Thank you

Chickened out of my scheduled biopsy -- opting to have an MRI instead. No idea what I'll do from there. The aftermath (bleeding) from the biopsy throws all my circuit breakers. Just can't deal with it.

great info many thanks :)

Iv recently got a p.s.a. of 24 & a pirads 5 on my m.r.i. scan, nuclear bone scan came back o.k. my doctor said he wants to do a biopsy, im 68 now, he said make a decision, after he explained in depth about a lesion found etc! Im torn between do i have the biopsy or do i not ? Do i just carry on and let them monitor it closely etc ! Im not worried about the procedure its just the after effects im concerned about 🙉

Always appreciate your direct answers. I have recurrent prostate cancer where initial cancer 3 tears ago was ine 4+3 and one 3+4; now have two 4+4, one is 15% of the tumor, and the ither is 10%. Am looking at radiotherapy but concerned about ed (considering impt, or photon sbrt). Has been hard to get figures on erectile dysfunction and if pills will help or will an implant be required. Also, what are your thoughts on whole gland tulsa pro for gleason 8? Ty

Correct me if I'm wrong, but a secondary cancer from radiation treatment might be one extra person per 1,000 treated? It would be nice to use cases per 1000 treatments so that the viewer can better understand risks.

I was diagnosed with PCa Gleason Score 8, grade 2C back in Aug 2023. I have opted to change what i put in my piehole...lol. I am on ADT therpy. sideceffects are not that bad, but i atribute that to my diet and lifestyle change. Im doing really good, lost 70lbs since then. My PSA started at 17.9, but is now down to 1.93.

Great content. I'm not sure where other men might be having a psma pet but here in Florida the cost without insurance was billed to my BCBS $89000. That's not a typo, almost $90k is just mind boggling to me when I saw the insurance eob

excellent presentation. Well paced!

Does age and fitness make any difference to the degree of side effects?

Thanks again for all of the helpful information in an understandable format. It was most appreciated.

.....and it's exactly why i'm not going to get one. too many 'tales'....of post-op probs and issues. All they're doing is...'Searching', somewhat-randomly, on your very delicate prostate. it's a Barbaric Procedure. No Thanks. Take my chances.

My PET scan was negative for anything outside of my prostate. However, the PET scan failed to detect some areas that were biopsied and were positive for cancer. I was told they were going to do additional deciphering tests on the remnants of biopsy samples. No results yet. One thought I had was what if the cancer I have developed is not sensitive to the PET Scan? Could it have already migrated out of my prostate into other areas of my body and simply be undetected because it is not yet sensitive to the PET Scan? Am I overthinking this? Thanks.

Are you familiar with the TULSA Modality using radiofrequency ablation on the prostate? How does it compare with radiation therapy and surgery? I have been offered the option of all three modalities. I am 68 years old and in generally good health. I am trying to weigh the risks and benefits of each. Thanks.

Thank you for this video. MRI showed PI RADS 5 and the fusion biopsy showed inflammation and no sign of cancer cells. (Psa 5,7 and 0,09). I am confused.

Is there any more data on IRE/nanoknife. You seemed focused on erectile dysfunction. If you are concerned about side effects of incontinence and colorectal issues and have 4+3 in one small segment why would nanoknife be a concern. I’m interested if you can do a talk more about IRE more such as nano knife.

The problem with surgery and radiation therapy is that there are side effects. As a result, the small additional risk of active monitoring might be worth it if you can live for many years without the side effects that you can have from treatment.

Lucky me … I am having 35 rounds of radiation after having been through the surgery

Thank you for a very factual and informative video..

52 year old male, have been on finesteride for the past 26 years for male pattern baldness, came off finesteride (5mg 1/4 daily) in March, psa went from 2.6 to 4.5 in 14 weeks, free psa % was 12.6%. Had an MRI 1 week ago, a 5mm lesion was identified with a PI RAD = 4 score. Urologist recommending a biopsy. Could this lesion have been in my prostate for a number of years whilst on finesteride and it has now become more aggressive from ceasing the 5 alpha blocker?

Is there anyone in colorado that would do this test

I live in Las Vegas, they don’t have that capability here.

Dr i have a digital and MRI confirmation of prostate cancer, i want to use fasting,diet and alternative therapy, i fear a biopsy it will spread? , im 65 ,and plan maybe to skip byopsie, your thoughts?. PSA last test 5 Please some common sense advice, if i can live another 5 or 10 and monitor id be happy,

My doctor sent me for a biopsy with psa at 5.6. Biopsy showed one of 12 positive for cancer what should I do now.

Hello doctor great information. I am 61 had psa score 6.6 had mti irad 5 had biopsy getting results tmrw. Only had light symptoms no aches stinging or night trips no symptoms at all last 6 weeks very nervous abt tmrw however.

Thank you for this great information. I’m 75 years old diagnosed with prostate cancer on March 2024. My psa is 4.3, Gleason 3+4 m=7, favorable intermediate risk, DRE negative with family history. My Psma Petscan is negative. However my Decipher is .64 and it puts me on high risk group. My choice is radiation or surgery. My radiologist thinks that I will need 6 months of ADT. However my hormone therapist left it up to me if I want ADT or not. He said in a bubble as far as needing ADT and my urologist agreed. If I do radiation I have to have a second TURP due to my bad urinary symptoms and I have to wait 2-6 months for prostate to heal before radiation. My first TURP was done 30 years ago. My surgeon favors radiation due to my age and side effects. If I do TURP on July 2024 and start radiation on December 2024, am I waiting too long to start treatment? Am I making the right decision for not wanting ADT due to my joint pains? Is surgery still a good option for me? Thanks.

Important!!! My first urologist made the conclusion that because my PSA was 23 he wanted to take 12-14 biopsies without a physical exam via the TRUSS approach. Second urologist with the knowledge of my PSA of 23 did do a physical exam then stated “you have cancer” then ordered a T3MRI with a T3 magnet and concluded the necessity of 12-20 biopsies via the TRUSS procedure. My third urologist reviewed the T3MRI that did identify cancer and ordered a TPP biopsy. (Not the TRUSS procedure) The 25 biopsies revealed cancer. He has ordered a PSMA PET scan to confirm if the cancer has spread through my body. Conclusion: do diligent and forensic research.

Appreciate the correspondence and sincerity you have with your commenters... Subscribed! (And yes, just got my MRI results showing a PIRADS 4 and 5 discovery after a PSA blood draw level of 4.74... age 61)

Am in the UK, my husband is just going through this. PI-RAD of 3, PSA of 10.1. He's had the MRI, 2 x DREs and now they are talking about a biopsy and will take 12 bites so my thoughts are why did they bother doing the MRI because they will revert to the grid system and just go with that anyway. Yet the MRI was sold as a tool to reduce biopsies - now it seems as though they are causing an increase in the number of bites during biopsy. Surely, if the MRIs are all they cracked up to be the biospy bites should just be in that area.

I was diagnosed with prostate cancer April 15 (my father has PC Stage 4 metastasized in his bones. He's 92yrs old, having only been diagnosed 3 yrs ago. Dr. said he would pass of old age so to speak, before the cancer could get him). I had a Total PSA of 2.9 and percent free PSA below 10% (the red flag that alerted me). My in-bore MRI targeted biopsy confirmed Gleason score 3+4=7. After exhaustive research I elected for in-bore MRI focal laser ablation. Surgery was outpatient and it went excellent. Surgery was 8 days ago and I feel great, with no negative conditions following the surgery. The only inconvenience was having a catheter in for 8 days. There were no issues with the catheter other than "it was in there". My best to all that have been diagnosed with PC.

Hi doc,No blood in the urine,abdomen twice are fine,ct are normal ,cystoscopy bladder are red. Burning in penis after toilet.doctor are no clue.should i go for biopsy

I did half my prostate 3 years ago with hifu but unfortunately it has come back. I was happy with the lack of side effects, however, sad that it didnt last long. I was psa 13 and had a 4+3, and a 3+4..

All of your comments are so thoughtful and respectful and considerate✅👌🏾 Your comments gives me humility on your part and that’s what I am looking for in a doctor. Your answer here says it all about your personality and how you approach healthcare and you are diligently replying to so many people. Thank you so much.

I don't know what to do. I have early T2a cancer, growing through the prostate capsule, possibly. My gleason is 3+7..psa 7.6. My cancer hasn't gone into any other areas, definitely not lymph nodes or reproductive ducts. I don't want surgery and can't have radiotherapy as also have median lobe enlargement. So am stuck. Terrified of the treatment not so much the cancer. I cannot make a sensible decision. My surgery would definitely cut out erectile nerves

A great summary of the stats. Your counterpart did a great job of pulling the data all together. I'm Gleason 8 and have been researching options for treatment. Your video was very helpful in understanding the risks of my Gleason group. Thank you.

Thanks ☮️ very useful information given me a clear understanding of my condition. ❤

Under MRI results show as PIRADS -2 & 3. Is here Biopsy test required?

Know this vid is a bit dated, but thought I'd add something not addressed in other comments, see if cancerbetter has any thoughts. my case: PCa biopsy confirmed Gleason 3+4, with quite narrow 4, and full workup confirmed prostate only, but 70y.o. & great general health so watchful waiting ruled out. Meanwhile, BPH symptoms quite serious, IPSS ~ 19-20, gland size ~150cc, so we opted first for PAE. PAE obviously for its own likely benefit, but also for possible indirect impact on PCa, with the working theory that PAE-induced size reduction, if significant, could impact PCa therapy risk/benefit decision-making. I have found almost no research for this theory (one paper did conclude a successful "proof of concept"). MRI at 3 months post-PAE, prostate size down ~35%, IPSS maybe 12, I will probably do focal HIFU, waiting for my uro's hospital to get the latest Focal-One unit installed. Any thoughts on potential synergies with these two therapies in some cases?

And don't forget , boat and condo payments HAVE to be made. So you will see Doctors pushing test after test after test.

Thank you so much for telling me what the options are. 👍

Thank you dear doctor. I have a lump on my prostate test psa was 1.0

One of the best videos I’ve seen, I like that you present actual data as I’m a numbers guy. One question I have not found an answer to: if you have a PSA>20 but all other measures are consistent with intermediate or low risk, the PSA overrides everything else and you are lumped in the high risk group. What is the evidence to support this decision? And is it really justified to group those w high PSA with those that have high Gleason scores? Thanks!!

Is the bottom line a complete removal of bladder when you are talking about muscle- invasive Dr? Thks...jc

Hope you can give me some insight.56 white male,been dealing with chronic Lyme disease for a little over a decade.Haven’t been treating it the way I should because I’m also a full time caregiver to my 91yr old mom who has Alzheimer’s/dementia in this same time period.I get all over body inflammation,brain fog and my adrenal glands are shot from the stress of watching my mom deciine.Shortly after my diagnosis of Lyme my psa started rising.Had a biopsy 6-7 years ago when psa was 7.8,I think my Gleason was 6.Came back negative.It’s steadily risen over the years.Last April it was 11.3 this April it’s 13.1.Can my cortisol levels being high and the chronic bacterial infection of Lyme be causing this continual rise?I also consumed way too much sugar.I’m cutting back on my sugar and my physician wants me to go back to the urologist.They didn’t do an mri last time they just went straight to the biopsy.Unless they’ve figured out a lesser evasive way of biopsy I want no part of it and my urologist seems to have a very aggressive manner of treating things.I truly feel that the continuous stress I’m under and bacterial load from Lyme can be causing this,what are your thoughts?Thanks for any input.

Hello Dr. I’ll be 52 years old in July, i had my 1st PSA scan 6months after I turned 50, it was 3.4, so i changed my diet lost 25-30 lbs starting eating healthier. I’ve always went to Dr appointments every 3-6 months for many years. I do have hypertension and take 1 pill a day of low dosage medication. Well, to my surprise I went to my 6 month appointment my bloodwork showed my PSA was at now 9.45. I went to a urologist, my bloodwork showed that PSA was at 10.45 in 2 week period. Prostate Biopsy was done and of 16 samples 11 test for PC, mri showed PC, PET scan showed it has spread to lymph nodes, femur bone, hip bones, spine, PSA now at 22. I have no symptoms, no pain, no signs of anything other than what I’ve shared. I actually feel great, except mentally it’s very disturbing. My Gleason score is 9 and I’m high risk. I just don’t understand this… Thanks for your input advice and videos 🙏🏿

I’m 64 and diagnosed with Gleeson 6, low risk prostate cancer cancer. But I cannot live with this in my mind if I follow the active surveillance program. What we do not know is the probability of the Gleeson score becomes higher in future,and therefore requires treatment. So I choose to have radical radiotherapy, involving just 5 fractions of SBRT. Fingers crossed

All I will say is get a 2nd or 3rd opinion before doing ANYTHING!

Insurance companies are still rejecting PSMA PET scans even now.

Thanks for smart advice. I like your enthudiasm and caring demeanor.