tinfly, you probably know, but in case you don't, the usual steps in finding a treatment plan is as follows. This is how it is for the majority of men here:
Detection begins with a high PSA result, or a lump/knot/mass being felt during a digital rectal exam (DRE). The doctor, if not a urologist, will refer the guy to a urologist. Once there, they may or may not repeat the PSA test, they definetly should do another DRE. The patient should abstain from any sexual activity for 3 days before the blood draw, and the DRE should not be done until after the blood draw is done. Most doctors will start us on a round of antibiotics for a couple/few weeks, then retest the blood. At that point, if the PSA is still higher than normal for the age and size of the prostate, a biopsy will be done, usually from 12 to 16 cores taken for the path. lab to examine. The results usually take a week or less to come back, and the results will determine the initial staging and Gleason Score, giving you an initial but not complete idea of the cancer, if there is any in the cores. A biopsy can totally miss a really small and early cancer, so if you get a "nothing found" result but still have high PSA, then you will need to retest PSA often and watch it. Any PSA rise would be the trigger for another biopsy. I hope I have given you the normal progression of testing and detection of PCa, as we see it here.
One other favor? Could you unlock your Caps button? Normal Internet protocol has all capitals typing as shouting. You may feel like shouting, with the results you may be facing, but we're here to help, ok?
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing
open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN