UPDATE HIGH PSA

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OMI100

Member
UPDATE
i WAS LOOKING FOR MY ORIGINAL POST BUT IT MUST HAVE DISAPEARED:)
SHORT STORY BELOW:)

Hmmm
I have a thread or 2 on my PSA.
I was waaaay higher than you.
DR wanted to do a blind biopsy.
Not no, but hell no.
Lets do a 4K blood test.
Results were good.
Still over 4.
Lets do a blind biopsy.
Hell no.
Let do a 3T-MP-MRI.
results came back good.
I had an infection.
After getting the right antibiotics the PSA came down.
Blind biopsy is not the best if you needed one.
Go here and sign up and do your homework on PCa on testing and treatment option.
Do your home work and research.
Us TOO Prostate Cancer - Inspire
some info here:
The 4Kscore Can Accurately Identify the Risk of Aggressive Prostate Cance
Prostate infection

UPDATE 9-26-20
O.K.
Saw another post about high PSA so this a continuation of my very first post.
My Urologist keep retiring and I keep getting new "OLDER" ones:)
High PSA (HMMMMM I have had that for looong time)
BIOPSY....
Not NO but HELL NO...
3T MRI time again (#2 if I am counting correctly).
Results came back with some areas in question flagged.
BIOPSY TIME said my Urol.
Not NO but HELL NO I said:)
It is 2nd opinion time I said.
Did my research on Inspire and noted that one DR keep coming up as Platinum for MRIs.
DR. BUSH.
He had recently relocated to Alpharetta GA.
Called to see if he did 2nd opinion on MRIs.
Yep.
Packaged everything up and mailed to him.
Could have done phone consult but only a short 5 hour road trip and overnight stay :)
Appointment came and I went to his office.
Looked like a NASA command center with 24inch monitors all over his desk:)
He had both MRIs up and explained that first MRI (my words here) was garbage and unreadable.
Said the second was better BUT still not of best quality.
He said he thought he saw the areas that were flagged on the NEW MRI, but he said he did think the areas were of concern.
Said he could perform an MRI that day and give me a definitive report.
Hell YES...
Staff took me to a dressings room and I prepped for the MRI.
Was in the MRI less than 30 minutes after I agreed.
After the MRI was done I dressed and by the time I was out of the dressing room he had the MRI up on the computer in his office.
He went over the MRI in great detailed and said he could now clearly see the area in question (2mm).
He said the area was so small that it would be almost imposable to do a hit with a biopsy needle.
He felt that the area was NOT cancerous and saw no other indications of cancer.
He does have the ability to do real time in bore biopsies if needed.
I was not concerned enough to even worry after the discussions that we had while going over the MRI.
Said come back in year for another MRI if I wanted:)
BTW he did say I had a reeeeeeealy large prostate (HMMMMM my BPH).
BTW Dr, Bush is out of network and all is self pay, but he will work with individuals that may not be able to cover his normal cost.
O.K. so where I am at now..
NO PCa :)
Reeeeealy large prostate :(
Getting up every 1.5hrs at night to pee :(
Have decided I need to do something about that and am now looking at procedures to resolve that issue.
Just like PCa, there are all kinds of procedures, so I just need to find one that I am comfortable with and a provider that take insurance:)
Thats my story and I am sticking to it:)
 
Last edited:
Defy Medical TRT clinic doctor

AyePopi

New Member
It definitely pays to do your homework, and I've found the Inspire website invaluable in my prostate journey. Patients always assume their Dr is up to date on current technology, & best practices, but that's not always the case
 

rugbyhit

Member
Thanks for the info..... I'm preparing myself for the possibility of having prostrate cancer and doing a ton of research, so when I do need to make a decision, I'm ready to go.

Glad to know your journey has a relatively positive one....except that getting up ever 1.5 hr sounds tough
 

Joe Sixpack

Active Member
UPDATE
i WAS LOOKING FOR MY ORIGINAL POST BUT IT MUST HAVE DISAPEARED:)
SHORT STORY BELOW:)

Hmmm
I have a thread or 2 on my PSA.
I was waaaay higher than you.
DR wanted to do a blind biopsy.
Not no, but hell no.
Lets do a 4K blood test.
Results were good.
Still over 4.
Lets do a blind biopsy.
Hell no.
Let do a 3T-MP-MRI.
results came back good.
I had an infection.
After getting the right antibiotics the PSA came down.
Blind biopsy is not the best if you needed one.
Go here and sign up and do your homework on PCa on testing and treatment option.
Do your home work and research.
Us TOO Prostate Cancer - Inspire
some info here:
The 4Kscore Can Accurately Identify the Risk of Aggressive Prostate Cance
Prostate infection

UPDATE 9-26-20
O.K.
Saw another post about high PSA so this a continuation of my very first post.
My Urologist keep retiring and I keep getting new "OLDER" ones:)
High PSA (HMMMMM I have had that for looong time)
BIOPSY....
Not NO but HELL NO...
3T MRI time again (#2 if I am counting correctly).
Results came back with some areas in question flagged.
BIOPSY TIME said my Urol.
Not NO but HELL NO I said:)
It is 2nd opinion time I said.
Did my research on Inspire and noted that one DR keep coming up as Platinum for MRIs.
DR. BUSH.
He had recently relocated to Alpharetta GA.
Called to see if he did 2nd opinion on MRIs.
Yep.
Packaged everything up and mailed to him.
Could have done phone consult but only a short 5 hour road trip and overnight stay :)
Appointment came and I went to his office.
Looked like a NASA command center with 24inch monitors all over his desk:)
He had both MRIs up and explained that first MRI (my words here) was garbage and unreadable.
Said the second was better BUT still not of best quality.
He said he thought he saw the areas that were flagged on the NEW MRI, but he said he did think the areas were of concern.
Said he could perform an MRI that day and give me a definitive report.
Hell YES...
Staff took me to a dressings room and I prepped for the MRI.
Was in the MRI less than 30 minutes after I agreed.
After the MRI was done I dressed and by the time I was out of the dressing room he had the MRI up on the computer in his office.
He went over the MRI in great detailed and said he could now clearly see the area in question (2mm).
He said the area was so small that it would be almost imposable to do a hit with a biopsy needle.
He felt that the area was NOT cancerous and saw no other indications of cancer.
He does have the ability to do real time in bore biopsies if needed.
I was not concerned enough to even worry after the discussions that we had while going over the MRI.
Said come back in year for another MRI if I wanted:)
BTW he did say I had a reeeeeeealy large prostate (HMMMMM my BPH).
BTW Dr, Bush is out of network and all is self pay, but he will work with individuals that may not be able to cover his normal cost.
O.K. so where I am at now..
NO PCa :)
Reeeeealy large prostate :(
Getting up every 1.5hrs at night to pee :(
Have decided I need to do something about that and am now looking at procedures to resolve that issue.
Just like PCa, there are all kinds of procedures, so I just need to find one that I am comfortable with and a provider that take insurance:)
Thats my story and I am sticking to it:)
let us know what you end up doing for the large prostate.
 
Have you tried daily Cialis (i.e. 5mg) for BPH symptoms?



 

OMI100

Member
Yep. On 5mg of Cialis now. Not sure if it is helping or not, but it does have other positive attributes beside BPH and erectile help. I get up to pee about 4 or 5 times a night and only way to see if it is helping would be to stop taking it:) Getting up 4 or 5 times a night is enough:)
I zeroed in on PAE as least invasive and reached out to a DR at UNC who has done a number of PAEs. Spent about 45 mins talking with him on the phone this A.M. and am scheduled for the procedure on the 26th of October.
Insurance provides coverage minus my portion.
Search YouTube for PAE BPH for some interesting vids.
More to follow:)
My second choice was to find someone that did guided FLA for BPH. There are a number of good DRs that do that BUT seems the procedure is still EXPERIMENTAL for the treatment of BPH or whatever like word the insurance companies use. It IS approved for treatment of PCa (I think whole prostate removal?) BUT not BPH (limited removal of areas in the prostate).
My searching stopped as of 0830 this morning :) Way toooo big a bite ($$$) without insurance coverage for the procedure.
 
Last edited:

Blackhawk

Member
Yep. On 5mg of Cialis now. Not sure if it is helping or not, but it does have other positive attributes beside BPH and erectile help. I get up to pee about 4 or 5 times a night and only way to see if it is helping would be to stop taking it:) Getting up 4 or 5 times a night is enough:)
I zeroed in on PAE as least invasive and reached out to a DR at UNC who has done a number of PAEs. Spent about 45 mins talking with him on the phone this A.M. and am scheduled for the procedure on the 26th of October.
Insurance provides coverage minus my portion.
Search YouTube for PAE BPH for some interesting vids.
More to follow:)
My second choice was to find someone that did guided FLA for BPH. There are a number of good DRs that do that BUT seems the procedure is still EXPERIMENTAL for the treatment of BPH or whatever like word the insurance companies use. It IS approved for treatment of PCa (I think whole prostate removal?) BUT not BPH (limited removal of areas in the prostate).
My searching stopped as of 0830 this morning :) Way toooo big a bite ($$$) without insurance coverage for the procedure.

@Orrin Israel , I saw Dr Karamanian in Houston last year for MRI and in bore MRI guided biopsy. He is a FLA specialist (And a real gem of a Dr). He said due to the size of my prostate that FLA would not be a good choice (One of the reasons I trust him... He is not trying to sell what he does when it is not a good choice). Your prostate volume is more than double mine.

I researched the options in depth last year and HOLEP or TULSA Pro seemed the best options, most reliable success rates and appropriate for large prostate. There is a specialist at U of Indiana who is THE guy for HOLEP. Also potentially up and coming, ES‑ThuLEP. Madman posted some info: Ejaculation‑sparing thulium laser enucleation of the prostate (ES‑ThuLEP)

I know your approach tends to be towards least invasive options and respect that, but your prostate is a whopper, and from my research, these other options look to have more durable success rates. Maybe with PAE initially, if needed, could you follow up with Laser enucleation or TULSA at a later date? I don't remember which treatments preclude having which others if the first fails, but having some treatments first rules out certain other treatments for the future.
 
Last edited:

OMI100

Member
TY Blackhawk.
As PCa is currently not an issue, less invasive methods look better.
I had a phone consulate with Dr Isaacson a few days ago and went over the whole procedure to include good points and negative points.
PAE works better with LARGE prostates:)
I have one of those:)
Out patient (go in in the morning and out in the afternoon with NO CATH:)
Minimal recovery down time.
I understand that results may not be forever BUT if I can end up sleeping most of the night UNTIL some of the newer options are picked up under insurance coverage, that is O.K.
TULSA PRO Looks like a good option, but not for self pay:)
I will ask Dr. I if PAE rules out any other procedures in the future, just to make sure:)
 

Blackhawk

Member
TY Blackhawk.
As PCa is currently not an issue, less invasive methods look better.
I had a phone consulate with Dr Isaacson a few days ago and went over the whole procedure to include good points and negative points.
PAE works better with LARGE prostates:)
I have one of those:)
Out patient (go in in the morning and out in the afternoon with NO CATH:)
Minimal recovery down time.
I understand that results may not be forever BUT if I can end up sleeping most of the night UNTIL some of the newer options are picked up under insurance coverage, that is O.K.
TULSA PRO Looks like a good option, but not for self pay:)
I will ask Dr. I if PAE rules out any other procedures in the future, just to make sure:)

Thanks for sharing the info and your reasoning, and let us know how it all goes!
 
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