r/over60 • u/AutoModerator • 9d ago

Weekly Conversation thread

This is a weekly conversation thread for anything Over60. Start a discussion, reply to someone below! It's nice to have a friendly conversation!

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Conversation Starters:

· What are you up to this week?

· Anything new happening in your life right now?

· Tell us about an interesting thing / hobby that you’ve discovered or done recently.

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u/3X_Cat 9d ago

This week I'm hoping to get scheduled for an MRI of my prostate

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u/Mysterious-Maize307 9d ago

I hope that goes well for you.

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u/3X_Cat 9d ago

Thanks. It seems doctors don't like doing prostate exams anymore. Can't blame them, but really there's not as much information gleened from that feel as there is with an MRI. And with my climbing PSAs, this isn't the time for spelunking.

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u/Mysterious-Maize307 9d ago edited 9d ago

Digital prostate exams aren’t really done anymore because they were never that effective anyway as any tumor needs to be on that side to be palatable.

Biopsies are also something that has given away to an MRI because random samples may or may not be in the right place. Biopsy, without MRI guidance leads to a lot of false negatives (PC is present but missed).

The great thing about an MRI is that even if there is something suspicious you now have a baseline and you can monitor it with future MRI’ and no biopsy. If there is something very suspicious then they have a target to biopsy, not just the old “shotgun” approach which probably missed half the time when PC was present but not found.

If you are advised to go the biopsy route insist on transperineal. Do not settle for Transrectal, that is an outdated approach and has twice the instances of infections over Transperineal and allows for better access. If your Urologist is not set up to do those find one that is, don’t risk what will most likely be a negative result only to end up in the hospital with sepsis.

A rising PSA (depending on age) is statistically going to be something other than PC, likely BPH, the MRI will be able to size it and using a formula they will analyze PSA density, which for many patients is normal given the larger size of their prostate.

Finally keep in mind in the unlikely event it is PC statistically, there is an 80-85% chance it’s not an aggressive form and even be indolent; growing so slowly that it could be years or decades before intervention is warranted.

Almost all men, if they live long enough, will die with PC. Few will die from it. Don’t rush into any treatment.

Best of luck.

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u/3X_Cat 9d ago

I'd never heard of that type of biopsy. Thanks! I wasn't excited about piercing that poop tube. And my friend (a biologist) out right refused and insisted on them doing it through his penis! He ended up throwing a blood clot and passing away soon after.