Prostate Cancer Progress Update for 2022

 Hi folks,

It has been about a year since my last real status update.  Lately my numbers have been trending up, so I thought it might be a good time for an update. 

The main point is that my PSA numbers have been trending up lately. I don't think it would be a stretch to associate my journey with prostate cancer to the old story of 'how to boil a frog'.  In my case, I'd have never known I had cancer if not for my quarterly PSA check-ups.  Guys, YOU'VE GOT TO MONITOR YOUR NUMBERS in your annual check-ups!!  Otherwise things like this can sneak up on you, and you don't find out until they actually do start causing problems with your health. As of today, I can still honestly say I haven't had any symptoms so far that would indicated anything other than an enlarged prostate. 

Just to re-coup, here's a brief history of my numbers.  

Date:            PSA
Jan 2017       2.94
Jul 2017        2.78
Jan 2018       2.7
Jul 2018        2.96
Mar 2019      4.88 (there are some things you shouldn't do just prior to PSA testing!! :) ) 
April 2019    3.76
Sept 2019     4.12
Jan 2020       5.13
Apr 2020      4.27

Dec 2020     5.97

Jan 2021      4.71

May 2021    5.58

Oct 2021     6.67

Feb 2022     7.53

An MRI in  Dec, 2021 indicates a larger tumor with more aggressive signal characteristics than the previous examination. 

Based on that Dec 2021 MRI, last Friday I underwent what I believed to be an MRI guided biopsy.  I've done this every couple years since being diagnosed but this was a new experience.  Up until last Friday my MRI guided biopsies had been done by Dr Joe Busch in either his Chattanooga or, most recently his Alpharetta office.  He'd give me a local, load me up in the MRI and directly stick the tumor once or twice.  After recovering for a few minutes, I'd drive myself home.  Going to Dr Busch was a quick and easy process.  

This last time was performed by Northside Urology though, and was definitely different.  Shame on me for not noticing the difference until the last minute, but what they perform is a 'Fusion Guided Targeted Biopsy' when I requested the MRI guided biopsy.  They administered anesthesia to knock me completely out, which of course required me to have my wife there to give me a ride home. Also, there was no MRI directly used during the biopsy.  As I'm now confirming with some research, I feel like I've been duped!!  During a Fusion Guided biopsy; 

    The urologist sees the target based on images generated from a previous MRI fused with real-time         ultrasound. However, real-time ultrasound does not distinguish tumor from prostate tissue within the     gland, so the software creates a “model” of the patient’s gland showing an artificial depiction of the         size, shape and location of the targeted tumor.

That sure explains why the Dr this time indicated he took 4 'sticks' to get the samples for the biopsy when Dr Busch only used to need 2.   Also makes me wonder whether my having to say 'Fusion Guided Targeted Biopsy' at least 4-5 times during the visit in response to "What procedure are we performing today?" from the nurses and Drs. was to cover the fact that I had requested an "MRI Guided biopsy".  Again, shame on me for not noticing and reacting to the different terminology used by my Urologist and the Radiologist and Nurses just prior to the procedure.

I'll cover MRI Guided vs Fusion MRI-targeted biopsies more in another post.

All that being said, I'm waiting to see the results of the biopsy to determine my next steps. I'm also anticipating looking for all new Drs related to my prostate cancer.  Anthem BCBS is currently negotiating with Northside Hospital here in the Atlanta area regarding whether they'll continue to recognize Northside Hospital as a preferred provider.  This relationship was originally going to end Dec 31, 2021 but due to 2 extensions ordered by local state judges, the contract between Anthem and Northside Hospital has been extended through April 15th, 2022.  I'm not looking forward to having to find all new cancer specialists, but I have to stick with someone that is covered by my insurance. Sadly enough, Dr Busch recently stopped accepting insurance and his prices  for procedures are high. The value he provides is significantly beyond what I've experienced from Northside Hospital and GA Urology, but without insurance coverage I find that I can't afford him.

Take care,

Tom