PSA opinions Please
BF
8.0, March of '08.
I had three negative biopsy's during this period.
June of '09 it dropped to 4.7 and Jan 26, 2010 it went up to 6.1, but
still lower than the 8.0 in march of '08.
I don't have an appointment with my urologist until Feb 8th so I thought
I could get some opinions here.
Thanks Bill
ron
Bill...With your PSA moving around that much, that quickly,
inflammation is probably at least partly responsible for your elevated
PSA numbers. Since you've had 3 negative biopsies (I'm assuming
standard trans-rectal), it's possible that you have PCa, but that it
is not in the region that trans-rectal biopsies can typically sample.
The primary tumor occurs in these other areas (central zone and
transition zone) around 20% of the time. Fortunately when PCa occurs
in these other areas it is typically slow-growing. You could have
these other areas examined either by color-doppler ultrasound (with
someone like Duke Bahn, Katsuto Shinohara or Fred Lee), endorectal MRI
(Katsuto Shinohara, John Kurhanewicz, Peter Scardino) or trans-
perineal biopsy...Best wishes and good health, Ron
Alan Meyer
Bill,
There are several factors that can elevate PSA. One is just having
an enlarged prostate. Others include infection and prostatitis.
Did the urologist give you any information about any of those?
Did he tell you your prostate was enlarged? Was there any
indication of infection or prostatitis (e.g., mineral deposits
or inflammation) in the biopsy report?
A lot of urologists will just say that cancer was or wasn't
found and not give you any more information. That isn't as
helpful as it could be.
You might call his office and ask for copies of your records,
including his own biopsy findings and the report from the pathology
lab. If there's anything in there that you don't understand (there
almost certainly will be if you're not a doctor), maybe someone
here can help interpret it for you, or maybe you can find
explanations elsewhere on the Internet.
If you get the information before your next consultation in Feb.,
you may be able to ask more informed questions when you meet
him again.
Good luck.
Alan
Steve Jordan
> My baseline PSA started at 3.4 December 2002 and continued to rise to
> 8.0, March of '08.
> I had three negative biopsy's during this period.
> June of '09 it dropped to 4.7 and Jan 26, 2010 it went up to 6.1, but
> still lower than the 8.0 in march of '08.
I recommend consideration of the PCA3 genetic test. Though it is
not yet FDA-approved, the record seems positive.
Read about it here:
http://www.prostate-cancer.org/education/preclin/Torres_PCA3.html
or
It is offered by Bostwick Laboratories.
See: https://www.bostwicklaboratories.com/global/home.aspx
or
I hope that the uro is familiar with it; some are not.
There also are confounding factors in PSA testing:
Using different labs
Ejaculation within 48 hours of the blood draw
A DRE within 48 hours of the blood draw
Infection
Irritation
Even bike riding.
Regards,
Steve J
Steve Kramer
news:hjv507$7i1$1...@speranza.aioe.org...
-- skramer remarks
As I recall, you also had an fPSA of 19 in June 2009. I forget, however,
what your DRE indicated.
PSA is not an absolute indicator of prostate cancer, but it is pretty good.
When combined with an unusual DRE, a biopsy is warranted. A high-needle
biopsy should find cancer if it exists, but I also forget how many needles
he's used in the past.
That said, I would think he should do a DRE. Just an aside, if he hasn't
done them in the past, you should switch urologists.
If he does a needle biopsy, I think you should pull out all the stops.
There is a color doppler ultrasound guided biopsy procedure I have heard
about in this forum. I don't know all the particulars, but I suggest it
might increase your chances of finding any cancer if you have any. I would
also suggest as many needles as they are willing to use, if they do a
biopsy.
I sure hope you have no cancer, but is seems you must have some prostate
problem.
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added daily 07/06
PSA undetectable since. Next Assay 02/02/10
Illegitimati non carborundum
Steve Kramer
news:805ca877-1948-470c...@21g2000yqj.googlegroups.com...
You could have
these other areas examined either by color-doppler ultrasound (with
someone like Duke Bahn, Katsuto Shinohara or Fred Lee), endorectal MRI
(Katsuto Shinohara, John Kurhanewicz, Peter Scardino) or trans-
perineal biopsy...Best wishes and good health, Ron
==> Once again, if only I would read ahead...
Steve Jordan
Once on the Bostwick site, search on PCA3Plus to reach the info.
Regards,
Steve J
Alan Meyer
Sometimes a man will have a high PSA and either he or his
doctor will be determined to find prostate cancer. They try
biopsy after biopsy. They increase the number of needles. They
use additional ultrasound and MRI tests.
Eventually, they find some indication of cancer - perhaps a few
cancerous looking cells in one of the needle cores. Then they
say, Aha! and schedule a radical prostatectomy.
I'm not an expert and I am often wrong about medical judgments,
but it seems to this layman that such an approach is fraught with
danger. If the cancer doesn't show up in the standard kinds of
tests then maybe, even if some cancer exists, it's just not
significant and not needing treatment. Surgery and radiation are
not simple, non-invasive treatments. They're serious assaults on
the body that can bring about significant, negative changes in
your life.
At this point, after three biopsies and a PSA that goes up and
down, I might personally be inclined to step back from all this
and go back to just watching the PSA.
If there is any indication of infection or inflammation or
mineral deposits (e.g. calcium) in the prostate in the biopsy
report, then there is even more reason to step back from the
cancer hunt.
In sum, I don't think you should make yourself crazy hunting for
cancer. You may have prostate cancer. It may actually be a
significant case. But it's looking like you don't and/or it's
not significant.
Alan
GoCycle
Mine shot from 0.68 to 2.3.
DRE: Negative
Uro says: We might to a biopsy.
Guess what:
I layed-off cycling for three weeks and it went down to 0.46
Resumed cycling and it went 0.70 In th past I had an .8 then down to 0.66
2.3 was a freak. Inflammation? Prostatitis? Who knows?
"BF" <Bf...@adelphia.net> wrote in message
news:hjv507$7i1$1...@speranza.aioe.org...
BF
from the beginning dating back to December 2002. DRE have all been OK. I
was on antibiotics a couple times but the PSA kept going up. My
Urologists is a little hard to get information out of and I am
considering finding someone else that seems to be a little more
concerned. On the other hand, he may feel that it isn't that serious at
this time, but he has a hard time conveying that to me. I believe he
knows what he is doing so I am going to see how the next appointment
goes before making a decision on finding someone else. There is a women
urologist in the same office so I considered asking to see her but then
I find out it is my Doctor's wife. Go figure.
Thanks again to everyone that responded.
Bill
Steve Kramer
> On 1/29/2010 12:13 PM, BF wrote:
> My prostate has been enlarged from the beginning dating back to December
> 2002. DRE have all been OK. I was on antibiotics a couple times but the
> PSA kept going up. My Urologists is a little hard to get information out
> of and I am considering finding someone else that seems to be a little
> more concerned.
-- skramer remarks
I was going to suggest this in my last post, but erased it. But, now that
you have mentioned it, I will assert that it is probably a good idea. I am
not saying that I know your doc and distrust him or that you have provided
me any information that causes me to distrust him. But clearly, you do not
trust him 100% or he is not satisfying you with his responses and/or
actions.
I think it would be a very good idea to get a second opinion.
Alan Meyer
> ... I
I have read that *most* cases of prostatitis are not caused by
bacterial infection. Furthermore, I have also read that the blood
supply to the prostate isn't that great and antibiotics don't
always do a good job of clearing up prostatitis even when it
is due to bacterial infection.
What does cause most prostatitis cases? As I understand it,
nobody knows. Mineral deposits (e.g., calcium) are thought
to be one possible cause - analogous to kidney stones. But
in any case, prostatitis could be a factor in your high PSA.
Enlarged prostate is almost certainly a factor. IIRC, there
is a formula that ron has posted from time to time for relating
prostate size to PSA output. For many men, though not
necessarily all, the formula can tell you how much of your
PSA is due to enlarged prostate and how much is above that,
due to prostatitis, cancer, or perhaps some other cause.
Alan