Told about elevated PSA by family doctor, referral to urologist. Enlarged prostate independently spotted in CT. At urologist, am shocked at the details of the biopsy, especially the bit with needles poked through the rectum and requirement of taking Cipro.

MRI of prostate is inconclusive. Nothing clearly looking like a tumor visible, just some larger spot that could be an inflammation or a tumor.

Urinary symptoms worsen with long sitting and gluten diet, improve significantly later the summer with gluten free diet.

Received phone call from family doctor's office because of further elevated PSA, now at 11.85. I had been doing fine though urinary symptoms worsened a bit over x-mas. Am totally shocked, called uro next day for appointment.

Agree to biopsy at uro on 13 Feb, get Cipro prescription. At biopsy on 21 Feb initially difficulties getting probe through somewhat tight anus. But afterwards had no issues with 12 shots fired into my prostate. However, am told results take a month.

In Montreal plan is to perform RRP at my local hospital, not specialising in prostate surgery. Referral to one of the high volume treatment centers with DaVinci equipment fails. Called in Germany, got dates for consultation and preliminary surgery appointment in case of positive biopsy. Booked flight.

Desperate to get results from 21 Feb biopsy, am trying at the archive of university hospital presumably having my slides. Sure enough, results are already on file, despite claims from my uro for a 4-6 week expected turnaround.

Left side 2 cores positive, Gleason 6 (3+3).
Right side 2 cores positive, Gleason 7 (4+3) with grade 4 cribriform pattern, suspicion of vascular invation, no PTEN loss.

RRP in Berlin. Catheter removed 9 April, good continence but no erections. Nerves spared only partly, tumour too close on rectal side of prostate.

Post-surgery pathology: G7 (4+3) WHO:3
pT2c pN0 (0 of 7 lymph nodes positive) pL0 pV0 R0(local) Pn1
Perineural growth predominantly on right hand side, tumour diameter 15mm 90% G4 10% G3
Prostatic parenchyma with glandular hyperplasia and chronic granular, partly purulent inflammation.
Percentage of prostate involved (based on own calculation of prostate and tumour sizes) less than 10%.