In 2016 my PSA went from 2 (where it had been for over 10 years), to 6.9. After consulting with a Urologist it was decided to repeat it in 6 months. It dropped down to 3.8. Another 6 months passed, it returned to 6.9. Over the next 3 plus years I had 3 MRIs and repeat PSA tests (all unalarming) and maintained a PSA of 6.9. My prostate was enlarged and it was determined I had BPH, so that may explain the PSA elevation. DRE was normal. In March of 2020 my PSA jumped to 9.5. The DRE was determined to have an Induration. A repeat MRI showed a PIRADS 4 1 cm nodule, and I knew it was time to have a biopsy. They had suggested a biopsy previously however, I was OK to 'watch and wait' after weighing all options and not really wanting to go through a biopsy. The biopsy (17 cores) came back with two cores Gleason 4+3. Additional cores were 3+3 and 3+4 (total of 8 cores being cancer). I was told I had an intermediate risk Prostate Cancer and it needed to be treated. I was given the option of surgery, radiation, or cryotherapy (freezing). After a great deal of research and opinions from top Surgical Oncologists, I decided to go with the Robotic Surgery. It was decided based on my excellent health and my age of 65. They had stated 'if it were them' they would "want it out of there" and it was overall "cleaner". It was explained to me cryotherapy had a higher risk of the cancer returning. The long term effects of some of the types of radiation (proton, stereotactic, cyber knife, etc.) were unknown and for someone my age and health overall, surgery was the preferred choice. I am scheduled for the surgery in two weeks and will report back as to how it went.

I had my robotic surgery and had no recovery issues. Walking and doing well right away. My biopsy showed I was T2a originally and my post pathology grade T3b. Seminal Vesicles were involved although only on the extreme proximal area. LVI, and cribiform cells were involved, none of which showed up on the initial biopsy. I have sent for a second opinion pathology report and genomic testing was ordered. Margins were clean. I now await the results of the previous as well as my first post surgery PSA. Will report back on results.

Post Prostectomy I got several expert opinions on my T3b diagnosis (Seminal Vesicle Invasion) as well as Extra Capsular Extension. The concensus now is to wait until PSA elevates and 'wait and see' rather than using Adjuvant Radiation. If and/or when it elevates they quickly begin 'Salvation' Radiation. They state this avoids possible side effects that may never be needed. My margins were clean post surgery. My first PSA came back <.01 which is very encouraging. I repeat the test every 3 months for the first year. Next test after the New Year.

Tom's e-mail address is: dlynsh AT gmail.com (replace "AT" with "@")