I also had a bulge felt by my primary physician. Sent to URO, did biopsy, no PC, just HPINS.
Year and few months later went to another Uro for kidney stones. He did a DRE also, felt bulge, and did a biopsy. Gleason 9.
Surgery at Cleveland Clinic, clean margins, 15 month PSA <.01.
I say all this to say
Gleason 9 is a nasty, aggresive form of prostate cancer. It grows very quickly
You have no way of knowing when the HPINS became cancerous. I would say as a non-doctor, that 1.67 indicates you didn't have very much if any PC at the time
You can beat yourself up, you can sue the doctor and spend a lot of money on lawyers, and maybe you can get something, the odds are as a non-lawyer, you can't.
You can just accept that it is what it is, and concentrate your efforts on fighting the disease, not the doctor. You need all the mental strenght, all the physical stamina, and well being .
This disease is a son of a b. You will find guys with a Gleason 6 on here who had 5 % volume , and had to have SRT. You will find guys who have Gleason 8's or 9's who are still doing ok without the radiation. There is not a lot of rhyme or reason sometimes.
I certainly am not telling you what to do. I have had to go through a lot of thinking on this whole thing, and I have found that just accepting the hand I am dealt, and playing it, has given me a lot more peace than wishing for an ace.
I do wish you the best of luck. Hopefully the PSA will go down on the next test,and some of your worry will be for nothing. On the other hand, many men here have gone to the next step and done very well.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic 4/14/09 Nerves spared, but carved up a little.
0/23 lymph nodes involved pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free 6 week PSA <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED. Trimix injection
No pads, 1/1/10, 9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01