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Dr. Andrew Rynne

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How can a bump on the prostate be treated?

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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10008 Questions

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Posted on Fri, 3 Mar 2017 in Urinary and Bladder Problems
Question: In the fall of 2012 my primary doctor felt a small bump on my prostate. I went to an oncologist and he done a biopsy. Found a XXXXXXX 6 in 1 of 12. with a .70 PSA. He Asked if I wanted cemo, radiation ,surgery or watchful waiting. I chose the waiting. I went online and done some reserch and changed my diet, started juicing taking vitamins, turmeric, etc. etc.. About 6 months later He done a MRI and said there might be something in one area. So then done another 16 core biopsy and found no cancer this time, PSA .80. . I have continued on my diet 80% of the time. I decided to stop going for about 2 years. He gave me another MRI. It said that I had a 10 x 13 x 9mm nodule which demonstrates decreased signal on ADC map imaging and abnormal enhancement kinetics on multiparametric imaging. No other abnormal nodules are identified. lymph nodes normal, Blatter normal, no bony lesion or fracture. PSA 1.1. He wants to do another biopsy, do you think I need one? I don't. Over 4 years with not much change. Only good oncologist need apply
doctor
Answered by Dr. P. T. Patil 20 minutes later
Brief Answer:
This query is being answered by me as it falls in demon of Urologist

Detailed Answer:
Hello
Thanks for query .

Based on the facts that your PSA has been persistently within normal range for last 4 years and negative biopsy results and other findings like lymph node involvement or bony metastasis being negative I personally think there is no reason to suspect you to have cancer of the prostate .

There is no harm in waiting for 2 more years and decide regarding doing biopsy after two years .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 21 minutes later
the first biopsy had 1 of 12 cores positive, a XXXXXXX 6. What about a MRI after another year or two instead of a biopsy. biopsy's are a little invasive, also a 4% chance of infection and a few days in the hospital I don't mind doing another MRI after a year. I do have a young wife and a 6 year old child. I don't take any medications, don't smoke or drink and on the skinny side. I do get a little exercise. If MRI didn't look good after another year, could then do biopsy. How does that sound.
doctor
Answered by Dr. P. T. Patil 1 hour later
Brief Answer:
Biopsy to be considered only if PSA goes above 4

Detailed Answer:
Hello
Thanks for follow up .

Biopsy of the prostate is the only reliable an confirmative test to confirm Cancer of the Prostate .

It is world wide accepted protocol to do a basic screening test of blood examination for Serum PSA and go for biopsy of the prostate only when PSA shows rising trend above normal value of 4 .

I still do not understand rational behind doing biopsy when your PSA levels have never gone above normal value of 4.

You can just do MRI and discuss with your Oncologist the reason for doing biopsy .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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