest to me, and do they really help while on active surveillance? I also think it would be helpful to reiterate that having sex, riding a bike, etc., within 48 hours of a PSA test can skew the results, and not in a favorable way. Thank you both for sharing this video!
What about Gleason 4+3? I am dramatically changing my diet to Mediterranean and am willing to pay for three MRIs / three PSA test per year for the rest of my life. Would this allow me to make a decision for Active Surveillance. Comments are welcome!
I'm curious to know what his Gleason score was. At 3+4, with PIRADS 4 and 5, I'm on the fence, and in the gray zone. It's encouraging to hear that his PIRADS went down after some years, but knowing his starting point would be useful, I think.
I have your same numbers. Pirads are not important because you know you have cancer already. I have been close to 4 years of AS. I will get my Targeted biopsy perineal this Dec
Does anyone know if there’s such groups in Europe? Great video! PSA 5.8 and PIRADS 4 with one lesion visible. Targeted biopsy done, waiting for results. 🤞🙏
I read a comment from France who asked to join a support group online in Canada with the Canada Prostate cancer foundation. They also have a yt channel… I realize now you were looking for the surveillance group 😁
@@DerekTaylor88 After lots of research, I found an experienced urologist trained with Koelis system which fuses the MRI results which leads to a more accurate targeted biopsy combined with the transperineal method. This way you boost chances of hitting the suspected area while minimizing to almost zero the chances of infection. Doctor took 16 cores from which 5 within the Pirads4 indicated area. Small blood in the first 2 urine, no pain and 100% in 2-3 days. The only considerable pain in during the bigger needle for anestesia, the one that goes a bit deeper. If feel it for a few secs but then no pain at all during the shots. Took around 30-40mins. Highly recommended over the transrectal biopsy. Good luck!
I'm on a lot of prostate cancer forum boards and that word cancer invokes such fear they want it out but the reality is meeting with the top surgeon just yesterday he said there's no guarantee that gets rid of it so I imagine they're surprise when seven years later pops back up and they don't even know that's a possibility plus, they might have incontinence in ED
Im exactly same , had a small sign of cancer in 2008 . Read a book " anti cancer new way of life " i took the advise on diet , haven't had a problem since despite annual checkups
I just had my 3rd MRI which showed a little something different than the last one so I’m going for a second biopsy in 2 weeks. I have low grade 3+4 Gleason score . My PSA is staying around 8.1,8.2
Over 50% of my prostate is Gleason 6. They tell me this is fine. two of the 12 cores were 90% Gleason 6. Nine of the twelve cores show cancer. How long will this be just fine?
Biopsy will accelerate cancer or will induce cancer and they Know , do only if necessary after had done different tests possible suspicious there’s cancer otherwise don’t do it!!!
I had ED for a few years before I found out I had prostate cancer. Turns out there is this massive tumor attached to a nerve. Radiated it 3 months ago and am waiting. ADT has shut it all down now. Prostate removal was an option which I said no. Why do that when radiation can be an option?
One thing I notice about many they don't ever talk about their Gleason score and not all prostate cancer is the same so it's really not relevant if you actively monitored a 3+3 versus a 4+4 or 4+3 it needs to be more specific to help individuals versus yeah I got it and I never did anything about it. Well, if you were a 3+3 Gleason score no kidding he probably never never had to in the first place. It's not some giant lifestyle change that help to you. It was never going to spread in the first place Now the point of this is that so many of these urologist many years ago wanted to zip out peoples prostate when they had no business doing so the intermediate favorable risk prostate cancer is the 3+4 with a higher recording four and the 3040 is a different cancer than a 3+3 here's another thing I noticed you'll hear men say yeah I had a process to me but and I'm still alive 15 years later but they don't mention they haven't been able to have an erection for 14 years and they haven't not been able to wear a pad for 14 years. I don't know why submit her soul uninformed about something this series, or unwilling to discern the different types of prostate cancer, and understand it.
MRI alone misses out 20-30% of cancers especially when the lesions are smaller than 1 cm. With a 45 cc prostate and some form of prostatitis, if your PSA level is higher than 10 or so, or the digital exam raises concerns then a biopsy is the next step to do.
I have to imagine that now AI is scanning through all of your MRI slices and determining your PI-RADS score and volume/density. Maybe a doctor looks it over afterward?
I eat well very healthy. I play Tennis almost every day. I'm 70 years old have a p s a of twelve point eight. But..... I have a Pi-Rad five tumor!!! THAT scares me. Any thoughts ANYONE!? I feel like doing NOTHING! Im favoring Brachtherepy . Either LDR or HDR ( I like this one BETTER).
I wanted it out,,,but instead have gotten chemo- radiation. Psa goes away then rises. ADT and bone chemo still whating on Pluvicto standing in line....wish they'd took it out before it became advanced
What an excellent video! I was diagnosed with 3+3 prostate cancer in 2017 . I went on active surveillance for several years until my PSA went to 18.7 and a3+4 gleason score. I chose HDR brachy therapy as my first form of treatment with 5 weeks of external beam radiation. My PSA decreased to a nadir of 1.1. However my PSA started creeping up to 3,5 at which point I took a PSMA Pet Scan which showed some recurrent cancer,,,still localized. At that point I contacted UCLA and Dr. Leonard Marks for a second opinion. He informed me I was not a good candidate for HIFU but was better suited for whole gland cryo therapy. That was 7 months ago and now my PSA is at 0.67. If not for PCRI and their informative videos I probably would have had an unnecessary prostatectomy years ago. Thank you PCRI.
Why were you not suitable for HIFU?
@@alanrobinson2229 Too much calcification or hardened tissue whereas the the ultrasound cannot penetrate.
How are your side effects?
What was your psa upon diagnosis of your 3 + 3?
@@schmingusss Ithink it was still around 10-12.
Excellent.
I would like to hear him talk further about his diet, exercise, lifestyle changes that helped him recover.
Great discussion. My doctors- Atlanta and Charleston disagree with my decision to "watch" my prostate cancer. Prostate cancer is still big business. This probably effects medical decisions and medical advice. I have modified my diet, increased my exercise, dropped alcohol, meat, trying hard to do my part. Age 77, do not need all those side effects of hormone therapy. JLH
What's your Gleason score? What percentage I'm assuming you have some 4 in one of the lesions.
If your Gleason scores are less than 8, probably you made the right choice. Life expectancy for a 77 year old male in NY, USA is 8.77 years. Take that into account when making decisions.
I’m not sure how long I have had Prostate cancer (pc) but think it’s about 12 years and found out that I had just a little pc. A Dr in training didn’t think I did but my Dr said I did but from this I gathered it was very little. Any way it became a journey of pca checks about every 6 months including a biopsy and at 94 still here . Dr did tell me something other than pc would kill me so I gathered mine was pretty small and still pca route!
@@keithwalker6892 WOW! You have made it a long way! Did you ever smoke or drink? That is a success story sir.
Thanks for the information. I sensed that the Urologist was strongly steering me to surgery while downplaying any other options. As I learned more about my Gleason 4+3; 3+4; and 3+3 in 3 of the 12 random biopsy cores; I became less and less inclined to have surgery. I have found that it is better not to let anyone rush you into a particular treatment. At this point I am more concerned about the treatments than the cancer!
IMO, with 3 out of 12 cores have cancer with one 4+3 and one 3+4 you are definitely not a good candidate for AS unless you are over 70 yo. Listen to your docs and go for treatment asap.
@@hn5460 I'm in my mid sixties and other than the prostate issue, I am in excellent health. I have had MRIs; PSMA/PET scans; X-Rays, Bone scans, CT scans, etc., all came back showing no spread outside the prostate. I have seen four doctors and unfortunately there is a financial incentive for doctors to rush patients into treatment. From everything that I have read from the leading cancer institutes (and my doctors), prostate cancer does not spread quickly like other cancers. We are talking 5 to 8 years in my case. I also had the Decipher genomic test done on my biopsy sample and the test reported that my cancer is not likely to spread quickly. I am concerned about having a doctor rush me into treatment until I am confident that I am getting the right treatment and that the side effects are not life altering. I understand you advice and I appreciate it. I wrote this long explanation to let you know why I am taking the approach that I am...at least for now.
@@hn5460 I was just diagnosed with Gleason 6, 3+3 with 2 out of 12 , any suggestions,? Thank you
Gleason 6 is AS
@raulvaldes270
Hi,
Your case is an easy and clear cut one: Be on active surveillance. Do not let the fear of haboring cancerous cells in your prostate makes you make irrational decision. I am pretty sure any good urologist will advise you just that.
Some men with Gleason scores of 3+4 can be good candidates for active surveillance as well, let alone you. Your biggest enemy right now is not the indolent Gleason 6 cancer, but the uneasy feeling of having prostate cancer. A Gleason 6 cancer can stay in its laziness indefinitely.
My second suggestion is to change your diet to a plant based diet (whole grains, leafy vegetables, nuts, tofu, beans, lentil, legumes, fruits...) with minimum processing. You can incorporate fish and other seafood to make your meals enjoyable. And remember to stay away from saturated fat (coconut oil, palm oil, animal fats). Olive oil and canola oil are 2 good oils you can use daily (ignore all the talks about the untrue pro-inflammation of canola oil).
I have been going to Sloan Kettering in New York City for almost ten years. I am now 62. I have Gleason 6 and am a patient in the active surveillance department at Sloan. I have a bi-annual appointments with a PSA and digital exam. Every 1.5 years I have an MRI and every 3 years a biopsy. I just had my 3 year biopsy with ten random cores and all were benign. The MRI was clean and PSA was 2.2. The doctors at Sloan do a great job of educating the patients. I would have had surgery ten years ago. However, Dr. Ehdaie, was amazing. He took the time to educate me, explained how Gleason 6 behaves and had a lot of data to back up his arguments. I was sold after that, and remain grateful to Dr. Ehdaie for guidance to be an active surveillance patient.
Looks like a biopsy was unnecessary in your case. Can't believe you agreed to have that done, with a low PSA. Biopsies can have potential lifelong consequences....
Good to hear I live in Astoria right over the bridge from Sloan; I just had my PSA jump from 2.1 to 3.2 after two years at 2.1, been on Avodart so double those numbers. My first MRI 2 years ago showed PRAD 1, the one from last week is PROD 4 but in the APEX with only one small 1.0x0.8 suspicious lesion. I need a biopsy to see my Gleason score but could still be negative. Let's see my urologist is not worried, all contained no protrutions, all else unremarkable.
He told me get the biopsy and you can go wherever you want.....Yikes
PSA are not enough evidence by themselves. I had my first biopsy with a 4.4 PSA. As explained at Sloan, they do find Gleason 7 at times with a low PSA.@@AnthonyShaw-ty9pi
A biopsy seems like the right approach. Don't panic, worst case you are treatable. I highly recommend you go to Sloan if the biopsy is not benign. Wishing you the best!@@johnmchale8308
Dont do the trans rectal biopsy !!! In england they don't allow it. transparennial Biopsy !!! no chance of INFECTION.
Thank you so much for sharing this man's incredible journey. I was diagnosed in 2014 and have fought with every urologist I have encountered in my moves around the country due to employment. Thankfully, I met a general practitioner whose father had advanced prostate cancer and who did research, especially in European journals, that led to alternatives. I am still waiting to meet a urologist who is adequately informed and possesses the humility necessary to learn something new.
Can I ask what alternatives have you done or doing? I'm currently doing JT protocol with Fenbendazole also doing ivermectin & quite a few supplements. I have an enlarged prostate and had PAE done a year ago after wearing a catheter for 6 months (No fun).1 yr later my PSA went to 13 and had an MRI which came back with abnormalities & a PI-RAD score of 4.Doc wants me to do a biopsy ASAP. I prefer not to & want to continue my protocol for a few months then have another MRI.
@@DerekTaylor88
Seen your post, I had a scare back in 2008 have been on active surveillance ever since.
I recommend a book "Anti Cancer a New Way of Life ".
I went by recommendations there ,turmeric with black pepper , also lycopene from tomatoes is beneficial , I eat cans of baked beans etc .
Haven't had a sign of anything despite annual psa checks and MRI scans ,even though my psa is high I don't think that's always relevant
@@DerekTaylor88 sorry it took me so long to reply. I didn't see this. He put me on metformin, a statin, and an anti-inflammatory. The statin is crestor and the anti-inflammatory is turmeric boswellia. My PSA went from 8 to 2 and my MRI was clear. If I were in your shoes, I would get a targeted biopsy. I also got PAE.
@@mulletheadbanger Well I am doing everything you said but no beans bro! You cannot have carbohydrates if you have prostate cancer man!
@@ricknowak4582
Appreciated, I'll take note .
Thanks for this interview. Education provides strength in our decisions. I'm 3+3 with fluctuating PSA readings for two and a half years.
Same here I'm 3+3 fluctuating PSA from 15.4, 12, 19, 17, 15.4, 15 cycling shoots PSA up what i was never told. Active surveillance since June 2020 living in UK
Same here. I am 3+3, 4 years now with psa rising from 5 to 8 in 4 years. Initially i was canalised to operation table but refused.
@@ThePatto56 15? 15 anything is not good sir.
Still today many urologists jump to surgery right away.
Absolute truth👍
They do thats what i was told, straight away but i have educated myself more about my diagnosis and its 3+4 pi rads2, so iam looking into alternatives, rather than surgery and this channel has been a complete eye opener
Yes they do. I’m so over doctors appointments and ridiculous charges out of my pocket plus I have insurance.
It has turned into an absolute money grabbing nightmare. Just like everything else.
$$$$$$$$$
@@hyway62 Yes...........I am 3+4 with 5.3 PSA I too am really educating myself a lot.
This was a GREAT video, and very helpful. I went thru my 50's and 60's with a PSA of 2. At age 68 it jumped to 4.5 in one year, then 7.03 at age 70. At this point my urologist wanted to do a trans-rectal biopsy on me. He said no prior PHI or MRI testing allowed beforehand. This did not sit well with me since, I had no family history, normal DRE, no urinary symptoms, and a normal ultrasound. I got a new urologist who allowed my requests. My PHI came back at 60 (bad), and my MRI came back PIRADS-5 (bad). I have a 17mm lesion on the entire left side of prostate in all three areas, and the right side is clear. I have a trans-perineal targeted biopsy scheduled in March 2024, 2 months from now. The lesion has not broken thru the capsule. At age 70, with no urinary systems, I'm still a bit hesitate about getting the biopsy, with some fear of needle seeding spread to outside the prostate. Mom and Dad lived to 93 and 98 years old. After watching all of PCRI's great videos, I would go with radiation for sure before surgery. Prostate volume is 58cc. Would like viewers to comment of whether Active Surveillance might be an option for me, for a while before submitting to that biopsy. I have read that even PIRAD-5 MRI's can come back negative, or Gleason 6 at times. I appreciate all comments from everyone. Thanks. Keith
Like my story bro. I have a Pi-Rad five lesion. Get the PSMA PET t scan. No biopsy! Absolutely not! I got one and I truly regret it. I am not the same person. I PEE more at night!!. And when I have an orgasm I bleed and it's very uncomfortable almost hurts. With the MRI and PSMA PET scan. You don't need a BIOPSY ! You have a pretty severe case brother. I am going with BRACHYTHEREPY and target ONLY THE LESION !!!
@@ricknowak4582Are you saying that you can get treatment without a biopsy, if your PSMA Pet scan comes back with bad news?
Hi Keith,
With a MRI PI-RADS-5 you are very likely to have PCa. You can go for a PSMA PET CT scan but I am confident that it will be positive too, and it is a waste of money. It will only make sense to take it before the biopsy if the MRI was negative or returned a PI-RADS < 3.
Now with a certainty of a clinical significant PCa (Gleason scores > 6), what should you do at age 70? You are probably healthy atm, and expected to live an extra 5 years compared to the typical male at your age, so roughly for another 17 years.
Back to the tumor itself, my guess is, it is a Gleason 4+3 or 4+4, not the 3+4 or 3+3 you are hoping for. The PSA doubling time probably is about 2-3 years at the moment and that is good news. You can take time to think about all of this before deciding on your options. Having say so, I think you should still go ahead with the TP biopsy in March to have your PCa categorized properly. I have done it with local anesthesia and it was not painful at all.
If the tumor turned out to be Gleason 4+3 or higher you should go for treatment asap, if it is 3+4 or 6 you should go for AS if your urologist does not oppose AS in your particular case.
Your PSA density is 0.12 ng/mL but it does not mean much in your case bc it just helps to decide whether you should go for an biopsy or not. If your MRI was negative then you can forgo the biopsy atm, but it was a PI-RADS 5 so you gotta take the biopsy to know for sure how lazy your PCa is.
You have BPH and that contributes about 1-2 ng/ml increase in PSA level, the rest is from PCa activity.
@@keithcolegrove2924 I believe patients can only be treated without an biopsy if PSA levels are higher than 40 ng/ml. At that level, almost all of the patients have PCa.
If your PSMA PET CT scan came back positive with very high PSMA uptake in your prostate and if you want to treat without going for an biopsy, and your urologist agreed to do so (I doubt it), IMO it is not a bad idea too, given the PI-RADS 5 category in the MRI scan result.
@@hn5460 Thanks so much for your helpful information. Appreciate you!!!
Just this past fall of 2023 I had a 12 needle biopsy, 2 cores Gleason 6 @ 15% of tissue and 1 core Gleason 7 also 15% of tissue. The urologist that did the biopsy took 2 weeks to get results back and is located 3 hours from my home. I told him I didn’t want to keep going back to him and wanted someone closer. He responded that he makes his living operating on prostates! I spent 2 months waiting for an appointment with a urologist closer to home and when I finally saw him, he spent probably less than 5 minutes with me and didn’t explain my pathology report but did give me a copy of it, which is how I know what I have. Here again he’s all about surgery. I’ve had a CT scan and a bone scan both negative for any spread. I’m considering SBRT, but I’m really annoyed with our medical community.
Find out if you’re positive for BRCA 1 and BRCA 2. Get a genomic test done to see if you have aggressive cancer. If these come out favorable, and you only have one core of Gleason 7, at 15%: In my opinion you could be on active surveillance. I am.
You need to find someone who is sympathetic with active surveillance. You may be a prime candidate.
I second the recommendation on getting a genomic test. I had one and it showed that my cancer had a very, very, low likelihood of spreading despite my Gleason 7 diagnosis.
@@gary4451 Thanks for the info. Mind sharing which genetic test specifically?
@@suggarface1 I had the Decipher genomic testing. It is the most pessimistic of the two or three major genomic tests. If you get a favorable result on their test, then you can be a lot more confident about the results. Good luck.
This is one awesome video for men newly diagnosed with pc with tons of info and showing there are many options, with active surveillance being available to lots of men with small amounts of prostate cancer! Its the the mental thing that is so hard to handle! Thanks Alex and what a lovely jacket!
I am a 3+4 with 40% in one core. If I were 3+3 I would never do treatment ever I would get my PSA monitored and work on all the other lifestyle changes.
I have a 3+4 and a 3+3,they gave me two scores?
What have you decided to do as I also am 3+4 with 35-40% in one core and 3+3 in another? I'm still avoiding surgery to the best of my ability.
@ I went to mayo clinic had cryotherapy focal ablation. No ED no incontinence have my six month check up in a few days.
Very good informative story. I know what he's talking about regarding a busy urologist. Mine ordered a bone scan to see if my lesion spread to my bones and I was waiting in the room for her and I heard her calling the hospital to get the report of my scan that was done 2 wks ago so she could talk to me about it for 2 min. My insurance did not want to pay for the scan, but was OK with me getting a biopsy. Anyway I paid $325 for the scan and my ins paid $25, so I was pissed about that on top of my urologist could hardly be bothered with the results. So I'm off to a great start with my dr and my medicare advantage plan in rural America.
My urologist immediately jumped to prostate removal and did not explain any other options to me at all. He said let’s schedule the surgery and if you have questions, we could talk before the surgery but let’s get it on the books
Excellent information and outstanding video. Thank you for educating your followers!
I'm in the UK and was diagnosed with prostate cancer in late 2010. I was given the option of surgery or active surveillance but the urologist did not push one way or the other. I chose active surveillance, which continues. I've had three biopsies, the last of which was a template version where 36 cores were taken and one core was found, length 1mm. The grading has remained at 3+3 throughout. I've had two MRIs with the latest PI-RADS score in 2021 of 2. As part of my active surveillance I have 6 monthly PSA tests.
The main issue that I have had with my prostate is poor flow and urgency which is down to prostate size. (My prostate volume in 2021 was 156ml). This is now under control with medication. I take Tamsulosin and Finasteride and my PSA score is back to the same level as 2010.
This diagnosis echoes my experience with my urologist. I had a 12 core biopsy with cancer in one core at 2%. I had a Gleason 6. I was strongly being directed into surgery immediately. My urologist told me, “I am a surgeon.”
Just had mpMRI and have PIRADS 4. Waiting to schedule a biopsy. My urologist is on top of things. This channel is very helpful. Plan to give a donation to you and my company will match.
Same with me. Same score. Doc wants biopsy right away.I want to wait & see. I read about 4k score & prefer doing that 1st.Not big on the biopsy myself. I'm currently doing the JT protocol with fenbendazole with quite a few other supplements , modifying my diet big time..Lots of research out there supporting this protocol even as preventative.
@@DerekTaylor88 what is the JT protocol
Same here just got my results PIRAD4, he wants a biopsy after my UTI is cleared up.
@@DerekTaylor88 Yes PIRAD4 , thinking I want the 4K score first myself.
There is another blood test more specific to prostate cancer PSE-EpiSwitch an accurate test up to 94% probability....just released late 2023...not widely available yet.
A video to tell cancer patients that self monitoring and management is equally important than solely embarking on Urologist/Oncologist treatment.
Excellent video!!
Very much needed, and educational for men.
I had a similar situation as his, at 65. Men must realize, that you have to do your research.
And lots of it. Or you will end up on the conveyor belt, when it wasnt necessary🤔👍😅
I have low risk PC, and is on active surveillance. I must be crazy because it doesn't bother me,and in fact I am grateful that what I have is not aggressive PC. I had been educating myself on PC long before my diagnosis so I was prepared for any scenario.
I would have liked to hear about his diet change and exercise plan!
Another well done presentation.You are a gifted host- Thank you.
Thanks for sharing 🙏🏼 very brave decision 🤜🏼
Bill Manning is right, you have to be your own "case manager". Doctors don't have the time to do it. I feel like the information I get from following Dr Scholz, Dr Morgantaler, Dr Ahlering, and Dr Kwon's, combined knowledge is a better guide of what to do than the advice from any PGY3 Urology Fellow or Endocrinologist I encounter at the VA hospital. If I bet wrong, well, whose life is it anyway? Not theirs.
What a great video. Yet another. Looks like I've been bitten, and your site is the best I've found so far to help me navigate. Oh, and what a fabulous host.
Was on Active Surveillance myself for 5 yr. or so with an excellent urologist; however, last year I underwent TURP surgery to deal with my BPH. My PSA few months pre-surgery was 12.5 (with Flomax and Avodart). 5 months post surgery, and off the pills the result was 18.6 which raised some concerns with my urologist. Have had a bone scan that shows an issue in the lower lumbar (L2-4) region, , but this could easily be from a climbing accident in the 80's; Actually had a prostate biopsy this morning, so will be interesting to see the results and another PSA test scheduled for early Feb. Categorized as Gleason 3+3, Pirads-3 at the moment.
Wish you well!!!
@@MM-sf3rl thank you, I watch this closely due to family history.
I had PAE done a yr ago. prostate went from 110cm to 65cm but has since grown to 84cm. PSA 13 MRI PIRAD4 doc wants biopsy asap. I'm hesitant..Trying alternatives even as preventative if I dont have C
@@DerekTaylor88 With PSA 13 and MRI PIRADS 4 you SHOULD go for a biopsy, do NOT hesitate nor try the alternatives. The odd that you are habouring a clinical significant cancer is VERY HIGH (> 60%).
Not to disparage urologists, this man's story supports the concept that urologists make more money scheduling tests and surgeries. To be fair, this gentleman isn't a typical patient. He took charge of his health, unlike most people, who just want to be directed. It's MY HEALTH, thank you, and I'll be in charge. If that's a problem for my urologist, I'll fire him. If I can't find a urologist who will allow me to manage my health, I'll do without. The downside of letting "health professionals" run my life is, in my opinion, just as bad as the alternative.
I really like this channel. Back in January 25, 2022 my PSA was 2.93. August 10, 2022 psa was 3.99. February 19,2023 psa was 3.19. Now July 19 2024 its down to 2.48. So much anxiety came off me today. Thanks to God. And changing my diet.
Thank you so very much for informing us of your incredible choices and story. Well done Sir!
Great insight. I have also participated in a longer surveillance before treatment and I have a very good urologist who taught and coached and discussed treatment options.
We should work to be self care case managers and help others help us.
I had quickly raising PSA in 2015. Had 12 needle biopsy. Urologist said less than 5% cancer in one sample. Gleason score of 6 Radiation oncologist ordered a prostate MRI. Found out Cancer spread to Seminole vessels. Had 25 days external radiation then internal radiation. PSA went to 0. 8 years later PSA was rapidly raising again. Had ct scan and bone scan. Cancer spread to lymph nodes in pelvis. Referred to medical oncologist. Been on casodex and lupron Depot 22.5 for the past year. Last PSA was just a little over 3. So have to stay on same treatment till hopefully PSA goes back to 0. Next PSA test and treatment in few weeks.
What what your PSA or other biomarkers that compelled a biopsy?
What was your PSA at the start?
Great video by any chance can you get him back on to talk about his diet? Thank you.
Yes, absolutely! Great idea!
@@ThePCRI and if he used supplements to thank you.
Been here with the first urologist. So much still to learn.
Outstanding video. Very informative. Thanks for what you all do. Great information.
Very helpful I have prostate trouble I am 7 on the Glesson plan about 1 year
Why is no one mentioning pmsa scan supposed to detect prostate cancer even in small amounts have been in since at least 2022
This is TRUE when combining with an MRI scan. The positivity and specificity rates are over 90% for the combined tests. Myself, I have gone through that combo recently to rule out PCa. I have a persistent high level of PSA around 20, and the MRI+PSMA scans indicated that I have no prostate cancer, which was later "confirmed" by biopsy as correct.
@@hn5460 I now have a PSA of 20 ... which I was told made me high risk. My other diagnostics; are stable but surgery is being strongly recommended. I am curious - what did your providers tell you was causing the elevated PSA?
@@michaelboyle1426 - Risks of finding Gleason 7+ prostate cancer for patients with PSA 20+ are high, around 70%.
But once the biopsy samples were taken and the results were known, there is no more risk of prostate cancer involved, except for the future risk of recurrences. So what were the biopsy results? Why did the doctors recommend surgery, based on the scan and biopsy results?
- What do you mean your "other diagnostics are stable"? Give more details if you can.
- The main causes of elevated PSA at 20+ levels are prostate cancer and prostatitis. In my case it was prostatitis caused it.
Thank you for these videos! So helpful!
I am 69 yrs old and have Gleason 6 prostate cancer diagnosed 5 years ago. Watching and waiting. Educating myself. I now know everything affects PSA. Bowel movements, bicycle riding, UTI's, biopsies, ejeculation, thinking about sex, etc. My PSA now is 6.7 which is LOWER than it was 5 yrs ago. I do have a question: why is it that once a diagnosis of cancer is stated that other BPH options are unavailable?
That was very interesting and instructive. Many thanks…
Interesting great level of information. It is good to be educated. Particularly noting that in Australia I am shocked that any reference we make to specific focus therapy methods both myself and two other friends has been responded to by our specialists with "I don't know what that is". "If we treat, we treat with surgery or radio therapy and treat the whole prostate". It should also be noted that none of us know what type of prostate cancer we have. One was advised that they "in relation to treatment options they would benefit from an appointment with a prostate specialising nurse". At the appointment the nurse advised that they can only talk about the basics and no options apart from their standard treatments (full surgery, full radiotherapy). The patient also did not know he was expected to choose one at the meeting. This all seems pretty shocking to me.
Relatable and informative. 2009 Brachytherapy. Fasting extreme exercise, etc. Thanks. Wm. In Vencouver
@TopSpinWilly How old are you if you don't mind me asking ?
Man this guy’s story is exactly the same as mine. Glad I didn’t listen to urologist who insisted on removing my prostate. The after effects of surgery are absolutely horrific for most men. Animal protein is like meth to prostate cancer. Cut that out of your diet and live a long healthy life if you have low or intermediate grade prostate cancer.
Not so sure about the meat diet affecting the prostate cancer. Talks on this channel are showing studies finding no correlation on prostate cancer and diet. I'm not a meat myself, but just want to say.
Yes, I have seen and read of many folks who really want to connect diet and Prostate cancer but the rigorous scientific studies don’t seem to back up that idea. (Of course, diet and exercise are important in general.)
Yes, I have seen and read of many folks who really want to connect diet and Prostate cancer but the rigorous scientific studies don’t seem to back up that idea. (Of course, diet and exercise are important in general.)
@@glenrose7925 yes i agree with u, I eat and drink whatever i want lots of meat every day, i have gone to 3 urologists and none have mentioned anything about diet, my pc is hereditary
@@robertmonroe3678 agree totally
Great info
Great video. I live in San Diego. I would like to know what Dr did the 3T MRI. I had MRI done JAn 2023 Had Pirad 4. Did biopsy Mar 1. Within a week I got a nasty infection. Negative biopsy-but still lingering effects from infection
Thanks
Bottom line is Active surveillance is just waiting for the inactive tumor to get active...and it always does.Biopcy is good only to attablissh the Glysome Score and no point doing second or third on the same tumor as it prove nothing.MRI does the same without the hustle.
I did active surveylence 20 years from the time the tumor was inactive but sure in 15 years it was active .
With the choice of treatments today there is no justification for surgery if the tumors are still in the prostate ....Just remove the tumors.
Most clinics will advice otherwise but now I monitor it myself and if another tumor is detected it will be removed whilst it is small because the aftereffects are worse if it is allowed to grow into active tumor.
Thank you for your insights Sir! Your info makes us think about this which is really good to try and get information on different levels. I am 3+4 =7 with a 5.3 psa this is all new to me and I want to ...have to think before I make ANY decisions from here on out! Thanks man!
I would love to know what changes Bill made in his diet.
Me too plz
why is it that once a diagnosis of cancer is stated that other BPH options are unavailable?
Have had 2 mpMRI with Pirad 3. Doc pushes for a 3rd Biopsy with my stable PSA=13. What does a Pirad 3 mean?
You look young and with a PSA of 13, it doesn't look good unless you have prostatitis. You should go for another biopsy if the first 2 ones found no cancers nor inflammation. Prostate cancers in younger men tend to be more aggressive.
what gleason score are you
@@MyFrank71 Six
@@Allessio777 same as me
I had a psa of 12 before doing anything other than diet change. Last week, I had a cryotherapy procedure.
I was on watchful waiting for about the same anount of time. Had a PSA of 4.1. My problem was l quit testing after 5 years. After about 14 years finally got a PSA test. Unfortunately all bad news, 87.1 PSA, immediately got biopsy. Gleason of 8. Cancer in 7 of 12 cores. PSMA test Wednesday, most likely metastatic. Don't make my mistake. Get checked.
@@michaelbryant2071 just checking in how you are doing now and did your cancer turn out to be metastatic
@spitfirekid1 PMSA test showed it was contained. Had RP on October 23. It did spread to lymph nodes. 3 of 9 were cancerous. Initial PSA was 1.6. Doing new test Thursday.
I did mri first dr found lesion on it wants do target biopsy. I do not know the size from mri not seen report. Will the report give me the size.
The MRI will say how big
treat by observation and life changes
BPH can also minic lesion in MRI, is this true?
No. The appearances are very different and all the BPH "lumps" are in the transition zone where there are much less chances for having cancers compared to the peripheral zone.
My husband was diagnosed with Gleason 8 prostate cancer and just had a psma test that showed no metastasis to bones or anywhere else, is he a good candidate for active surveillance? , he will be going to the dr next week and is inclined to want to do that, he is 76 yrs old in good health
Alonzo Mourning the basketball player recently had his prostate removed. Wonder was it that serious. Well i just read in 2022 stage 3 and 2023 he had Glesson score of 8
Very informative. Thank you.
In the same boat, had problems getting mri. And doctors have no time for me. Fighting to get a reason for surgery. Do not get straight up answers. 4 doctors so far
Excellent video and great info. He also mentioned diet and exercise, and it would have been interesting to hear how he specifically modified his diet. Also, did he start any supplements, like saw palmetto, etc.? While I'm low risk also, those are a couple areas that of interest to me, and do they really help while on active surveillance? I also think it would be helpful to reiterate that having sex, riding a bike, etc., within 48 hours of a PSA test can skew the results, and not in a favorable way. Thank you both for sharing this video!
China Study. Watch documentary Forks over Knives.
How did he change his diet?
Liquid biopsy is now a non-invasive option.
What about Gleason 4+3? I am dramatically changing my diet to Mediterranean and am willing to pay for three MRIs / three PSA test per year for the rest of my life. Would this allow me to make a decision for Active Surveillance. Comments are welcome!
For specific questions and information, please reach out to our Helpline here: pcri.org/helpline
Getting trus test is great for density 4:20 4:21 4:21 4:22 4:24 4:25 4:25
I'm curious to know what his Gleason score was. At 3+4, with PIRADS 4 and 5, I'm on the fence, and in the gray zone. It's encouraging to hear that his PIRADS went down after some years, but knowing his starting point would be useful, I think.
I have your same numbers. Pirads are not important because you know you have cancer already. I have been close to 4 years of AS. I will get my Targeted biopsy perineal this Dec
Does anyone know if there’s such groups in Europe? Great video! PSA 5.8 and PIRADS 4 with one lesion visible. Targeted biopsy done, waiting for results. 🤞🙏
I read a comment from France who asked to join a support group online in Canada with the Canada Prostate cancer foundation. They also have a yt channel… I realize now you were looking for the surveillance group 😁
Can I ask how bad was the biopsy? MRI showed PIRAD 4 as well.Doc is pushing biopsy but I'm hesitant.
Your data is close to mine, but my PSA fluctuating up and down for 2 years. I'm 74 and am considering a second biopsy at 3 years.
@@DerekTaylor88 My husband had it done. It was no big deal to him. Fairly quick too. Easier than a colonoscopy for sure.
@@DerekTaylor88 After lots of research, I found an experienced urologist trained with Koelis system which fuses the MRI results which leads to a more accurate targeted biopsy combined with the transperineal method. This way you boost chances of hitting the suspected area while minimizing to almost zero the chances of infection. Doctor took 16 cores from which 5 within the Pirads4 indicated area. Small blood in the first 2 urine, no pain and 100% in 2-3 days. The only considerable pain in during the bigger needle for anestesia, the one that goes a bit deeper. If feel it for a few secs but then no pain at all during the shots. Took around 30-40mins. Highly recommended over the transrectal biopsy. Good luck!
Can I ask about his diet? No animal proteins?
I can’t believe somebody would just rush into it specially surgery how invasive it is
I'm on a lot of prostate cancer forum boards and that word cancer invokes such fear they want it out but the reality is meeting with the top surgeon just yesterday he said there's no guarantee that gets rid of it so I imagine they're surprise when seven years later pops back up and they don't even know that's a possibility plus, they might have incontinence in ED
Im exactly same , had a small sign of cancer in 2008 .
Read a book " anti cancer new way of life " i took the advise on diet , haven't had a problem since despite annual checkups
@ProstateCancerResearchInstitute, do you have any videos on Enlarged Prostate?
I just had my 3rd MRI which showed a little something different than the last one so I’m going for a second biopsy in 2 weeks. I have low grade 3+4 Gleason score . My PSA is staying around 8.1,8.2
What a journey ❤
Over 50% of my prostate is Gleason 6. They tell me this is fine. two of the 12 cores were 90% Gleason 6. Nine of the twelve cores show cancer. How long will this be just fine?
Why do urologists are pushing for biopsy?
They make a fortune and get to fly the F35 (DaVinci Robot).
$$$
Biopsy will accelerate cancer or will induce cancer and they Know , do only if necessary after had done different tests possible suspicious there’s cancer otherwise don’t do it!!!
Medieval sh&t…avoid at all costs!
biopsy provides a lot of acurate information ,often Pet scan is done first
Bill, I was wondering how did you change your diet
He mentioned the China Study. Watch documentary Forks over Knives.
I don't know what he has changed to, but the correct way to change your diet is: plant based diet with minimum processing.
I had ED for a few years before I found out I had prostate cancer. Turns out there is this massive tumor attached to a nerve. Radiated it 3 months ago and am waiting. ADT has shut it all down now. Prostate removal was an option which I said no. Why do that when radiation can be an option?
One thing I notice about many they don't ever talk about their Gleason score and not all prostate cancer is the same so it's really not relevant if you actively monitored a 3+3 versus a 4+4 or 4+3 it needs to be more specific to help individuals versus yeah I got it and I never did anything about it. Well, if you were a 3+3 Gleason score no kidding he probably never never had to in the first place. It's not some giant lifestyle change that help to you. It was never going to spread in the first place Now the point of this is that so many of these urologist many years ago wanted to zip out peoples prostate when they had no business doing so the intermediate favorable risk prostate cancer is the 3+4 with a higher recording four and the 3040 is a different cancer than a 3+3 here's another thing I noticed you'll hear men say yeah I had a process to me but and I'm still alive 15 years later but they don't mention they haven't been able to have an erection for 14 years and they haven't not been able to wear a pad for 14 years. I don't know why submit her soul uninformed about something this series, or unwilling to discern the different types of prostate cancer, and understand it.
I wish this institute was based in NC
It’s frustrating, cancer treatment hasn’t changed much since my
Mom passed from cancer 42 years ago. Options are cut it out, radiate it or Chemo it. 😕
Yes active surveillance is 1:43 1:45
Had mptesla mri came back normal except for prostitus and 45 cc prostate urologist still wants to do biopsy why??
MRI alone misses out 20-30% of cancers especially when the lesions are smaller than 1 cm. With a 45 cc prostate and some form of prostatitis, if your PSA level is higher than 10 or so, or the digital exam raises concerns then a biopsy is the next step to do.
I have to imagine that now AI is scanning through all of your MRI slices and determining your PI-RADS score and volume/density. Maybe a doctor looks it over afterward?
I eat well very healthy. I play Tennis almost every day. I'm 70 years old have a p s a of twelve point eight. But..... I have a Pi-Rad five tumor!!! THAT scares me. Any thoughts ANYONE!? I feel like doing NOTHING! Im favoring Brachtherepy . Either LDR or HDR ( I like this one BETTER).
I wanted it out,,,but instead have gotten chemo- radiation. Psa goes away then rises.
ADT and bone chemo still whating on Pluvicto standing in line....wish they'd took it out before it became advanced
These are heavy thoughtful choices that we all have to make.
55 psa here one day at a time
A trus test is much better 6:52 6:52 6:54 6:55
Very informative. Thank you.