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HomeAnswersUrologyprostate cancerIs surgery needed for my prostate cancer?

Do you recommend surgery for my prostate cancer?


The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 27, 2016
Reviewed AtJune 26, 2023

Patient's Query

Hi doctor,

I am on active surveillance for the last two years. My initial prostate biopsy was two years ago and showed one out of 10 needles cancerous, Gleason 6, slow growing and Prolaris test showing a medium growth rate. I had second biopsy six 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 two weeks ago. Prostate volume 81 cc and two lesions were found. First lesion measuring 0.27 x 0.23 cm x 0.27 inch, Pi Rads 4, well contained mid gland and the second lesion 0.47 cm x 0.23 cm x 0.27 inch, 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.


Welcome to icliniq.com.

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.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Khant Shahil Ramesh Bhai
Dr. Khant Shahil Ramesh Bhai


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