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chazaroo
New Member


Date Joined Jul 2010
Total Posts : 6
   Posted 7/24/2010 9:07 AM (GMT -7)   
I was tested in June and had a PSA of 3.5. Another test a month later revealed a PSA of 3.8. I now have an appointment with a urologist but won't see him until late August. The suspense is getting to me. I'm 61 and nobody in my family has ever had prostate cancer. Other symptoms include bladder not feeling completely empty after urination, periodic urethra pain, though none during urination. And some lower back pain. Not sure if any of this is relevant but it's everything I can think of. What are the odds of cancer?

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 971
   Posted 7/24/2010 9:12 AM (GMT -7)   
I can't answer your question but why should you have to wait "in suspense" until late August? Call the urologist's office, tell them you have anxiety about your condition and would appreciate it very much if they would fit you in sooner -- or at least call you if they have a cancellation so you could see the doc earlier.
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


chazaroo
New Member


Date Joined Jul 2010
Total Posts : 6
   Posted 7/24/2010 9:24 AM (GMT -7)   
Already tried that. The guy is booked solid and he's the only one nearby in my "plan." I'm going to try to get in sooner with another doctor who is about a hundred miles from here. We'll see.

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 977
   Posted 7/24/2010 9:31 AM (GMT -7)   
PCa generally grows very slowly. Waiting a month for an appointment is very unlikely to be a problem. If you are concerned about moving quickly to address the situation if it is PCa, perhaps you should start looking into treatment options, facilities, and doctors. Then you can move quickly if the news is bad.

I can't comment on the probability that you have PCa with your PSA and one month increase.
Dx with PC Dec 2008 at 56, PSA 3.4


Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
psa May 10  .50

Aril 10 MRI and Bone Scan show lesion on lower spine, false positive. 
 
Started HT 5/25/10 with 3 month shot of Trelstar. SRT scheduled for late July

Post Edited (BB_Fan) : 7/24/2010 9:35:06 AM (GMT-6)


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2978
   Posted 7/24/2010 9:35 AM (GMT -7)   
The statistical odds I have read/heard are 25% of biopsies find cancer. Having said that I really dont find that , that hopeful, cause some times it takes more than one biopsy to find it. A rise of .3 in one month is of concern, but for your age psa is not that high, so if found you will have caught it early probably. Its a tough thing to have to deal with, but having gone thru it myself, in retrospect it hasn't been THAT bad. Stick around here it will ease a lot of your concerns.
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci, extensive PNI, That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " Francois de la Rochefoucauld, source courtesy of Tatt2


chazaroo
New Member


Date Joined Jul 2010
Total Posts : 6
   Posted 7/24/2010 9:37 AM (GMT -7)   
I always thought PSA grew slowly. That's why the one month jump surprised me. If it were to continue at that velocity, it would go from 3.5 to 7.1 in one year.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/24/2010 11:25 AM (GMT -7)   
Read up on this as good background:

www.yananow.net     read PSA 101
 
tab therein (read everything there anyway)
Fluctuations can occur that are more than you might believe too. Always have to verify any psa levels, mentioned by leading onco docs ad for many reasons.


Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 7/24/2010 11:30:32 AM (GMT-6)


chazaroo
New Member


Date Joined Jul 2010
Total Posts : 6
   Posted 7/24/2010 11:28 AM (GMT -7)   
Thanks. I'll check PSA 101.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/24/2010 11:35 AM (GMT -7)   
Yeah better make it easier:

www.yananow.net/PSA101.htm
 
That will get you there.


Youth is wasted on the Young-(W.C. Fields)


chazaroo
New Member


Date Joined Jul 2010
Total Posts : 6
   Posted 7/24/2010 12:02 PM (GMT -7)   
Found it. Thanks!

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 7/24/2010 12:10 PM (GMT -7)   
Seems to me the urologist doesn't really have to do any heavy lifting in a psa test, other than order it. I dont see why you cant call the office, have the nurse setup the test, and even have the nurse get back to you with the result... perhaps you'll then be in a better position of knowledge when you DO see the uro in August? I hope to find out that you are concerned for no reason.
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Listed on patholgy as PT3, but with extraprostatic extension,
microscopic invasion of the bladder neck, PT3A is perhaps the case.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain! Update 7/14/2010: When I tried changing this sig a few days after creating it, system was broken. My new rad oncologist are discussing IMRT.. though he says he can see why waiting a bit and watching the PSA on super sensitive basis might make sense. I am leaning towards IMRT.. thinking is my body is pretty strong now, i'm 51, and if I can rid my body of this while trying to minimize the side effects.. I dunno. No really Good answers. When I said I didnt want radiation to the point of being a veg.. I really meant there is a limit as to where I wish to go in order to realize only a small increase in life expectancy.. and not that I am an unreasonable person. I do, after all, have an obligation to my wife and kids.


reachout
Veteran Member


Date Joined May 2009
Total Posts : 587
   Posted 7/24/2010 12:34 PM (GMT -7)   
I concur with what others have said, and only a urologist can tell you whether you have PC or not. My PSA bounced around like that, went over 4, came back under 3, then back up to around 5 before I was diagnosed through a biopsy. If it helps, my urologist told me that PSA bouncing around that much usually indicated a prostate infection rather than PC, though in my case I hit the low odds. But I didn't have the other symptoms you describe that might suggest a prostate infection. If you can't get in to see a urologist but are really concerned, you might see your regular doctor and ask for a free PSA test. I had that and the doctor showed me a chart that told me that for my total PSA and my free PSA my odds of PC were about 30%. As I said, I hit the low odds, but if you are interested in odds, that free PSA test could give you that kind of information.
Age 64 yrs
DX 5/2009
8 out of 12 cores positive
PSA 5.6
Gleason Score 3+4=7
Stage T2a
Da Vinci Surgery 08/07/2009
Upgrade Gleanson Score 4+3=7
Stage pT2c
Neg Margins and Nodes
Extracapsular extension noted but neg Extraprostatic Extention (??)
Dry immediately
Daily Cialis 5mg slow recovery
First PSA 3 Nov 09 <0.1
Second PSA 2 Feb 10 0.01
Third PSA 1 Apr 10 <.014
Fourth PSA 19 May 10 <0.1
Starting trimix July 10


chazaroo
New Member


Date Joined Jul 2010
Total Posts : 6
   Posted 7/24/2010 12:58 PM (GMT -7)   
Actually the reason for going to a urologist was my regular doctor's idea. He did a blood test in June and said my PSA was elevated (3.5) He then scheduled a second for July 15. His office called yesterday to say he wanted me to see a urologist because the PSA was up over the first test and was 3.8. I assume the velocity is what he's concerned about.

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 469
   Posted 7/24/2010 6:15 PM (GMT -7)   
Chaz,  PSA numbers can be quite variable for some of us.  My numbers were very variable with no explanation most of the time.  Check my numbers below and you will see why I am a big believer in check, recheck, and check again. 
Carlos
 

Date

PSA Level

7/26/1993

2.5

1/5/1995

5.1

2/8/1995

1.5

3/7/1995

3.5

9/12/1995

2.9

3/13/1996

2.5

12/19/1996

1.6

11/3/1997

4.2

3/2/1998

3.4

9/22/1998

2.8

4/2/1999

3.0

5/24/2000

3.6

1/3/2001

3.6

1/2/2002

4.1

6/27/2002

2.5

7/1/2003

2.7

7/2/2004

3.0

11/10/2005

3.2

11/14/2006

3.8

11/28/2007

6.5

12/27/2007

6.9

1/17/2008

9.1


Diagnosed 2/2008 at age 71, Gleason score 5+3=8, stage T1c, PSA 9.1. 
Robotic surgery 5/2008, nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3=8 
PSA <0.1 at 26 months and at all tests since surgery.


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5967
   Posted 7/24/2010 6:46 PM (GMT -7)   
Chazaroo,

Be sure and consider the factors that can make PSA higher than it "should be" - sex, DRE, or impact on the prostate in the day or so before, or a simple infection.

Abstain before the next test, and yes, I agree with those who mention that you should be able to get a PSA from another doctor - try going back to your GP for a quick check and another test.

I had the same issue with the urologist - it was only an accident (ok, someone else's) that I got in within a few days. The official schedule had me waiting several months.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2368
   Posted 7/24/2010 6:46 PM (GMT -7)   
Yes indeed, PSA velocity is very important. You should ask your GP to put you on a run of Cipro or some other antibiotic to rule out infection before you see the U-doc..Your symptoms sound more like infection than cancer...An infection can make your PSA number jump..As you can see from Carlos and myself, you can't draw any conclusions about cancer from a PSA test.. But when it takes off for no reason, something is going on..

You must live in a remote area if your choice of U-docs is so limited...
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. A "top" radiation oncologist here in Denver, equipped with the latest IMRT/IGRT/RapidArc machine says he can do better by me..


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5967
   Posted 7/24/2010 7:03 PM (GMT -7)   
Fairwind,

I'll testify that even in a major metro area, and still employed (not yet medicare age), insurance can be very limiting. I've have the same problem. Staying "in network" so to avoid thousands of dollars in extra deductible and out of pocket costs was one of the largest challenges I had in "surviving" DaVinci and adjunct radiation. I did not have the resources to go out of network. A little less attention, and all could have gone very badly.

Outliving one's money is unpleasant.

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 594
   Posted 7/25/2010 9:52 PM (GMT -7)   
I would not be surprised if you have a prostate infection, those are the same vague pain symptoms I had on several occasions. I know you will worry anyway but the discomfort you are feeling doesn't square up that good with pc IMO. Good luck.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2368
   Posted 7/25/2010 10:26 PM (GMT -7)   
142, I'm VERY much aware of the role cost plays in cancer treatment..I started a thread on this board (or the PC other board) called "cost" but it wasn't very popular..My own "Medicare Advantage plan limits me to my home "group", which is kind of silly, since the underwriter, United Health-care, does business coast to coast and they are reimbursed by Medicare..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2632
   Posted 7/26/2010 8:41 AM (GMT -7)   
I would say the statistcial odds that you have cancer is 1 in 6, which is what every man has. How you factor your higher PSA into those odds is not my forte, but obvioulsy it will change the odds. Perhaps as high as 50 %.

I would also agree that based on symptoms and age, you most likely have some prosatitis of some orgin going on. Most men, particularly with low PSA's, have no symptoms of PC.

The real question that will need to be answered is , if you have cancer, how agressive is it, and is it local or systemic. Once your uro determines that with a biopsy, you can begin to worry.

Just relax ( I know you can't) as much as possible and wait for your appointment. This is not an emergency type of situation. Even after a positive biopsy you probably will take 2 or 3 months to begin treatment.

Good luck. Sometimes the worrying is worse than the treatment.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

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