drtracygapin.c... Don't have a standard prostate biopsy. Learn how prostate MRI and MRI-guided targeted biopsy has revolutionized the approach to prostate cancer screening.
My dad had a high PSA when he was 65. He had a prostate needle biopsy every 6 months for the next two years, Nothing abnormal. He told his doctor, to hell with this, no more painful biopsies. At age 91, his PSA is still high and he's still kickin'.
And at 91, I can almost guarantee if you do enough prostate biopsies, you will find a focus of Prostate Cancer. Let the man have his ice cream, and don't worry about his prostate!
I am 61. I have had BPH and a 90cc prostate for a long time. I am not over-weight. I have had regular PSAs & DREs for many years (neither is painful). Last week, my PSA was 5.20 (six months before it was 5.10). Thirty-two months ago, I had a 16-core random needle biopsy. It was painless and found nothing. I had the biopsy while under IV propofol. After the biopsy, I had a little bit of blood on my stool, in my urine, and in my ejaculate--none of these things caused any pain or fear. Btw, I decided to eat lightly, have only soft foods and broth for a few days before the biopsy. I did not want to run the risk of being constipated after the biopsy and have to strain to pass stool while I was healing. I also had an enema (at home) a few hours prior to the biopsy--just to be super clean and reduce the risk of infection. Gentlemen, if I had to have a biopsy every year (which I do not), I wouldn't consider it a big deal. Later, after my urologist retired, I found another. He ordered a Multi-parametric MRI of the prostate. The MRI was painless and found nothing. Do not let fear prevent you from being proactive. Get tested and screened. In most cases, the MRI will be the first and only thing that you will have to undergo (other than the PSA and DRE). IF a mass is found or suspected, then a biopsy will be done--a more targeted biopsy. In the meantime, improve your health by quitting the smokes, the over-eating, and the lounging around. Cancers are cured all the time--more so if caught early. Do it for those who love you and need you. You are the master of your fate. Set your course and fear not! Stay well and bless you, my friends.
Most people panic when they have a high PSA (including doctors and hospitals) my first advice is do not panic, my PSA was 16, yes, 16 the first thing my doctor said to me was do not panic, he did a few tests and found I was not emptying my bladder, also had a enlarged prostate. He recommended having a TURPS operation (which I had) he found a large amount of stones in my prostate which was causing my elevated PSA, they sent off my scrapings to lab from my prostate and there was no cancer
High PSA levels are speculative at best. I have a PSA level of 11.2 and I believe it is because I do not eat red meat of shellfish. Typically high PSA levels are caused by a diet low in zinc b/c the prostate is the organ that requires the most zinc in the male body. The best foods that zinc can be only acquired is through red meat or shellfish. it's best to take zinc supplements as zinc supplements are cheap and widely available everywhere. Just take 50 mg of zinc a day for 90 days and any problems associated with an enlarged prostate will go disappear.... For just $20 of zinc supplements prostate problems can be cured easily.... It's cheap fix and at least worth a try......
LOL. You guys are funny. I wish I had the problem of having a PSA of 4.5, or 12, or 16, or 25! When I was first seen at the ripe old age of 50, my PSA was above 1,500. No, that is not a typo. My PSA was above 1,500. I was stage IV from the get go. I'll be lucky to live the next 5 years. Stop worrying about whether you'll need a prostatectomy. Be thankful that yours was caught before you were screwed.
I had a biopsy done 4-years ago. It’s a very short procedure and I did not experience and pain or discomfort. My urologist was terrific because he told me a funny story about his best friend who is also a very famous actor. Procedure took less than 3-minute , if that. Don’t lose sleep over having to face this procedure. BTW: cataract surgery; although this has nothing to do with prostate, is also an easy, painless procedure. Guys! We are such cowards sometimes:) My PSA fluctuates: I’m 71- years old. One year it’s 5.0 then the next 6.5 then back to 6…. I’m on a 99% plant base diet now, I’ve cut out sugar as much as possible, and have lost 20-lbs. 5 lbs to go. My next PSA test is in November 2022 🤞🤓 Good Health to all!
Probably the best explanation of Prostate problems I have had the good fortune to view. Good job. Most Urologists do not have the patience to explain leaving patients bewildered
Wow, I am a Brazilian man ag 54 and 3 years ago my PSA was about 9,3 and my doctor was so concerned about that could be a cancer, so, he mencioned about biopsy prostate but, minutes after, he guided me to try a MRI and it showed only a BPH and no sign of cancer at all. I have now a PSA 1,8 and keep taking medicine pills forBPH. Great.
So you didn't have biopsy ? Because my MRI as well did not show any cancer but just enlargement however my PSA was 4.25 2 years before the MRI and reach to 5.30 when we had the MRI done then after like 4 months it was like 6 . I am 45 years old now . The doctors advise to do biopsy because of the PSA apart of one doctor said that we can just observe the PSA for next 6 months as he believes its very unusual to have cancer in my Age ... i am very confuse between doing the biopsy or not .. can you till me how your PSA was rising ? And what was your symptoms ? What was the treatment ?
@@dr.muhannadalnaser2082 can you please tell me if you don't mind what has happened since ? have you been diagnosed and what was your symptoms before you went to the doctors.
@@aghafoor9868 hi , thank god they did not find cancer in prostate after the biopsy even despite the fact that the doctor was saying that he believe strongly i would have because the way how part of my prostate enlarged seem not unusual but yah the results was negative , so they asked me to be doing every year or 6 months a MRI to keep eye on it as its still strong changes in my prostate .. i done it one time the MRI but i did not receive from them the results since 8 months due the vivid 19 issues they closed many clinics . Advised me to eat healthy and use supplements care for prostate and described some medications witch was not really a solution . I did not check my PSA since one year , my symptoms are the same i go often to toilet but no difficulties apart of sometimes need sometime to start go then all good ,no pain , sexual life acceptable without medication however i do much much better using 5mg cialis witch is i think as well a treatment for prostate . Nothing more i have done. After the biopsy i was fine but just some days felt some pain when I have to wee , blood in the sperm for around week . Dont worry there is always solution and its not bad as its sound
I had a biopsy done a few years ago. It was a horrible experience. Nothing was found, after seeing this video I’m very concerned. Thank you for the information
Thank You SO MUCH! I've had two biopsies that came back negative then I requested a prostate MRI, the results of which I never was told by my doctor. Hence, I 're decided to switch doctors. Thank You Again for your EXCELLENT Advice and I'm SURLY going in with a WHOLE New medical game plan for my HEALTH.
After watching videos over the weekend I canceled my biopsy and I'm having a follow up with the Dr. to see why he didn't have the same information. Do not just go and do what Doctors say without investigating first.
My PSA was a 104 ... my prostate was so badly inflamed it blocked my urine flow and damaged my kidneys and ureter something people don't talk about. I had to get on dialysis 4 hour a day 3 times a week,it sucked. Doc did a TURP to clear my urethra and Nephrostomy tubes were placed in my from the kidneys. I recovered from it all ... PSA 1.20, with the help of Eligard (horomone therapy) only two treatments. I had to stop it. Doc tells me I have stage 4 prostate cancer ,mastitis to bone . No chemo or radiation for me. Ate greens took some herbs ... doing better. Peeing good but I'm not out of the woods yet, getting there tho. Oh, I'm off dialysis. Yay
My PSA level currently is 8.3. Is there the possibility of cancer? If yes, how is its status now, and what can be done to avert possible complications?
Yeah, my PSA was 443 and I was passing blood, having trouble urinating and leaking. They set me up for radiation and harmone therapy. I have finished my radiation and have had my 2nd harmone shot. No more leaking or trouble urinating. Tired all the time from meds but other wise feel pretty good. Go back in May for 6mo. checkup.
Thank you very much, doctor, for these very clear explanations. My father has a very high PSA and I had no idea what to expect once he would decide to see an urologist. Now I know. Thank you once again.
My PSA had been mid 8’s to 9 but pretty consistent for about 3 years. I had a few MRI’s and it would come back as enlarged prostate. My urologist said unless the numbers made a significant increase he would be comfortable diagnosing the matter as PBH. This month I finally had a TURP when my urine flow was reduced to dribbling and frequently at that. A biopsy was performed at the same time as the TURP. No cancer. Flow is back to normal.
Thanks for this information. I have a biopsy scheduled in less than to weeks. I am going to call and cancel it and schedule an appointment with my urologist to discuss the MRI screening as a next step.
Well mine went from 1.8 to 10.0 in one year. I was worried sick I might have cancer. I wouldn't have a biopsy until you rule out other causes. In my case I went on Doxycycline for 3 months, turns out I had a prostate infection. PSA went back down under 2.0 on long term anti-biotics. A good doctor can usually do a physical exam and tell you if he thinks you have cancer. If not rule out everything else before a biopsy. They are quite painful.
Mine as well. Readings were 8.5-9 over a three year period. Due to an enlarged bastard of a prostate that ruined my life with dribbling, explosive runs to the bathroom and absolute fatigue from nocturnal bathroom visits.
My husband 72 PSA is 3 primary dr referred him to a urologist for follow up no symptoms but since he did not have a DRE and is aPSA Was rising During DRE a lump was found uriologist ordered a mri aggressive lesion and small nodulars so a biopsy ordered lesion cancer and the other 6 nodulars Gleason score 7 option offered removal of prostate or chemo and radiation he decided to remove prostate
About 25 years ago, my father had prostate cancer. His older brother (my uncle) died from it. With my father, they used radioactive "seeds" implanted around his prostate. That stopped the cancer. BUT, we did not know about the collateral damage that this procedure produced. Years later, he had blood in his urine. The doc said that is due to the scar tissue coming from his bladder that was caused by the seeds. So they went in through his penis with a camera and laser and tried to fix the damage in his bladder. It was not successful and now he is completely incontinent. For the rest of his life he had to use Depends. Also, as more scar tissue tried to exit his bladder, the urethra would become completely blocked (causing many emergency trips to the ER). That led to wearing a catheter full time. Then the catheter would plug up forcing a flush routine. Then, later he started bleeding rectally. We were told this was due to the damage done to his colon because of the seeds that were implanted around his prostate. He lived with us and made it to 88 years old but the quality of life was dismal. I'm 67 and my PSA scores are climbing faster than "normal". I am scheduled to see my doc in a few weeks. I'm pretty pessimistic about what he is going to say and recommend.
I am 64 and have had a 6.0-6.6 range PSA test for just over a year now. Doc wanted to go straight to a biopsy. I said No Way. Poking me in the rectum 14 times willy nilly hoping to find something is just a complete assine idea! So I tried an MRI but like most people could not go into that tiny tube!!! Why not sedate for this and have a 100% success rate??? What the hell is wrong with that profession that they refuse to sedate why can save lives!!!!! Anyways next step was a 4K score which will allow me to know for sure whether to do a biopsy. More to come......
Thankyou doctor, i am going in for a biopsy tomorrow (3. 3. 22) and am not sure what to expect.....i will get back for an update when more has happened.....regards from England uk.
My PSA was 4.5 at age 42 I was diagnosed with stage 4 and given a year after biopsy and was treated at Lakeland cancer center in Florida. I passed the digital exam biopsy only showed 2 out of like 13 or 14 needles used were cancer free 95% of my prostate was cancerous. They need to start screening men at least a decade earlier and yes I am aware that my case was unusual but more lives could be saved with earlier screenings there is a misconception that prostate cancer can be relatively low pain I had adenocarcinoma and trust me I went through hell before they found it. Thanks for educating people on this.
Thanks Steve for sharing this. I'm 46 and my psa has been 3, 4 and 3.5 in the last 3 years. There is a history of PCa in my family. Should I be concerned
@@muralimahadevan4860 yes definitely I my opinion u need a biopsy. Go to a urologist/oncologist please. Trust me u can feel something isn't right. Best of wishes. God speed
I've had an ènlarged prostate. Five biopsies have been done and one of them done while in the middle of treatment of prostatitis. PSA was 21.9. Biopsies have been negative of cancer. I'm 72 years. I'm now ignorant of what to do.
I had three prostate biopsies and Two MRI scans with contrast. Gleason score 3+3 on all three biopsies over a 12 year period. PSA ranged from 4.5 to 7.5 but scored 5.4 on my last test. I'm concerned that when a needle biopsy punctures a cancerous tumor, that the needle causes cancer cells to bleed out into the body. Is my concern warranted?? Thanks
Good video - I have PSA around 12 (I am 59 years old) and got very ill after an infection caused by a non-targeted biopsy. Then my consultant started trying Finasteride and other drugs on me and I realised he was basically going through trying the whole pack of everything, making me sick when I wasn’t sick before. So I insisted on an MRI scan which was negative, took myself off all his drugs and now monitor the PSA. I still don’t know for sure if I have cancer or not but this video will help me know what to ask for if the PSA rises further so thank you. The reality for us guys is that this very common male cancer is years behind in research terms because we men have been reluctant to talk about the issues and have not insisted on the levels of research funding that has gone into other cancers. At last that’s starting to change.
MRI scan showed any abnormalities and lesions, cant confirmed whether cancer, bph or inflammation except thru biopsy. To start finasteride at 59 is a bit too early, adverse effects on your libido
@@adam.3035 No abnormalities shown on scans (I have them every couple of years) and PSA has remained around same level. Nowadays I take 5mg daily of Tadalafil which helps a lot with enlargement symptoms.
Excellent vidéo thank you 🙏 very much ! My father and grandfather died with prostate cancer its the first cancer killer for men . I have done a biopsy and nothing but they want do others after 3 months I stopped since 4 years then I choosed IRM I will do it . My PSA is the same since 4 years 6 .
When I was in my early 70s I was aware that my psa was slowly rising and I really wanted to believe it was due to old age. My doctor finally convinced me to get a biopsy and, you guessed it, I had cancer. I was treated with radiation for a few months and now a few years later it's looking like that treatment did the trick. For those of you who are reluctant to get the biopsy, I am totally with you and understand the reluctance. But the biopsy doesn't hurt and Better to Know Than not to know. Now dealing with BPH. It's hell getting old.
Do You mean that there is no obligatory diflection of psa to have prostate cancer? If the blood test is enough to be calm or there are some other neccesary test?
4K score is a biomarker that’s helpful in certain situations and can help us make key decisions regarding prostate cancer detection. But unfortunately it does not “detect” prostate cancer nor rule it out. It is another helpful tool in our arsenal!
Had the 4K score test and my urologist called me today to see about setting up an MRI appointment and possibly a biopsy. I didn’t know about the MRI fusion procedure for the biopsy. I will find out if that’s what’s going to happen. Thank you for educating me on this issue. Age 70 PSA 6.2. 4K 19%
This advice reflects the current 'standard of care' for potential prostate cancer. With an elevated PSA, my urologist was set to suggest the old-style random needle biopsy, but when he saw I had gathered research material advising that the MRI approach is best, he immediately issued a requisition. MRIs are relatively scarce in Canada, but three years ago, regional peer research (Cancer Care Ontario) determined that indeed MRI is "best practice" for prostrate cancer diagnosis, so I was put into the centralized system to gain access wherever an MRI machine is available. The local hospital confirmed a 12:10 a.m. Sunday appointment, and I showed up on time. A few days later, the radiologist confirmed I almost certainly have BHP not prostate cancer,. Point is, as discussed here, you should not get.needle biopsy until after you have been checked with an MRI. If the MRI detects something questionable, then a targeted biopsy is indeed rational and the right thing to do.
I have my MRI biopsy in a few days - scared stiff -can't face it with local anesthetic - trying to get a general anesthesia for it ! Informative film ! R.
I am 70 i have been on testosterone replacement therapy for 9 years taking 2 ml testosterone shots a month during this time. My psa test at the beginning my therapy was 3.5. 9 years later i applied for insurance and had to take a medical evaluation . This included a psa test. My psa was 7.0. I immediately stopped my testosterone therapy and waited a month tested again and my psa went down to 6.0 my testosterone level went to 207. I waited 5 more months with no testosterone and tested again. My psa level was 2.7 and my testosterone level was 217. My suggestion for someone who has been on testosterone therapy for a long time is get off for a few months and retest. I went from 7.0 to 2.7 all i did was alow the effects of the testosterone to clear my system.
im 57 years old and after having 4 of them in the first one they told me i had cancer and put on watchful wating with a biopsy one a year but having second taughts now it was 2017 i was told i had cancer
my case: 65 y, PSA9 _, MRI Pirads 5_ bioppsy 8 from 12 points +, consultings/opinions with 7 different urologist, Da Vinci prostata removing, prostata 50ccm, Gleason 4+3, T3a, PSA after 4 monts 0.018. Im glad been measuring PSA for the last 20 years.....maybe i could have had thebsurgery sooner...
Thank Doctor! I got the labs on Thursday and freaked out. Oddly I didn't run straight to Dr. CZcams. I feel greatly relieved now. Still very concerned, but relieved. I think I had prostatitis.
Great presentation and comments from viewers. Your information is exactly what I feel my team should have presented to me, Dang it. Moving on, I had my first standard biopsy taken from twelve sites, “left” and “right”. Future biopsy method if indicated, will be with Fusion MRI. Would love to hear your view on comparing PSA numbers with Free-PSA percentages and what those comparisons may indicate, if anything. Like your watermelon seed analogy; mine is using a Ouija Board at a seance. Personally, I feel I was used as a lab rat for practice. Seriously. Not bitter, just disappointed that this department was way below the level of care available at the same place for eye surgery. My take-away is to pay much closer attention to research under pressure conditions. Hairs rising from the back of the neck actually do have meaning...
Very informative and echoes exactly what my urologist here in Massachusetts explained very clearly to me yesterday. Helps provide confidence that I am getting the best possible approach to identifying what is going on.
Paternal GF and my Father both had prostate cancer. My Dad is 86. had his prostate removed at 63 (close to my age now). The first doctor either didn't explain it or my Dad didn't listen and UNDERSTAND: even after the cancerous prostate is removed, monitoring your PSA is necessary. my Dad's metastasized and he had tumors on his brain and lungs. (10 years after the removal ) he had the 2 largest tumors removed from his brain surgically, the other 12 smaller spots in his brain were removed via gamaknife. The spots on his lungs disappeared after he had a one year treatment of some drug that lowered his testosterone level to that of a castrated male. (Evidently his testicles still worked just fine.) 6 years later (now he is getting his psa very 6 months and it started to rise sharply without a prostate in his body) he had another tumor on his brain and had it removed. Let me tell u....Prostate Cancer is bad shit!
Thanks for the information,I am a male of the age to be concerned. So the PSA result is inconclusive, the Biopsy may miss the cancer, if indeed you have one, and if you have one, it may be so slow, that other things get you, and an elevated PSA might put you through a Biopsy for no reason. All very depressing. However if your work can localise and identify a cancer and establish the best treatment, all to the good. I post this after a good friend died after complications from having his prostrate removed. Yes females have equal problems, if not more. I hope your expertise will help us all, thank you.
An informative video. I have some family history of Prostate cancer and while I have no symptoms or anything to suggest I have problems at this stage I do find it frustrating that all the commonly used tests including PSA, DRE and typical indicators like ability to pee etc. are all virtually worthless in eliminating or confirming cancer. As discovered recently with a family member all such tests/indicators can show everything is fine, but cancer was found suspected and then confirmed following an MRI for an injury that picked up the presence of cancer by accident. It seems many in the comments section are in the same position of not knowing whether there is an issue or not despite going through the traditional testing procedure.
@@adam.3035 I'm not sure of the entire history as to diagnosis, the abnormality was spotted during a scan for an injury. Thereafter other testing was done. A biopsy is hit and miss in many cases since the cancer can be so tiny the chances of hitting the right area is slim. Overall the available techniques for detection are unfortunately unsatisfactory.
Thank you Dr. Gapin. Very informative. I am faced aged 72 with this problem having recently received quite a high PSA test result. I can now have an informed discussion / consultation with my Urologist on the next steps to be taken.
. My PSA has jumped from 4 to over 10 in 2 years. They found cancer with the first needle biopsy and then more with the second one. Yet my doctor doesn't seemed concerned because it is a less aggressive cancer.
Thank you Dr. Gavin, the best lecrture I've so far heard. The vlog is very clear and helpful to a prostate patient like me. Thank you again. From the Philippines
This was very good information about what causes an Elevated PSA, however it’s sad to know that given the numbers of 30% of prostate cancer goes undetected that the STANDARD prostate biopsy by (blindly sticking needles “hoping” to locate the cancer if there is even cancer) should automatically not even be a procedure anymore. The MRI procedure should be the only way to go since it can pinpoint any irregularity of the prostate. Hopefully this not basically telling the patients you have two options. 1. Go the Standard route and hope and pray that the doctors get the cancer (if it is cancer). 2. Go the MRI route, but it’s probably going to cost an outrageous amount (just for the machine alone probably costs hundreds of thousands of dollars, maybe even in the millions) it’s so sad that in this day in time that we here in the USA are one of the highest in the medical field, but it’s all about the citizens that can afford it that are the ones that stay alive.
I got the line “we found it early, chances are you could have years before you need to treat it”. As luck would have I had to get another doctor, 6 months after the first biopsy they compared the initial MRI to a new one. And that inspired a second biopsy, and the doctors shook their head saying “that shouldn’t happen, you don’t have small cell carcinoma”. It turns out that in 6 months I went from one “mass” the size of a dime, to two. One the size of a nickel and another almost the size of a quarter. I decided I didn’t care about why get it fixed, I got HIFU one treatment. Cancer free 6 years.
@@rodgerss5836 High Intensity Focused Ultrasound. I had one treatment and done. No Chemo, No radiation. Find someone in your area that does it and interview them. Don’t believe everything any doctor tells you, they are in the business of medicine and as such will promote themselves.
Thank you. If your PSA rises from say 1.5 to 3, get an MRI. I know of five people who have had prostate issues, one sadly passing away recently aged just 54.
I underwent two rectal biopsies last decade. They were not fun, but it was endurable. One biopsy resulted in a systemic infection, which responded very well to one dose of antibiotics administered intravenously. Five years ago, I underwent a perineal biopsy, which went quite well, although it cost a lot more than a rectal procedure. A perineal biopsy is day surgery, performed under general anesthesia. No discomfort at all. The perineal biopsy found a cancerous condition that had eluded the 2 rectal biopsies.
My psa rose from 5.5 to 7.6 in a year. Last week I had to argue with my urologist because he wanted to do a biopsy instead before an MRI saying that he is the doctor and knows best...but I insisted and finally referred me for one.
Good information. I had a PSA test done back in 2017 with a result of 1.1 total. I be 51 next month. Recently had another PSA test done about 2 weeks ago and the results came back as 5.83 total. My brain is working on overload trying to understand how it increased so much in 5 years. Now have my first appointment with a Urologist first week in August.
I just had a follow up (after 6 months) multiparametric prostate MRI (my second) last week. Seeing your video presentation had made it a lot easier for me to better understand the impressions given from results that came out of the exam. In retrospect, I seemed not to have been enlightened beforehand of this med procedure since 7 years back. Was it because the multiparametric MRI of the prostate was still at the testing stage, thus not yet developed and not really subscribed to by some Philippine urologists? Let alone very expensive compared to the intra-rectal UTS procedure. I expect to have an interesting and more engaging discussion with my Urologist on Monday. Thank you for sharing.
It is absolutely impossible to get a straight answer from any urologists office on what protocol they follow. My urologist wants to do a random biopsy only. How fo we find a urologist that uses mri ?
16 years ago I had a PSA of 61 after an episode of prostatitis. I've had two biopsies since then both negative and both of which resulted in infection of the gland. After multiple treatments, I am now allergic to 4 classes of antibiotics and still have a now resistant organism in my prostate. Wish I'd never had the PSA - a worse than useless test.
My PSA is 11.5 and I also have a monocyte count of 1.0. I have a cyst in my scrotum area as well. My doctor has me on some antibiotics and we retest the PSA in 6 weeks once the infection has been treated to see if this is all caused by this cyst. I'm very nervous about it all. My father-in-law died of prostate cancer so it scares the hell out of me.
I had a rising psa in my late 50’s and early 60’s. I also had, in the words of my doctor, the largest prostate in town. I had 3 biopsies in 4 years, the last one guided by MRI and 30 cores. Everything negative. He tried a separate MRI, blood tests, a prostate massage test with a blood snd urine test, and X-rays. No sign of cancer anywhere. I was put on finasteride and Tadalafil and my prostate shrank, psa reduced, and symptoms substantially subsided. The doctor checks my psa annually and does the standard exam, but says I likely do not have cancer. I am still a little upset that he did so many tests when everything kept coming back negative, but I think he was sure that I had cancer and just needed to find it.
My PSA climbed steadily to 40 and now seems to have stopped . I am 94. Have had usual tests and living along quite normally. Think PSA seems to be some thing else in my case. I’m enjoying life and find my PSA tests interesting and don’t want any thing else done.
I’m 61 and had blood work done by my family Doctor which showed a PSA of 10, he referred me to a Urologist who did a DRE, and decided to wait 6 weeks and redo the bloodwork. My PSA had risen to 11, so he suggested a Prostate biopsy, which was quite painful. Had that done almost two weeks and will get my results it two more days. Not sure if I should rely on the result if it comes back negative. (Getting a little stressed).
Hi Lawrence, I am about your age and have been through this. It is a bit stressful. I had a first biopsy (a tad uncomfortable) without the benefit of the MRI. This video is correct, a biopsy without the benefit of the MRI is hit and miss. For me the first the biopsy was inconclusive. I waited for a year to repeat the biopsy, PSA shot up in that time. Ahead of second biopsy I had a MRI which showed up a small tumour. Biopsy then came back with detail of the a cancer and graded as quite aggressive. Removal was for me the best option. Its all clear now. Its major surgery. I don't regret it in my circumstances and diagnosis. If you did not have the benefit of a MRI and your test comes back negative or inconclusive discuss with your Dr/urologist the benefits of a MRI now. With your PSA elevation I think it justifies prompt action to resolve the yes or no issue. If you are not happy with the opinion of the DR or Urologist get a second opinion. This issue justifies serious attention from you and your health professional. Be proactive, get the best advice and treatment, seek second opinions on the various phases if you feel its warranted. Good Luck
Just a quick update....my biopsy was positive for Cancer, and was graded at a Gleason score of 6 (3+3)...My Urologist decided to wait 2-3 months the have an MRI. I paid privately to have a 3T MRI, which I had 4 days ago and the result shows another lesion which has been graded at a Pi rads 4, and suggesting a targeted ultrasound biopsy. This is not at the sight of the previous positive biopsy....will see my Urologist next week to discuss this. Any thoughts? Starting to get scared now. (Oh yea..my PSA continues to rise..now at 12.)
Hi @@lawrencefuller5296, you are having a tough time and there is no denying it. You are doing the right things, pushing ahead with the diagnosis and you will now enter the treatment phase and have decisions to make etc. I cant speculate on this for you. But I know precisely what you are going through. I had the surgery and the cancer was confined to the prostate and I am clear of cancer. And I am thankful for having it identified and treated . There are support groups you can join, or just contact etc. You may find these of help, information is useful. I must admit I kept my research at this time on the treatment options and the recovery steps post treatment and what I need to do ahead of treatment, keeping healthy. Stay strong and best wishes.
Thanks for the feedback Neil...I have been attending a Prostate Cancer Support Group for the past two months, and yes, you’re right, they have been incredibly supportive and a great source of information. I guess decisions will be made after I see my Urologist next week.....will post after that.
Wow, why didn’t my urologist recommend prostate MRI and MRI-GUIDED FUSION BIOPSY? I was scheduled for a standard prostate biopsy tomorrow, I’ve since canceled the appointment. I feel like I’ve dodged a bullet but at the same time lost confidence in my doctor who is board certified. I’m considering finding another urologist that knows how to do the newest and most effective procedure.
DrGapin.com - Smart Men's Health Dr. Gapin thank you, I’ll certainly keep you in mind if I don’t get any satisfaction from my current urologist. As it turns out I just discovered that his practice does offer the MRI FUSION BIOPSY, I’m really disturbed why he recommended this procedure over the traditional biopsy method, my guess is it’s dollars and cents. By the way are you familiar with the 4K score blood test, do you recommend it? 4kscore.com .
Joaquin Yes, I use the 4K score often. It’s a blood test referred to as a biomarker test that is useful for men with a persistently rising PSA despite a negative biopsy (and/or) MRI. It can help avoid unnecessary repeat biopsies. It does not rule out prostate cancer and should not be used in your case to try to avoid initial MRI/biopsy! Hope this helps.
very clear explanation. i had PSA 16.0 no infection, it got down to 12 .4 in 30 days, no infection, i feel great, not going to biopsy, rectal exam Ok, stand by
Star Baby I didnt do nothing especial. Whent to another Doc. And new laboratorie. Its important not to press or touch the area of the prostate few days before exam. No sexual activity. No bycicle raiding or similar that could press that area. Changes ocurr after a month or two The exam by finger must be ok. Magnetic resonaince of special type my help. I my self waiting to do it. Its a little expensive here
Thank you so much and now i understand why my Dr did targeted MRI for me but did not show any cancer thank GOD however its larger and psa elevated in 2 years up to 5.30 before it was 4.25 so we need to do biopsy using the MRI to target the wright location . You make it clear for me now and i am going soon to do it . I am stressed but not too much . Thank you
Forst my psa is 3.8 and i'm 62 this year, first i met a urology he perform a dre and ultrasound and he told me that nothing abnormal, he sent me to mri and it came there some abnormal i my prostate and my bone so he sent me again to bone scan they enjected me a radioavtive substans a week after he perform ultrasound guided biopcy now waiting for the result if i have prostate cancer the waiting giving me anxiety.
I kinda feel ripped off, with a PSA of 13.2. (Not a typo), and a recent 2 month biopsy that came back negative with 4 of 12 samples showing inflammation. Instructed to provide another PSA in 6 months. That’s it. I’m white, 67 and otherwise in very good health.
Thank you, great video! I requested an MRI after reviewing your video. My PSA was 4.25 last April, went up slightly and back down to 4.25 now. I had a prostate MRI on yesterday here is some of the report. Impression: No evidence for high-grade prostatic malignancy. BPH Findings: BPH in the transitional zone Peripheral zone maintains normal signal Bones: No suspicious osseous lesion Lymph nodes: No Pathologically enlarged or morphologically suspicious-appearing lymph nodes I haven’t spoken to my doctor yet, but does anyone know if this sounds favorable? Thanks!
I've had all your recommend procedures and came out with a Gleeson score of 7...i'm sorry i had the biopsy because I'm convinced that the biopsy has stimulated the cancer. ...should have left it alone
A biopsy can stimulate the cancer when the biopsy needles are withdrawn through the cancer hence spreading the defective cells. not rocket science, think about it.
@@DrTracyGapin Are you not aware that biopsy needle withdrawal can spread the cancer? There is also no evidence earlier prostate cancer detection prolongs life.
I'm going get a prostate biopsy today 6/12/2019 and wonder why this wasn't even recommended to me. I will ask about it though. Thanks Dr. Tracy , very informative.
DR Gapin Im a Nuclear tech. Im seeing pts have MRI after the Biopsy, My situation 2.6 age 50, 5.3 age 57, 25 months later I'm at 5.1 , Ive had BPH for 5 or 6 years. DRE appears to close to useless. A recent Harvard study showed that the probability is that all these tests would save 1 man out of 1000, But cause extensive psychological pain for all. They refrained from doing anything but talking with your dr. Cancer is the whole reason for all these tests but what is the actually likelihood of aggressive ca out of 1000 men with elevated psa. TY God Bless
Hi Walter, great question... There has been a lot of public discussion and debate about the value of PSA testing. The European trial (ERSPC) has demonstrated an overall survival benefit of over 21% with PSA testing and that value has continued to increase as we follow those men over time. The US-based PLCO study was greatly flawed, yet it has also shown a survival benefit with PSA testing. The critical part of it all is how we manage prostate cancer once it is detected. For too long, we have over-treated clinically insignificant, low grade cancers that do not cause mortality. In those men, the side effects of treatment has offset any potential benefit. But men with higher grade, clinically significant cancers NEED treatment - there is no question. So the overarching question is how can we find the significant cancers while not over-detecting the insignificant cancers. In my professional opinion, MRI is very helpful in that regard. Three recently published large prospective studies support this. Hope this helps...
I just had a PSA test go from .6 from last year to 9.5 this year. My doctor called with the results and stated we will check it again in 2 months. Should I wait that long?
There is not a procedure where the MRI guided biopsy is done by entering the perineum. Way less invasive. No threat of infection because the rectum is not involved.
A year ago, my PSA score was 453, 6 months ago, it was 596, 6 weeks ago, it was 705! I am having symptoms, sporadic pain in my back, thigh hip, and legs. Had leg fracture 33 months ago and pin in my bone. test positive for bone cancer. I will have some baking soda, molasses, water and Black seed oil treatment.
My dad had a high PSA when he was 65. He had a prostate needle biopsy every 6 months for the next two years, Nothing abnormal. He told his doctor, to hell with this, no more painful biopsies. At age 91, his PSA is still high and he's still kickin'.
My Dad had High PSA and Urethra Tube...he lived to be 96
4@@beckford5415
lol
And at 91, I can almost guarantee if you do enough prostate biopsies, you will find a focus of Prostate Cancer. Let the man have his ice cream, and don't worry about his prostate!
@@davidh9844 I0
I am 61. I have had BPH and a 90cc prostate for a long time. I am not over-weight. I have had regular PSAs & DREs for many years (neither is painful). Last week, my PSA was 5.20 (six months before it was 5.10). Thirty-two months ago, I had a 16-core random needle biopsy. It was painless and found nothing. I had the biopsy while under IV propofol. After the biopsy, I had a little bit of blood on my stool, in my urine, and in my ejaculate--none of these things caused any pain or fear. Btw, I decided to eat lightly, have only soft foods and broth for a few days before the biopsy. I did not want to run the risk of being constipated after the biopsy and have to strain to pass stool while I was healing. I also had an enema (at home) a few hours prior to the biopsy--just to be super clean and reduce the risk of infection. Gentlemen, if I had to have a biopsy every year (which I do not), I wouldn't consider it a big deal. Later, after my urologist retired, I found another. He ordered a Multi-parametric MRI of the prostate. The MRI was painless and found nothing. Do not let fear prevent you from being proactive. Get tested and screened. In most cases, the MRI will be the first and only thing that you will have to undergo (other than the PSA and DRE). IF a mass is found or suspected, then a biopsy will be done--a more targeted biopsy. In the meantime, improve your health by quitting the smokes, the over-eating, and the lounging around. Cancers are cured all the time--more so if caught early. Do it for those who love you and need you. You are the master of your fate. Set your course and fear not! Stay well and bless you, my friends.
Thank you for your testimonial.
P
You are smarter than most of the doctors.
@@scottjackson163 Sure hope not.
Thanks for sharing this. You helped reduce my fears and answered some questions..
Most people panic when they have a high PSA (including doctors and hospitals) my first advice is do not panic, my PSA was 16, yes, 16 the first thing my doctor said to me was do not panic, he did a few tests and found I was not emptying my bladder, also had a enlarged prostate. He recommended having a TURPS operation (which I had) he found a large amount of stones in my prostate which was causing my elevated PSA, they sent off my scrapings to lab from my prostate and there was no cancer
High PSA levels are speculative at best.
I have a PSA level of 11.2 and I believe it is because I do not eat red meat of shellfish. Typically high PSA levels are caused by a diet low in zinc b/c the prostate is the organ that requires the most zinc in the male body. The best foods that zinc can be only acquired is through red meat or shellfish. it's best to take zinc supplements as zinc supplements are cheap and widely available everywhere. Just take 50 mg of zinc a day for 90 days and any problems associated with an enlarged prostate will go disappear....
For just $20 of zinc supplements prostate problems can be cured easily.... It's cheap fix and at least worth a try......
LOL. You guys are funny. I wish I had the problem of having a PSA of 4.5, or 12, or 16, or 25! When I was first seen at the ripe old age of 50, my PSA was above 1,500. No, that is not a typo. My PSA was above 1,500. I was stage IV from the get go. I'll be lucky to live the next 5 years. Stop worrying about whether you'll need a prostatectomy. Be thankful that yours was caught before you were screwed.
Are you.still.with us?
❤6@@terrellwilliams5829
I had a biopsy 21 years ago,15 samples taken which found six tumors.The technology sure has improved. This was very information video.
I had a biopsy done 4-years ago. It’s a very short procedure and I did not experience and pain or discomfort. My urologist was terrific because he told me a funny story about his best friend who is also a very famous actor. Procedure took less than 3-minute , if that. Don’t lose sleep over having to face this procedure. BTW: cataract surgery; although this has nothing to do with prostate, is also an easy, painless procedure. Guys! We are such cowards sometimes:)
My PSA fluctuates: I’m 71- years old. One year it’s 5.0 then the next 6.5 then back to 6…. I’m on a 99% plant base diet now, I’ve cut out sugar as much as possible, and have lost 20-lbs. 5 lbs to go. My next PSA test is in November 2022 🤞🤓
Good Health to all!
How was your PSA? Curious coz my husband and I are going on a plant based diet and wonder if it makes a difference m
Probably the best explanation of Prostate problems I have had the good fortune to view. Good job. Most Urologists do not have the patience to explain leaving patients bewildered
Muhleng central marching Spartans band
Wow, I am a Brazilian man ag 54 and 3 years ago my PSA was about 9,3 and my doctor was so concerned about that could be a cancer, so, he mencioned about biopsy prostate but, minutes after, he guided me to try a MRI and it showed only a BPH and no sign of cancer at all. I have now a PSA 1,8 and keep taking medicine pills forBPH. Great.
So you didn't have biopsy ? Because my MRI as well did not show any cancer but just enlargement however my PSA was 4.25 2 years before the MRI and reach to 5.30 when we had the MRI done then after like 4 months it was like 6 . I am 45 years old now . The doctors advise to do biopsy because of the PSA apart of one doctor said that we can just observe the PSA for next 6 months as he believes its very unusual to have cancer in my Age ... i am very confuse between doing the biopsy or not .. can you till me how your PSA was rising ? And what was your symptoms ? What was the treatment ?
@@dr.muhannadalnaser2082 can you please tell me if you don't mind what has happened since ? have you been diagnosed and what was your symptoms before you went to the doctors.
@@aghafoor9868 hi , thank god they did not find cancer in prostate after the biopsy even despite the fact that the doctor was saying that he believe strongly i would have because the way how part of my prostate enlarged seem not unusual but yah the results was negative , so they asked me to be doing every year or 6 months a MRI to keep eye on it as its still strong changes in my prostate .. i done it one time the MRI but i did not receive from them the results since 8 months due the vivid 19 issues they closed many clinics . Advised me to eat healthy and use supplements care for prostate and described some medications witch was not really a solution . I did not check my PSA since one year , my symptoms are the same i go often to toilet but no difficulties apart of sometimes need sometime to start go then all good ,no pain , sexual life acceptable without medication however i do much much better using 5mg cialis witch is i think as well a treatment for prostate . Nothing more i have done. After the biopsy i was fine but just some days felt some pain when I have to wee , blood in the sperm for around week . Dont worry there is always solution and its not bad as its sound
@@dr.muhannadalnaser2082 thank you for your time in replying back.
@@aghafoor9868 most welcome you can always ask and good luck take it easy bro
I had a biopsy done a few years ago.
It was a horrible experience. Nothing was found, after seeing this video I’m very concerned.
Thank you for the information
Thank You SO MUCH! I've had two biopsies that came back negative then I requested a prostate MRI, the results of which I never was told by my doctor. Hence, I 're decided to switch doctors. Thank You Again for your EXCELLENT Advice and I'm SURLY going in with a WHOLE New medical game plan for my HEALTH.
After watching videos over the weekend I canceled my biopsy and I'm having a follow up with the Dr. to see why he didn't have the same information. Do not just go and do what Doctors say without investigating first.
John Gillin i definitely agree!,
So what did you do?
My PSA hit 7. After several tests, including MRI Guided targeted biopsy, I start Radiation treatment for Stage 4 Prostrate Cancer TODAY. Age 71.
Excellent Doctor with clear explanation of the topic. Prostate MRI must be done before any biopsy. Thank you Dr. Tracy.
My PSA was a 104 ... my prostate was so badly inflamed it blocked my urine flow and damaged my kidneys and ureter something people don't talk about. I had to get on dialysis 4 hour a day 3 times a week,it sucked. Doc did a TURP to clear my urethra and Nephrostomy tubes were placed in my from the kidneys.
I recovered from it all ... PSA 1.20, with the help of Eligard (horomone therapy) only two treatments. I had to stop it. Doc tells me I have stage 4 prostate cancer ,mastitis to bone . No chemo or radiation for me. Ate greens took some herbs ... doing better. Peeing good but I'm not out of the woods yet, getting there tho. Oh, I'm off dialysis. Yay
My PSA level currently is 8.3. Is there the possibility of cancer? If yes, how is its status now, and what can be done to avert possible complications?
Yeah, my PSA was 443 and I was passing blood, having trouble urinating and leaking. They set me up for radiation and harmone therapy. I have finished my radiation and have had my 2nd harmone shot. No more leaking or trouble urinating. Tired all the time from meds but other wise feel pretty good. Go back in May for 6mo. checkup.
Thank you very much, doctor, for these very clear explanations. My father has a very high PSA and I had no idea what to expect once he would decide to see an urologist. Now I know. Thank you once again.
I got a high PSA for years and now 94 and feel just as good as ever.;never had treatmrnt
My PSA had been mid 8’s to 9 but pretty consistent for about 3 years. I had a few MRI’s and it would come back as enlarged prostate. My urologist said unless the numbers made a significant increase he would be comfortable diagnosing the matter as PBH. This month I finally had a TURP when my urine flow was reduced to dribbling and frequently at that. A biopsy was performed at the same time as the TURP. No cancer. Flow is back to normal.
Thanks for this information. I have a biopsy scheduled in less than to weeks. I am going to call and cancel it and schedule an appointment with my urologist to discuss the MRI screening as a next step.
My PSA was 86 and then 5000! Yes cancer has spread to far to try and cure.
Well did you get treatment when it was 86?
Well mine went from 1.8 to 10.0 in one year. I was worried sick I might have cancer. I wouldn't have a biopsy until you rule out other causes. In my case I went on Doxycycline for 3 months, turns out I had a prostate infection. PSA went back down under 2.0 on long term anti-biotics. A good doctor can usually do a physical exam and tell you if he thinks you have cancer. If not rule out everything else before a biopsy. They are quite painful.
This is a very good video btw.
did you have any feeling you had an infection or did you feel normal
Did you have any symptoms of the infection?
How long did you have to take antibiotics for?
I just had a prostate biopsy very painful waiting for the results . This video was very informative thanks 🙏
A benign enlarged prostate will also give a high PSA level due to the density of the prostate.
Yes, as I mention in the video, there are numerous causes of an elevated PSA besides cancer...
Mine as well. Readings were 8.5-9 over a three year period. Due to an enlarged bastard of a prostate that ruined my life with dribbling, explosive runs to the bathroom and absolute fatigue from nocturnal bathroom visits.
My husband 72 PSA is 3 primary dr referred him to a urologist for follow up no symptoms but since he did not have a DRE and is aPSA Was rising During DRE a lump was found uriologist ordered a mri aggressive lesion and small nodulars so a biopsy ordered lesion cancer and the other 6 nodulars Gleason score 7 option offered removal of prostate or chemo and radiation he decided to remove prostate
About 25 years ago, my father had prostate cancer. His older brother (my uncle) died from it. With my father, they used radioactive "seeds" implanted around his prostate. That stopped the cancer. BUT, we did not know about the collateral damage that this procedure produced. Years later, he had blood in his urine. The doc said that is due to the scar tissue coming from his bladder that was caused by the seeds. So they went in through his penis with a camera and laser and tried to fix the damage in his bladder. It was not successful and now he is completely incontinent. For the rest of his life he had to use Depends. Also, as more scar tissue tried to exit his bladder, the urethra would become completely blocked (causing many emergency trips to the ER). That led to wearing a catheter full time. Then the catheter would plug up forcing a flush routine. Then, later he started bleeding rectally. We were told this was due to the damage done to his colon because of the seeds that were implanted around his prostate. He lived with us and made it to 88 years old but the quality of life was dismal. I'm 67 and my PSA scores are climbing faster than "normal". I am scheduled to see my doc in a few weeks. I'm pretty pessimistic about what he is going to say and recommend.
😉🙏🏻
I am 64 and have had a 6.0-6.6 range PSA test for just over a year now. Doc wanted to go straight to a biopsy. I said No Way. Poking me in the rectum 14 times willy nilly hoping to find something is just a complete assine idea! So I tried an MRI but like most people could not go into that tiny tube!!! Why not sedate for this and have a 100% success rate??? What the hell is wrong with that profession that they refuse to sedate why can save lives!!!!! Anyways next step was a 4K score which will allow me to know for sure whether to do a biopsy. More to come......
Thankyou doctor, i am going in for a biopsy tomorrow (3. 3. 22) and am not sure what to expect.....i will get back for an update when more has happened.....regards from England uk.
My PSA was 4.5 at age 42 I was diagnosed with stage 4 and given a year after biopsy and was treated at Lakeland cancer center in Florida. I passed the digital exam biopsy only showed 2 out of like 13 or 14 needles used were cancer free 95% of my prostate was cancerous. They need to start screening men at least a decade earlier and yes I am aware that my case was unusual but more lives could be saved with earlier screenings there is a misconception that prostate cancer can be relatively low pain I had adenocarcinoma and trust me I went through hell before they found it. Thanks for educating people on this.
Thanks Steve for sharing this. I'm 46 and my psa has been 3, 4 and 3.5 in the last 3 years. There is a history of PCa in my family. Should I be concerned
@@muralimahadevan4860 yes definitely I my opinion u need a biopsy. Go to a urologist/oncologist please. Trust me u can feel something isn't right. Best of wishes. God speed
How are u doing now
Did you have your prostrate removed and how are you doing now? Thank you.x
I've had an ènlarged prostate. Five biopsies have been done and one of them done while in the middle of treatment of prostatitis. PSA was 21.9. Biopsies have been negative of cancer. I'm 72 years. I'm now ignorant of what to do.
I had three prostate biopsies and Two MRI scans with contrast.
Gleason score 3+3 on all three biopsies over a 12 year period.
PSA ranged from 4.5 to 7.5 but scored 5.4 on my last test.
I'm concerned that when a needle biopsy punctures a cancerous tumor, that the needle causes cancer cells to bleed out into the body.
Is my concern warranted??
Thanks
Thank you for explaining this procedure for us common people! It takes out a lot of the fear of the whole process.😊
Good video - I have PSA around 12 (I am 59 years old) and got very ill after an infection caused by a non-targeted biopsy. Then my consultant started trying Finasteride and other drugs on me and I realised he was basically going through trying the whole pack of everything, making me sick when I wasn’t sick before. So I insisted on an MRI scan which was negative, took myself off all his drugs and now monitor the PSA. I still don’t know for sure if I have cancer or not but this video will help me know what to ask for if the PSA rises further so thank you. The reality for us guys is that this very common male cancer is years behind in research terms because we men have been reluctant to talk about the issues and have not insisted on the levels of research funding that has gone into other cancers. At last that’s starting to change.
MRI scan showed any abnormalities and lesions, cant confirmed whether cancer, bph or inflammation except thru biopsy. To start finasteride at 59 is a bit too early, adverse effects on your libido
@@adam.3035 No abnormalities shown on scans (I have them every couple of years) and PSA has remained around same level. Nowadays I take 5mg daily of Tadalafil which helps a lot with enlargement symptoms.
Excellent vidéo thank you 🙏 very much ! My father and grandfather died with prostate cancer its the first cancer killer for men . I have done a biopsy and nothing but they want do others after 3 months I stopped since 4 years then I choosed IRM I will do it . My PSA is the same since 4 years 6 .
I had a PSA of 11.4 and went through that horrible test for cancer. Turns out a med I was on caused the high reading. It was called Lamictal.
Drugs such as Lamictal (Lamotrigine) have been shown to LOWER PSA. www.jstor.org/stable/48504110
When I was in my early 70s I was aware that my psa was slowly rising and I really wanted to believe it was due to old age. My doctor finally convinced me to get a biopsy and, you guessed it, I had cancer. I was treated with radiation for a few months and now a few years later it's looking like that treatment did the trick. For those of you who are reluctant to get the biopsy, I am totally with you and understand the reluctance. But the biopsy doesn't hurt and Better to Know Than not to know. Now dealing with BPH. It's hell getting old.
Look into 4K Score Testing which helps to detect Prostate Cancer.
Remember, having a high or low PSA doesn't mean you have or don't Prostate Cancer.
Do You mean that there is no obligatory diflection of psa to have prostate cancer? If the blood test is enough to be calm or there are some other neccesary test?
4K score is a biomarker that’s helpful in certain situations and can help us make key decisions regarding prostate cancer detection. But unfortunately it does not “detect” prostate cancer nor rule it out. It is another helpful tool in our arsenal!
Had the 4K score test and my urologist called me today to see about setting up an MRI appointment and possibly a biopsy. I didn’t know about the MRI fusion procedure for the biopsy. I will find out if that’s what’s going to happen. Thank you for educating me on this issue. Age 70 PSA 6.2. 4K 19%
My PSA was about 6 8 years ago. Had a biopsy and no cancer was found. The biopsy was uncomfortable but not painful.
I plan on meeting with my urologist in Jan. 2022 and will take this information about the “targeted biopsy”.
This advice reflects the current 'standard of care' for potential prostate cancer. With an elevated PSA, my urologist was set to suggest the old-style random needle biopsy, but when he saw I had gathered research material advising that the MRI approach is best, he immediately issued a requisition. MRIs are relatively scarce in Canada, but three years ago, regional peer research (Cancer Care Ontario) determined that indeed MRI is "best practice" for prostrate cancer diagnosis, so I was put into the centralized system to gain access wherever an MRI machine is available. The local hospital confirmed a 12:10 a.m. Sunday appointment, and I showed up on time. A few days later, the radiologist confirmed I almost certainly have BHP not prostate cancer,. Point is, as discussed here, you should not get.needle biopsy until after you have been checked with an MRI. If the MRI detects something questionable, then a targeted biopsy is indeed rational and the right thing to do.
I have my MRI biopsy in a few days - scared stiff -can't face it with local anesthetic - trying to get a general anesthesia for it ! Informative film ! R.
I am 70 i have been on testosterone replacement therapy for 9 years taking 2 ml testosterone shots a month during this time. My psa test at the beginning my therapy was 3.5. 9 years later i applied for insurance and had to take a medical evaluation . This included a psa test. My psa was 7.0. I immediately stopped my testosterone therapy and waited a month tested again and my psa went down to 6.0 my testosterone level went to 207. I waited 5 more months with no testosterone and tested again. My psa level was 2.7 and my testosterone level was 217. My suggestion for someone who has been on testosterone therapy for a long time is get off for a few months and retest. I went from 7.0 to 2.7 all i did was alow the effects of the testosterone to clear my system.
Are you back on testosterone?
im 57 years old and after having 4 of them in the first one they told me i had cancer and put on watchful wating with a biopsy one a year but having second taughts now it was 2017 i was told i had cancer
my case: 65 y, PSA9 _, MRI Pirads 5_ bioppsy 8 from 12 points +, consultings/opinions with 7 different urologist, Da Vinci prostata removing, prostata 50ccm, Gleason 4+3, T3a, PSA after 4 monts 0.018. Im glad been measuring PSA for the last 20 years.....maybe i could have had thebsurgery sooner...
Thank Doctor! I got the labs on Thursday and freaked out. Oddly I didn't run straight to Dr. CZcams. I feel greatly relieved now. Still very concerned, but relieved. I think I had prostatitis.
I was diagnosed with prostate cancer after my PSA jumped to 6.5. I elected to have robotic surgery. It's been 11 years now & my PSA is less than .oo1
Great presentation and comments from viewers. Your information is exactly what I feel my team should have presented to me, Dang it. Moving on, I had my first standard biopsy taken from twelve sites, “left” and “right”. Future biopsy method if indicated, will be with Fusion MRI. Would love to hear your view on comparing PSA numbers with Free-PSA percentages and what those comparisons may indicate, if anything. Like your watermelon seed analogy; mine is using a Ouija Board at a seance. Personally, I feel I was used as a lab rat for practice. Seriously. Not bitter, just disappointed that this department was way below the level of care available at the same place for eye surgery. My take-away is to pay much closer attention to research under pressure conditions. Hairs rising from the back of the neck actually do have meaning...
Very informative and echoes exactly what my urologist here in Massachusetts explained very clearly to me yesterday. Helps provide confidence that I am getting the best possible approach to identifying what is going on.
Hello Tony Can you please tell me the name and location of your urologist here in MA . Lacking confidence in mine. Thank you.
This is fabulous. Thanks. They found a nodule about two years ago, and I had normal psa, still worried.
Both PSA and prostate exam are important for prostate cancer screening...
Paternal GF and my Father both had prostate cancer. My Dad is 86. had his prostate removed at 63 (close to my age now). The first doctor either didn't explain it or my Dad didn't listen and UNDERSTAND: even after the cancerous prostate is removed, monitoring your PSA is necessary. my Dad's metastasized and he had tumors on his brain and lungs. (10 years after the removal ) he had the 2 largest tumors removed from his brain surgically, the other 12 smaller spots in his brain were removed via gamaknife. The spots on his lungs disappeared after he had a one year treatment of some drug that lowered his testosterone level to that of a castrated male. (Evidently his testicles still worked just fine.) 6 years later (now he is getting his psa very 6 months and it started to rise sharply without a prostate in his body) he had another tumor on his brain and had it removed.
Let me tell u....Prostate Cancer is bad shit!
what stage/gleasson score had after prostata removing?
Thanks for the information,I am a male of the age to be concerned.
So the PSA result is inconclusive, the Biopsy may miss the cancer, if indeed you have one, and if you have one, it may be so slow, that other things get you, and an elevated PSA might put you through a Biopsy for no reason.
All very depressing.
However if your work can localise and identify a cancer and establish the best treatment, all to the good.
I post this after a good friend died after complications from having his prostrate removed.
Yes females have equal problems, if not more.
I hope your expertise will help us all, thank you.
An informative video. I have some family history of Prostate cancer and while I have no symptoms or anything to suggest I have problems at this stage I do find it frustrating that all the commonly used tests including PSA, DRE and typical indicators like ability to pee etc. are all virtually worthless in eliminating or confirming cancer. As discovered recently with a family member all such tests/indicators can show everything is fine, but cancer was found suspected and then confirmed following an MRI for an injury that picked up the presence of cancer by accident. It seems many in the comments section are in the same position of not knowing whether there is an issue or not despite going through the traditional testing procedure.
i wonder how MRI scan can pick up the presence of cancer? MRI can only detect any abnormal spots and lesions which is not conclusive until biopsy
@@adam.3035 I'm not sure of the entire history as to diagnosis, the abnormality was spotted during a scan for an injury. Thereafter other testing was done. A biopsy is hit and miss in many cases since the cancer can be so tiny the chances of hitting the right area is slim. Overall the available techniques for detection are unfortunately unsatisfactory.
My PSA was 10.37, I had a Gleason score of 3+4, had an MRI scan, I had Brachytherapy two years ago, my PSA is currently 1.1. Get tested and get sorted
Normally Gleason scores like yours are not normally treated but usually just monitored with "watchful waiting".
@@mrofnocnon with a PSA above 10 usually means higher risk cancer
@@dgfarr1 yes it does. Have a 3T MRI or a biopsy to confirm or not. Could well be BPH.
What does Jacki Gleason have to do with it?
Thank you Dr. Gapin. Very informative. I am faced aged 72 with this problem having recently received quite a high PSA test result. I can now have an informed discussion / consultation with my Urologist on the next steps to be taken.
.
My PSA has jumped from 4 to over 10 in 2 years. They found cancer with the first needle biopsy and then more with the second one. Yet my doctor doesn't seemed concerned because it is a less aggressive cancer.
Thank you Dr. Gavin, the best lecrture I've so far heard. The vlog is very clear and helpful to a prostate patient like me. Thank you again. From the Philippines
This was very good information about what causes an Elevated PSA, however it’s sad to know that given the numbers of 30% of prostate cancer goes undetected that the STANDARD prostate biopsy by (blindly sticking needles “hoping” to locate the cancer if there is even cancer) should automatically not even be a procedure anymore. The MRI procedure should be the only way to go since it can pinpoint any irregularity of the prostate. Hopefully this not basically telling the patients you have two options. 1. Go the Standard route and hope and pray that the doctors get the cancer (if it is cancer). 2. Go the MRI route, but it’s probably going to cost an outrageous amount (just for the machine alone probably costs hundreds of thousands of dollars, maybe even in the millions) it’s so sad that in this day in time that we here in the USA are one of the highest in the medical field, but it’s all about the citizens that can afford it that are the ones that stay alive.
Prostate MRI is generally covered by your health insurance.
I got the line “we found it early, chances are you could have years before you need to treat it”. As luck would have I had to get another doctor, 6 months after the first biopsy they compared the initial MRI to a new one. And that inspired a second biopsy, and the doctors shook their head saying “that shouldn’t happen, you don’t have small cell carcinoma”. It turns out that in 6 months I went from one “mass” the size of a dime, to two. One the size of a nickel and another almost the size of a quarter. I decided I didn’t care about why get it fixed, I got HIFU one treatment. Cancer free 6 years.
what is HIFU
@@rodgerss5836 High Intensity Focused Ultrasound. I had one treatment and done. No Chemo, No radiation. Find someone in your area that does it and interview them. Don’t believe everything any doctor tells you, they are in the business of medicine and as such will promote themselves.
thank you
My psa was high and urinating was also painful but after taking black jack herb and 20mg zinc for one month the pain disappeared and psa is now 0.01
@@muhamudsewagudde shame on you trying to peddle your snake oil…
Thank you. If your PSA rises from say 1.5 to 3, get an MRI. I know of five people who have had prostate issues, one sadly passing away recently aged just 54.
I underwent two rectal biopsies last decade. They were not fun, but it was endurable. One biopsy resulted in a systemic infection, which responded very well to one dose of antibiotics administered intravenously.
Five years ago, I underwent a perineal biopsy, which went quite well, although it cost a lot more than a rectal procedure. A perineal biopsy is day surgery, performed under general anesthesia. No discomfort at all. The perineal biopsy found a cancerous condition that had eluded the 2 rectal biopsies.
My psa rose from 5.5 to 7.6 in a year.
Last week I had to argue with my urologist because he wanted to do a biopsy instead before an MRI saying that he is the doctor and knows best...but I insisted and finally referred me for one.
Good information. I had a PSA test done back in 2017 with a result of 1.1 total. I be 51 next month. Recently had another PSA test done about 2 weeks ago and the results came back as 5.83 total. My brain is working on overload trying to understand how it increased so much in 5 years. Now have my first appointment with a Urologist first week in August.
@angelsegarra5279 good move... wish you all the best.
this is SUPER info for men - PSA numbers are so confusing.
I just had a follow up (after 6 months) multiparametric prostate MRI (my second) last week. Seeing your video presentation had made it a lot easier for me to better understand the impressions given from results that came out of the exam.
In retrospect, I seemed not to have been enlightened beforehand of this med procedure since 7 years back. Was it because the multiparametric MRI of the prostate was still at the testing stage, thus not yet developed and not really subscribed to by some Philippine urologists? Let alone very expensive compared to the intra-rectal UTS procedure.
I expect to have an interesting and more engaging discussion with my Urologist on Monday.
Thank you for sharing.
It is absolutely impossible to get a straight answer from any urologists office on what protocol they follow. My urologist wants to do a random biopsy only. How fo we find a urologist that uses mri ?
Insist on MRI prior to biopsy and then targeted biopsy if necessary.
16 years ago I had a PSA of 61 after an episode of prostatitis. I've had two biopsies since then both negative and both of which resulted in infection of the gland. After multiple treatments, I am now allergic to 4 classes of antibiotics and still have a now resistant organism in my prostate. Wish I'd never had the PSA - a worse than useless test.
As I mention in the video, there are numerous causes of an elevated PSA besides cancer. The key is to identify the cause.
My PSA is 11.5 and I also have a monocyte count of 1.0. I have a cyst in my scrotum area as well. My doctor has me on some antibiotics and we retest the PSA in 6 weeks once the infection has been treated to see if this is all caused by this cyst. I'm very nervous about it all. My father-in-law died of prostate cancer so it scares the hell out of me.
Wow! Have one scheduled in 3wks, but I'm canceling this appointment and i am now going with the information in this video. Thank you doc.
So what did you do?
I had a rising psa in my late 50’s and early 60’s. I also had, in the words of my doctor, the largest prostate in town. I had 3 biopsies in 4 years, the last one guided by MRI and 30 cores. Everything negative. He tried a separate MRI, blood tests, a prostate massage test with a blood snd urine test, and X-rays. No sign of cancer anywhere. I was put on finasteride and Tadalafil and my prostate shrank, psa reduced, and symptoms substantially subsided. The doctor checks my psa annually and does the standard exam, but says I likely do not have cancer. I am still a little upset that he did so many tests when everything kept coming back negative, but I think he was sure that I had cancer and just needed to find it.
I wish 6.5 mine is >600, 2nd test >900 no symptoms with flomax and RSO I don't feel like I'm dying but apparently I am...
My PSA climbed steadily to 40 and now seems to have stopped . I am 94. Have had usual tests and living along quite normally. Think PSA seems to be some thing else in my case. I’m enjoying life and find my PSA tests interesting and don’t want any thing else done.
Thank you Doctor for your advice ,God bless you.
I’m 61 and had blood work done by my family Doctor which showed a PSA of 10, he referred me to a Urologist who did a DRE, and decided to wait 6 weeks and redo the bloodwork. My PSA had risen to 11, so he suggested a Prostate biopsy, which was quite painful. Had that done almost two weeks and will get my results it two more days. Not sure if I should rely on the result if it comes back negative. (Getting a little stressed).
Hi Lawrence, I am about your age and have been through this. It is a bit stressful. I had a first biopsy (a tad uncomfortable) without the benefit of the MRI. This video is correct, a biopsy without the benefit of the MRI is hit and miss. For me the first the biopsy was inconclusive. I waited for a year to repeat the biopsy, PSA shot up in that time. Ahead of second biopsy I had a MRI which showed up a small tumour. Biopsy then came back with detail of the a cancer and graded as quite aggressive. Removal was for me the best option. Its all clear now. Its major surgery. I don't regret it in my circumstances and diagnosis. If you did not have the benefit of a MRI and your test comes back negative or inconclusive discuss with your Dr/urologist the benefits of a MRI now. With your PSA elevation I think it justifies prompt action to resolve the yes or no issue. If you are not happy with the opinion of the DR or Urologist get a second opinion. This issue justifies serious attention from you and your health professional. Be proactive, get the best advice and treatment, seek second opinions on the various phases if you feel its warranted. Good Luck
The stress generates cortisol which is not good.
Just a quick update....my biopsy was positive for Cancer, and was graded at a Gleason score of 6 (3+3)...My Urologist decided to wait 2-3 months the have an MRI. I paid privately to have a 3T MRI, which I had 4 days ago and the result shows another lesion which has been graded at a Pi rads 4, and suggesting a targeted ultrasound biopsy. This is not at the sight of the previous positive biopsy....will see my Urologist next week to discuss this. Any thoughts? Starting to get scared now. (Oh yea..my PSA continues to rise..now at 12.)
Hi @@lawrencefuller5296, you are having a tough time and there is no denying it. You are doing the right things, pushing ahead with the diagnosis and you will now enter the treatment phase and have decisions to make etc. I cant speculate on this for you. But I know precisely what you are going through. I had the surgery and the cancer was confined to the prostate and I am clear of cancer. And I am thankful for having it identified and treated . There are support groups you can join, or just contact etc. You may find these of help, information is useful. I must admit I kept my research at this time on the treatment options and the recovery steps post treatment and what I need to do ahead of treatment, keeping healthy. Stay strong and best wishes.
Thanks for the feedback Neil...I have been attending a Prostate Cancer Support Group for the past two months, and yes, you’re right, they have been incredibly supportive and a great source of information. I guess decisions will be made after I see my Urologist next week.....will post after that.
Do you have a list of things for a patient to not do before getting the blood test?
Does your group do studies about what can affect the readings?
Wow, why didn’t my urologist recommend prostate MRI and MRI-GUIDED FUSION BIOPSY? I was scheduled for a standard prostate biopsy tomorrow, I’ve since canceled the appointment. I feel like I’ve dodged a bullet but at the same time lost confidence in my doctor who is board certified. I’m considering finding another urologist that knows how to do the newest and most effective procedure.
DrGapin.com - Smart Men's Health Dr. Gapin thank you, I’ll certainly keep you in mind if I don’t get any satisfaction from my current urologist. As it turns out I just discovered that his practice does offer the MRI FUSION BIOPSY, I’m really disturbed why he recommended this procedure over the traditional biopsy method, my guess is it’s dollars and cents. By the way are you familiar with the 4K score blood test, do you recommend it?
4kscore.com .
Joaquin Yes, I use the 4K score often. It’s a blood test referred to as a biomarker test that is useful for men with a persistently rising PSA despite a negative biopsy (and/or) MRI. It can help avoid unnecessary repeat biopsies. It does not rule out prostate cancer and should not be used in your case to try to avoid initial MRI/biopsy! Hope this helps.
Joaquin
Oh he knows about the MRI, he just does not want to spend the money on you to be tested!
Joaquin
I'm about to go 2 weeks.
My doctor never told me other options. I'll be looking for other options or urologist.
thank you, I have gotten more information now.After tell us about active surveillance.
Thank you for the info. I'm right where Joe is.
Very informative.
Mine was 8 got a biopsy and had nothing . Year later went to a T clinic and they took my psa ... it was 4.5
Presentation is great, very informative. Thanks
Best video on that subject. Clear and concise. Marvelous !. Thanks.
very clear explanation. i had PSA 16.0 no infection, it got down to 12 .4 in 30 days, no infection, i feel great, not going to biopsy, rectal exam Ok, stand by
Roberto Peña Hello if I may ask how did you get it down. my dad is at 9 . Thank you I'm worried
Roberto Peña Best wishes to you
Star Baby I didnt do nothing especial. Whent to another Doc. And new laboratorie. Its important not to press or touch the area of the prostate few days before exam. No sexual activity. No bycicle raiding or similar that could press that area. Changes ocurr after a month or two
The exam by finger must be ok.
Magnetic resonaince of special type my help. I my self waiting to do it. Its a little expensive here
Roberto Peña Thank you..best wishes
Mine is 20.
Thank you so much and now i understand why my Dr did targeted MRI for me but did not show any cancer thank GOD however its larger and psa elevated in 2 years up to 5.30 before it was 4.25 so we need to do biopsy using the MRI to target the wright location . You make it clear for me now and i am going soon to do it . I am stressed but not too much . Thank you
If the MRI was clear why have an invasive biopsy?
@@mrofnocnon they said just the biopsy will show 100% if its canser or not . I have done it and its not thank God
@@dr.muhannadalnaser2082 Good news.
An MRI cannot diagnose cancer, only structural abnormalities.
@@ransomcoates546 I don't think u understood my comment .
Monitor your psa if rising every 3 months get mri..than biopsy..than take action...dont delay
Forst my psa is 3.8 and i'm 62 this year, first i met a urology he perform a dre and ultrasound and he told me that nothing abnormal, he sent me to mri and it came there some abnormal i my prostate and my bone so he sent me again to bone scan they enjected me a radioavtive substans a week after he perform ultrasound guided biopcy now waiting for the result if i have prostate cancer the waiting giving me anxiety.
I kinda feel ripped off, with a PSA of 13.2. (Not a typo), and a recent 2 month biopsy that came back negative with 4 of 12 samples showing inflammation. Instructed to provide another PSA in 6 months. That’s it. I’m white, 67 and otherwise in very good health.
Thanks for your video. Very informative.I am at 4.8 PSA. i am seeing my doctor tomorrow to discuss whats next.
What do you for the cancer? After all these information.
Thank you, great video! I requested an MRI after reviewing your video.
My PSA was 4.25 last April, went up slightly and back down to 4.25 now. I had a prostate MRI on yesterday here is some of the report.
Impression:
No evidence for high-grade prostatic malignancy.
BPH
Findings:
BPH in the transitional zone
Peripheral zone maintains normal signal
Bones: No suspicious osseous lesion
Lymph nodes: No Pathologically enlarged or morphologically suspicious-appearing lymph nodes
I haven’t spoken to my doctor yet, but does anyone know if this sounds favorable?
Thanks!
No evidence of malignancy that sounds great.
I have always maintained a PSA around one or less . My urologist said he would be more concerned if my PSA rose to 1.5 or two .
I've had all your recommend procedures and came out with a Gleeson score of 7...i'm sorry i had the biopsy because I'm convinced that the biopsy has stimulated the cancer. ...should have left it alone
grahmhw Prostate biopsy doesn’t cause cancer. Be thankful your cancer was found early.
Sarasota Prostate Care i didn't say biopsy caused the cancer. ..
A biopsy can stimulate the cancer when the biopsy needles are withdrawn through the cancer hence spreading the defective cells. not rocket science, think about it.
It is proven that early detection means little, the death rate is the same. Do your research.
@@DrTracyGapin Are you not aware that biopsy needle withdrawal can spread the cancer?
There is also no evidence earlier prostate cancer detection prolongs life.
Great video and so well explained - step by step practical approaches. Thank you
Thank YOU. Excellent, well spoken commentary and very elucidating. It all makes total sense, and helps someone make prudent decisions.💫
I'm going get a prostate biopsy today 6/12/2019 and wonder why this wasn't even recommended to me. I will ask about it though.
Thanks Dr. Tracy , very informative.
What about high definition ultrasound that can kill prostate cancer if the patient qualifies ?
DR Gapin Im a Nuclear tech. Im seeing pts have MRI after the Biopsy, My situation 2.6 age 50, 5.3 age 57, 25 months later I'm at 5.1 , Ive had BPH for 5 or 6 years. DRE appears to close to useless. A recent Harvard study showed that the probability is that all these tests would save 1 man out of 1000, But cause extensive psychological pain for all. They refrained from doing anything but talking with your dr. Cancer is the whole reason for all these tests but what is the actually likelihood of aggressive ca out of 1000 men with elevated psa. TY God Bless
Hi Walter, great question... There has been a lot of public discussion and debate about the value of PSA testing. The European trial (ERSPC) has demonstrated an overall survival benefit of over 21% with PSA testing and that value has continued to increase as we follow those men over time. The US-based PLCO study was greatly flawed, yet it has also shown a survival benefit with PSA testing. The critical part of it all is how we manage prostate cancer once it is detected. For too long, we have over-treated clinically insignificant, low grade cancers that do not cause mortality. In those men, the side effects of treatment has offset any potential benefit. But men with higher grade, clinically significant cancers NEED treatment - there is no question. So the overarching question is how can we find the significant cancers while not over-detecting the insignificant cancers. In my professional opinion, MRI is very helpful in that regard. Three recently published large prospective studies support this. Hope this helps...
I just had a PSA test go from .6 from last year to 9.5 this year. My doctor called with the results and stated we will check it again in 2 months. Should I wait that long?
There is not a procedure where the MRI guided biopsy is done by entering the perineum. Way less invasive. No threat of infection because the rectum is not involved.
Awesome video thank you. Any chance of making an update to this?
Ultimate reassuring advice ,very well presented ....Thank you very much Sir !
Conscious sedation during biopsy allows the urologist to poke away without your discomfort. Gleason score?
A year ago, my PSA score was 453, 6 months ago, it was 596, 6 weeks ago, it was 705! I am having symptoms, sporadic pain in my back, thigh hip, and legs. Had leg fracture 33 months ago and pin in my bone. test positive for bone cancer. I will have some baking soda, molasses, water and Black seed oil treatment.
Are you seeing a doctor?
Thanks for that wealth of information, God bless you 🇬🇧👍🙏🏼
Question: what is the role of a cytoscopy here, if at all. I think my urologist is going to use that.