In 2006-07, I had a severe prostatitis infection and went into urgent care. It was diagnosed as prostatitis and my PSA had dropped to 2.1 but in my discussions with the doctor, I was left with the impression that it was BPH.

April 2013

I had a terrible flare-up in late April, 2013 and went into urgent care. The urgent care doctor did a DRE found nothing but ordered a PSA test that I had e-mailed to me over the weekend. She also put me on a half-dosage of Cipro. The PSA test showed 101.6. I panicked figuring out that a reading like this would normally be metastatic cancer. I found references on this site that says this isn't necessarily so. I managed to get my stepson on the phone who is a resident who told me that his information was that prostatitis could cause an elevation of 75. I also found a web reference from UCSF that it be as high as 100.

I discovered Yananow that terrible weekend. And found cases where prostatisis had even higher PSA readings.

Got into see me GP the next Monday. He did a digital, felt that it was inflamed but not terribly and no nodules but told me he didn't think it was cancer and referred me to a urologist. He said they normally don't take PSA tests in the middle of prostatisis infection.

Got to see the urologist on Tuesday and he assured me that he thought I had prostatitis and that the high PSA could be cause be that alone. He kept me on the dosage of CIPRO and wanted me back in two weeks after another PSA test.

May 2013

My PSA dropped to 19.4 after two weeks. Met with uro who said he didn't think I had PCa but that we would continue to work on bringing the PSA down. Negative DRE. Put me on a full course of antibiotics and wanted me to see another uro because he was moving his practice to Kansas City.

July 2013

PSA dropped some more to 9.08 but new uro said still too high and urged a biopsy. I thought that I needed a different course of antibiotics and he agreed to that for six weeks.

August 2013

PSA dropped again to 7.50, but free PSA; test was only 12%. At this point, I agree to a biopsy.

September 2013

Biopsy performed the trus showed my prostate was 100cc's and uro said that explains your high PSA and offered to discontinue the test but recommended going through with the biospy because of my low free PSA; %. I agreed.

October 2013

Results came out today. Showed one core positive for prostate cancer with approximately 10% and a Gleason score of 6. Another core was suspcious for carncinoma and another for high grade prostatic intraepithelial neoplasia--which I understand to mean pre-cancerous.

My urologist told me that he would do active surveillance if it were him under these circumstances. A follow-up PSA and DRE is scheduled for three months. He is also going to prescribe finasteride to try to get the size of my prostate down. I asked for this for two reasons, one to help with my symptoms and two to get it down to size where bracheytherpay is an option, which I would seem to ge a candidate for but for my enlarged prostate.

I would love to hear your thoughts on this. Did I make the right initial choice?

I've gotten more comfortable with active surveillance since being diagnosed a month ago with Gleason 6 in 1 out of 12 cores--approximately 10% of the core with no perineural invasion identified. My urologist was OK with AS too. Quarterly PSA tests are in my future as are annual biopsies--though I may push my next one to 15 months because of how my insurance works. My uro even talked about 18 months before the next biopsy. I'm 56 and meet even the strict John Hopkins criteria for AS except for my relative youth (no health issues to speak of).

PSA won't be taken again until January.

My concern is this. In looking at the pathology report, it shows other things to think about in addition to that one core:

1. One sample "suspicious for cacrinoma" with "small focus of atypical glands" next to sample with carinoma.

2. One sample with high grade prostatic intraepithelial neoplasia--is this what we would call a Gleason 2+2 or 2+3?

3. Many samples with "atypical glands" and "atrophy" including one that shows a "small focus of atypical glands" adjacent to a nerve "which may represent partial atrophy in glands adjacent to a nerve", however "the possibility of perineural invasion cannot be entirely excluded."

It seems to me that I have a pretty unhealthy prostate and have for years. I know atypical glands can be caused by prostatitis (and BPH?) and it has been confirmed that I have all three prostate ailments--BPH, Prostatitis, and PCa.

I'm limiting myself to one helping of red meat a month (only one since diagnosis) no dairy and eating fish and vegetables. Japanese food I like.

I'd like to have a couple of years before treatment -- maybe early 2016 or longer if possible with such a generally unhealthy prostate that seems on the verge of being riddled with cancer. Am I probably safe in doing that if I have a biopsy rougly in the middle of those two years with quarterly PSA tests?

I had my first post-diagnosis PSA test. After four months on finasteride, my PSA dropped from 7.6 to 2.89!

Here's my PSA history:

1/2007 - 2.1
4/2013 - 101.6
5/2013 - 19.4
7/2013 - 9.8
8/2013 - 7.6
2/2014 - 2.89

It seems to me that the drop from April to August was clearing up a prostatitis infection. The drop since August was treating BPH with Finasteride. Very little of this is cancer.

I'm seeing my uro day after tomorrow, but it looks like I'm staying on AS for awhile. Treatment may be more driven when Obamacare moves me off of my Cadillac Plan to a $10000 co-pay deductible. I didn't vote for him. That will happen no later than 2018, and I'll still have 5 years to go to Medicare after that.

I saw my urologist today. My DRE was normal. He said that because my PSA has fallen so far and is now in the normal range, that a follow-up visit and PSA test can be pushed back six months. A repeat biopsy may not be needed for two years. This is a bit looser than the usual active surveillance protocol. But I'm comfortable with it.

The side effect of rhinitis--basically post-nasal drip may or may not be from the Proscar. I read that nasal irritation is a less common side-effect but has been reported. It could be completely unrelated but it did start shortly after I started Proscar in October. But the value of Proscar in likely reducing the size of my prostate, possibly controlling cancer growth, and improving my urinary system, outweighs sneezing a bit more than usual and some mucous in the back of my throat. It might find a way to deal with it when I see my GP next week for a general physical.

I also told my uro that my goal was to push off any treatment to 2017 and he said that if my PSA's stay low that is likely possible. In fact, he suggested that where Obamacare is headed if a repeat biopsy shows no significant change, I might have trouble getting insurance to pay for treatment.

I mentioned that I if I need treatment I leaned towards radioactive seeds. He said with the size of my prostate (100 cc's before the Proscar Rx), that would be difficult. I pointed out that the size is likely down significantly because the PSA dropped from 7.5 to 2.89 in about four months. We basically left it as "we'll cross that bridge when we come to it".

All in all, very good developments. I'll check in again in about six months. Thanks to Terry and all for putting this site together. It has been of great help.

I am happy with active surveillance. My PSA started with a high of 101.6 about 18 months ago as a result of infection and after treatment for the infection and a year on Finasteride, it has dropped to 2.67 (2.89 seven months ago). Clearly, the high PSA was the result of BPH and and infection. That I submitted to a biopsy as a result of this got me diagnosed with prostate cancer that appears to be one of the "academic" kinds. It may have been better for me psychologically if it was never diagnosed. I spent a great deal of time worrying about it through April '13 to February '13 and wasted a chunk of my life needlessly.

My advice: If you have a strong indication that a high PSA is caused by infection or BPH--consider Proscar or Adovart. I know they come with the FDA warning that they may mask cancer, but my understanding is that that is inconclusive. I don't see my urologist until next week--if he feels something in the DRE, I'll let you know, otherwise I'll check-in in 6 months.

It was sad to hear about the passing of Terry. He helped me out so much and made this problem easier for me.

Just got my PSA results and they came back at 2.15, a continued downward trend. Since I still have my prostate, this is good. I have been on a weight reduction program for the last 7-8 weeks and have lost 35 pounds. I probably have about 30 pounds to go. I've been hiking 20 mile day hikes as well.

I sort of expected the PSA reading to go up because some of my other prostate ailments like sudden urges and getting up at night seemed to worsen a bit within a few days of starting the diet. That apparently is a function of the higher volume of liquids I have been consuming as part of the diet and doesn't effect PSA or it might in that healthier living means a healthier prostate.

My urologist, who I am seeing day after tomorrow, last time thought another biopsy is due within the next few to several months. I'll see what he says.

To my friends on this site, I wish you all the best and hope you will have a longer life because you started taking care of yourself when you got this usually very survivable type of cancer. It took me a year or so, but making the decision to get into shape because of the diagnosis will probably save me from other things that would have gotten before prostate cancer did.

Life if is good. Social life is better too.

I hadn't had my PSA checked since July (about 9 months). It came back today at 2.17, up from 2.15. This is the first increase I've had since I started down this road about 3 years ago when I had a 101 PSA; caused by prostatitis. But it's really just statistical noise.

I switched urologists and my new one is not even sure I need a biopsy. They found 2 1/2 years ago just one of twelve cores with 10% cancer Gleason 6. He thought highly likely my PCa is non-aggressive but thinks a biopsy would be useful to confirm that and that I may not ever need another one.

I'll probably schedule it in a couple of months.

I've been blessed and I hardly think about this, except the week before my test.

I had my six-month check-in for active surveillance since being diagnosed with prostate cancer almost three years ago. My urologist said my PSA is remarkably stable and the finger test revealed nothing. I was inclined for a repeat biopsy--I'm 2x past due. But he said he wouldn't if he were me. He said if we missed something given your PSA's, it would be a case for the medical journals. He also said it was unfortunate that the cancer was discovered because it's very likely mine is the kind that will never be an issue.

During the last visit he said that if I did one more biopsy, that it was possible they wouldn't find cancer given the size of my prostate (which causes other problems--another reason for my visit).

I am somewhat curious how much Finasteride has reduced the size of my prostate, so I may go ahead and do the biopsy. I have flex plan money set aside to cover my out-of-pocket expenses.

I am very lucky. I thank God for these blessings and wish all those on this site good health and low PSA's.

Just got my PSA results and they are lower at anytime since it was first measured in my late 40's. I still have my prostate too. My urinary symptoms from BPH are improved too -- never have to get up in the night. That probably is reflected in the lower PSA. I am seeing my urologist this afternoon and I expect he will say no need for a biopsy and it has been about 3-1/2 years since my last one.

The only urinary type symptom I have is a sudden urge to go when I am taking a long drive. My urologist said that is function of the extra coffee I drink on such trips. Duh.

Unless my urologist surprises me, this will be my regular six-month update.

I had my six-month follow-up. Last time my urologist thought I should think about another biopsy since it had been over three years since my last one revealed only 10% Gleason 6 in one of 12 samples. This time he said the protocol is that I should have a biopsy but really doesn't think it is necessary. My PSA has bounced around 2 for almost three years now. I think I will go in for a biopsy next year, because he said that there is good chance they will not find cancer and to be safe.

I had my PSA test checked last Thursday and it was up slightly from 2.050 to 2.269. I'm surprised it wasn't up more than that because I've been sick with a bad cold or flu...sick enough to cut short a trip I was on in South America. I felt a little like I had some UTI issues too. I had it checked when I was seeing the doctor for the cold and walked across the hall to the lab for the test.

Seeing the urologist on Tuesday. It has been almost five years since I was diagnosed. I think it might be time for another biopsy. Not until the fall probably.

I saw my urologist yesterday. He thinks given the stability in my PSA that he would not do a biopsy. He did recommend, however, an MRI of my prostate to get confirmation that active surveillance is the best course of action. It is in the process of being scheduled.

I got the results of the MRI of my prostate. My urologist said it was "somewhat reassuring" and agreed with my decision to stay on active surveillance. When I first got the results I was "somewhat disappointed" because the MRI found a 15 mm lesion that was "probably" cancer. My urologist had had earlier indicated to me that since my PSA has been so stable that the MRI probably would find no cancer or be inconclusive.

He did note that the lesion was found in approximately the same area my 2013 biopsy found Gleason 6 in a sample of approximately 10% cancer. So evidently, it is not growing. The MRI found also that it is contained inside the prostate with clear margins.

I guess I should be reassured that we know where the cancer is, it is not growing, and its extent is limited enough that continuing on active surveillance is appropriate. I hope insurance will pay for another MRI in a year and we can determine whether it is growing at all.

I am now approaching 5 years of my diagnosis of prostate cancer. That will make me a five-year cancer survivor and the only thing done to treat is to take Finasteride which was actually prescribed for an enlarged prostate. It apparently has worked for slowing progression of cancer (as it is said to do) but hasn't done much to shrink the size of my prostate--it is still 82 cc's! I'm starting a diet and as part of I'm told that I need to drink 64 oz of water a day. Fortunately the bathroom is around the corner form my office.

I wish everyone low PSA's and good health!

I had my six-month Active Surveillance check-up yesterday. My PSA came in at 2.75 slightly higher than six months ago but was not of concern to my urologist particularly because I was sexually active the night before and was not for the previous test.

We went over my MRI results which found the cancer but suggested it is not near penetrating the capsule and indicated it had not grown significantly in the five years since I was diagnosed with cancer.

I discussed some future treatment option ideas I had. I have other prostate issues resulting from an enlarged (80cc) prostate. I wondered whether a TURP could be performed perhaps targeted to the ara the cancer is. He said that a TURP could be performed on a prostate that has cancer but that it could not be targeted. He did say that he had patients who had TURPs so that the prostate size could be reduced enough for HIFU treatment.

I'm giving serious thought to that approach. I'm not terribly worried about the cancer. But sudden impulses to urinate (my prostate is growing into my bladder), I could do without. I'm retiring in 2 or 3 years and I would like to do the TURP at that time.

Did my six month check-up. My PSA is lower than it was 5 years ago. I'm a little over two years to retirement and about three years to Medicare. I'm probably going to have a TURP. My problem is BPH, not likely cancer. My prostate is 80cc's. I might have HIFU to Target the area where the cancer is Afterwards. Moving to Ecuador when I retire.

It has been almost seven years since I was diagnosed with PCa. The diagnosis was I had my six month follow-up. to recap my history:

4/2013 PSA 101.6

5/2013 19.4

7/2013 9.08

8/2013 7.5

9/2013 Biopsy revealed one sample positive for PCa, Gleason 6, approximately 10% of sample. Also revealed a 100c prostate. Go on Finasteride for BPH.

2/2014 2.89

10/2014 2.67

7/2015 2.15. Switch urologists at this point because the one at the time keeps pushing me towards another biopsy.

3/2016 2.17 New urologist says biopsy unnecessary in light of my stable PSA.

9/2016 2.20

4/2016 1.76

10/2017 2.05

5/2018 2.290 MRI performed which reveals some cancer in the same in the area the biopsy indicated. My urologist calls it "somewhat encouraging". Also indicates my prostate is 82cc's.

10/2018 2.75

5/2019 2.78

11/2019 2.32. The latest. Uro performs finger test. Normal. Further discussed treatment plan. Since my prostate problem is BPH and not so much cancer, the treatment plan I proposed is to do a TURP to reduce the size of the prostate and improve my urinary problems. This will be scheduled just as I am about to retire and will have good insurance. Then, after I retire, HIFU to deal with area of the prostate where the cancer was discovered.

I am a lucky one. Something besides prostate cancer is going to kill me. But I hope my story encourages those who are just starting this journey and only have a small and apparently non-aggressive form of this disease. Don't rush into treatment take you time.

My PSA upticked around a point at 3.55 and is the highest its been since I was diagnosed almost seven years. I still have my prostate and have not had treatment hoping to postpone it until just before I retire. Well, I'm going to retire next year and it's time to think about that.

My urologist wasn't alarmed. Pointed out that I had a biopsy in 2013 and an MRI in 2018 and my cancer was about the same size and in the "exact" same place. I wondered whether stress could effect PSA and he said there is no study but he has seemed to notice a correlation. He wasn't in a hurry to do anything. I was the last appointment of the day and we talked a lot about the election.

The stress is the isolation from COVID and putting my house on the market.

Here's my plan which he broadly approved: another PSA test in December, biopsy in January, and a TURP in February to reduce the size of my prostate. Then I will explore HIFU.

I had my PSA checked last month and it was 5.21 the highest it has been since 2013. My PSA has been remarkably stable from 2014 to early this year--falling in the 2's except for one test that was below 2. Last summer it rose to 3.5 or so. My urologist was not concerned.

Then I had a general physical and decided to get another PSA test at the same time and it came it the higher number. I was planning to have my first biopsy in early 2021 in advance of a TURP. I have a very large prostate. I wrote my uro and rather than moving up the biopsy, he suggested an MRI which was done on 30 Nov 2020. I had had a biopsy in May of 2018. It had concluded that a 15 mm lesion was likely cancer (a "4" on the rating system with the highy likely cancer being a "5").

Surprisingly, the MRI showed that the lesion had shrunk to 4 mm and downgraded to a "3" (uncertain whether cancer). The MRI showed some inflammation which could explain the higher PSA.

I met with my Urologist. He is uncomfortable relying on an MRI and its time for a biopsy since it has been over 7 years since my last one which did reveal Gleason 6 cancer in 10% of one of 12 samples. I agree. It will also be useful for the "TURP" I'm planning early next year to deal with BPH.

I was expecting that the MRI woud show the cancer clearly advancing and that I would have to have the prostate removed. In fact, it showed the opposite. But I'm still not out of the woods yet and the biopsy might show something the MRI missed but my urologist thinks that is unlikey.

My conversion to Orthodox Christianity and being rebaptised might have something to do with my apparent shrinking and perhaps disappearing cancer.

God is great!

I got my first biopsy results after 7+ years since my last. My PSA was in the 2's (except for one at 1.8) from Early 2014 to last summer when it hit 3 and is now 5. As a result had an MRI and a biopsy. MRI showed that the area suspected to be cancer shrank and might not be after all.

12 needle biopsy came back with 4 samples positive for Gleason 6 with 5% on three and 15% on one. I guess MRI's only show significant cancer. It may have grown a little but after 7 years that seems to me to be of not that great of a concern.

I went back and reviewed the stories here after 7-8 years of surveilling my prostate and did some more research (not as much as I did in 2013). I've gleaned the following:

1. Active surveillance is getting to be standard for Gleason 6, T1c cancer. That wasn't as clear in 2013.

2. Checking the 700 or so survivor's stories here, Gleason 6, T1c cancer the vast majority of the time stays under control without treatment. There are some cases where it should have been graded 7 that became problems.

3. Radical treatments like prostectomy and radiation for Gleason 6, T1c cancer have become less common than they were 7 years ago.

4. There is some debate as to whether Gleason 6 is cancer but the consensus is that it is cancer.

My urologist strongly urged me to stay on active surveillance. He also agreed to do a laser prostate reduction because my real problem is enlarged prostate.

It's been 8 years since I started my prostate journey. I still have a prostate but less of one. I had a PSA spike starting the summer of last year ('20). This led to an MRI Nov '20 (cancer uncertain) and a biopsy early this year a little more cancer found but not sigfnificant ans still Gleason 6. My uro says keep the prostate and stay on active surveillance.

But I have (now had) a very large prostate: 110cc's. Because of BPH issues he said he could do a laser TURP--by far the biggest he's done. He did a PSA just before surgery and it had dropped to 4.3. After outpatient laser surgery two days ago, my uro estimates my prostate is still 40cc--still large. But it was a lot of work.

I was in the hospital at 9:30am and out at 5:30pm. Had dinner with friends that evening. Catheter was out this morning. Other than a little burning and blood in the urine. Things seem normal. We won't know for sure for a few months. I hope the part of my prostate with cancer was the part that got vaporized.

In 2013, I had a serious prostate infection, then found to have a 100cc+ sized prostate, and finally prostate cancer 3+3 and fairly limited after a biopsy. I chose active surveillance for the cancer and fiansteride for the enlarged prostate. 2013-2020, my PSA's consistently came back below 3 and my urologist did not push for treatment or even another biopsy. I did have an MRI in the later part of that perid that showed no significant change.

In 2020, my PSA started to drift upwards and exceeded 5 late in the year. This prompted another MRI and biopsy that showed some minor inflammation but again not much cancer.

I had discussed dealing with my quite large prostate with my urologist and he agreed to do a laser reduction on it last April. The surgey went fine, eliminated pretty much all of my urinary problems.

The following July I moved to Ecuador and did not do a follow-up PSA until now. My PSA dropped to 2.73 without Finasteride. My urologist is pleased.

PSA down a bit from my last check about 10 months ago. Seeing my uro tomorrow. It has been nearly 10 years since I was diagosed my PSA has stayed about the same. I have had two biopsies and two MRI's over the course of the last ten years. I'm wondering how often to see my uro and get PSA's done. I'm thinking annually should be fine instead of twice a year. Just do it in connection with my annual physical.

I got a reminder to update my story. It's been over a year. I'm in the middle of some tests. PSA has drifted up but my uro wasn't terribly concerned. He just said that my type of cancer just doesn't turn aggressive. I've had an MRI about a month ago and it suggested 1 cm leison likely cancer. Also showed inflammation which could explain the higher PSA. I had a laser TURP 3 years and my prostate was about 40cc's--down from 100cc's ten years ago.

My uro has not commented on the results but the plan was I'd get a biopsy after the MRI. He probably didn't comment because it didn't show much change. I may as well get another biopsy.

I have a new manageable health concern. Last year, I had my first colonoscopy 17 years late. That just found one pre-cancerous polyp which was removed. Don't need another one for 7 years (now 6). But I had an upper done to stretch my esophougus because food was getting stuck im my throat. Some biopsies were done and a couple samples showed low-grade dysplasia (pre-cancer). I'm having an ablation done in 2 1/2 weeks.

The biggest irritation about this is thst I'm spending most of my time in Ecuador and it's hard to coordinating my prostate, esophougus, and general care in one trip. At least I'm keeping my airline status up.

I'll let you know what the biopsy shows.

Jack's e-mail address is: brent.boger AT gmail.com (replace "AT" with "@")