Q. Do you recommend surgery for my prostate cancer?

 

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Hi doctor,

I am on active surveillance for the last 2 years. My initial prostate biopsy was 2 years ago and showed 1 out of 10 needles cancerous, Gleason 6, slow growing and Prolaris test showing a medium growth rate. I had second biopsy 6 months ago. Before the second biopsy, my PSA was 5 and four months after the second biopsy, PSA was 16. My doctor recommended an MRI based upon the elevated PSA.

An MRI was done 2 weeks ago. Prostate volume 81 cc and two lesions were found. First lesion measuring 0.7 cm x 0.6 cm x 0.7 cm, Pi Rads 4, well contained mid gland and the second lesion 1.2 cm x 0.6 cm x 0.7 cm, ungraded, margins not sharply defined and a slight bowing of the capsule. I have had intermittent infections after the second biopsy and been on a three regimens of antibiotics. I have also experienced retrograde ejaculation after second biopsy. I am thinking that the second biopsy caused my elevated PSA (5 to 16), swelling of my prostate and perhaps I can remain on active surveillance with antibiotics since the MRI showed my cancer being well contained. I am wondering if I should have surgery as recommended by my urologist to remove my prostate.

 

 

Answered


Hi,

Welcome to dr.sitehome.info.

I have gone through your details.

  • My main concern is the rise of PSA (prostate-specific antigen) from 5 to 16.
  • Though it might be due to infection, since three months you are taking treatment of infections. So, your PSA should have reduced if the rise was due to infection.
  • At present, you are in the best stage and shape to get rid of cancer by radical prostatectomy.
  • I suggest that you should undergo surgery and get rid of it. Also, you are only 62 years. Since life expectancy is more at some stage, you have to get rid of it before it progress more.
  • So, I suggest you better do it now than later or too late. Take care.

For further information consult a urologist online –> https://www.dr.sitehome.info/ask-a-doctor-online/urologist

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