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inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/8/2012 2:16 PM (GMT -6)   
Hi, new to the forum.
A month ago received a psa test reading of 5.4, the 1st psa I have had in my life time. I am 73 now. Dr put me on antibiotic for a month.
Month later, psa test reads 10.4. Dr wants me to go to urologist. Research tells me the PSA tests are not that accurate, but my be only means
of early detection of cancer. I was concerned about the rise in psa levels in just a short period of time and what that means. Thanks

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5913
   Posted 10/8/2012 2:31 PM (GMT -6)   
Welcome to HW. Sorry that you find yourself here, but the door is always open.
 
There are additional blood and urine tests that you may want to pursue (such as a "free-PSA"), but going to a urologist for a proper DRE is a valid first step. He would be able to better evaluate whether the problem is infection, BPH, or something else.
 
PSA tests are getting bad press right now, but they are one of the tools to help understand if you have a problem (not just cancer).
 
By the time I close this I imagine there will be a few responses from those who actually type, so I'll expect that you'll have a lot to digest fairly quickly.
 
Some books that will be useful:
 
Dr. Patrick Walsh, Surviving Prostate Cancer (3rd Ed.)
Dr. Peter Scardino's Prostate Book
 
Ask questions as you have them - we have guys here who have done virtually every treatment path.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808
HT (Lupron) 6-mo injection 9/12

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2358
   Posted 10/8/2012 2:45 PM (GMT -6)   
Having your PSA rise after a month of antibiotic rules out an infection as the cause of the high PSA. You should consult with a Urologist who may run other tests. I think a biopsy may be recommended. Good luck.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
DaVinci surgery 2/9/09 Gleason 4+4 EPE,
Margins, SV, clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
PSA tests every 3 months undetectable
PSA at 32 months: .005
PSA on 1/25/12 .094 (ouch) lab error
retested2/21/2012 <.01
PSA on 4/3/12 <.01 (38 months)
PSA on 10/1/2012 <.01 (44 months)

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/8/2012 3:06 PM (GMT -6)   
Ok, thanks for the info, these forums are very useful, I will see the DR on Friday of this week. I have always been healthy and have never taken medications, guess I better get on better diet. Later

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 3107
   Posted 10/8/2012 3:14 PM (GMT -6)   
Welcome and sorry you need to be in our corner of the world.

PSA is just an indicator that something is wrong in the prostate - it's not a test for cancer. Cancer is just one of a number of bad things that can be going on in the prostate. Infection is one, BPH (enlarged prostate) is another and of course cancer. Also the PSA test gets a lot of bad press. It's not the most accurate test but it's a good screening test to see if you need more tests.

A rise of 5 in a month is worrying and deserves to be checked out - it means something is wrong. You'll need other tests to figure out what is really going on. A urologist will likely want to do a few other tests - dre, free PSA and very likely a biopsy to pin down exactly what is up. The biopsy (annoying and undignified) is the only test that can positively show the presence of cancer.

I'd recommend getting Dr. Walsh's book as a place to start learning and get yourself over to see the urologist for the other tests. That rapid rise in PSA really need to be checked into.

Let us know what the Uro says or if you have other questions.

All the best,
Andrew
I'll be in the shop.
Age 52
PSA 4.2 10/11, 1.9 6/12
GS 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My PC blog

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 10/8/2012 3:31 PM (GMT -6)   
Welcome to HW. Make sure you come back and let us know what you find out Friday, so we can add to our shared knowledge pool, ok?
James C, 65, A Better Man /Injections? Read This
4/07: PSA 7.6, 3/16 PCa, 5% inv, lf. lobe, GS6
9/07: open RP, Path: pT2c, 110 gms., Prob. micro.inv.-left apical margin -GS6
5 Yrs: .04 'til 4/10-.06, 12/10-.09, 5/11-.08, 9/11-.14, 2/12-.10, 7/12-.13

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 10/8/2012 3:38 PM (GMT -6)   
Welcome to HW/PC!
 
A lot of prostate infections are hard to nail down...your GP seems to realize that a urologist might be better suited to help.
 
It seems from this experienced lay-person's perspective to be very distant "stretch" to believe that the 1-month difference in PSA results were due to a suddenly uber-aggressive PC...relax.  At 73 years old, the probability is that you have some naturally occurring PC in your prostate (70% of 70-year olds do), but at the relatively low PSA levels you have at your age, there is not much to make anyone believe it is a high-risk case needing aggressive attention.  Most 70-year olds alive today have PC and will never know it...most cases are slow growing & indolent. 
best wishes...

Post Edited (Casey59) : 10/8/2012 2:41:18 PM (GMT-6)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3250
   Posted 10/8/2012 4:26 PM (GMT -6)   
Hey inpower,
Welcome to Healing well.

Did anyone tell you that ejaculation or any manipulation of the prostate also raises your PSA? The effect can be huge.
You should abstain for at least 24 hours. I'd wait 48 hours before a test.
If the doc gave you a DRE and then asked you to get a PSA test done the same day I'd seriously be looking for a new doc.
Good luck.
Jeff
Age: 59, Mar 36 yrs, 56 dx, PSA: 4/09 17.8, 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Glsn 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 7/10 <0.01, 7/11 <0.01, 1/12 <0.02
AdV Sling 1/10/11 Dry

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2690
   Posted 10/8/2012 5:12 PM (GMT -6)   
Get a biopsy, don't waste time taking bunch of tests to see if you need a biopsy. The high psa , your age, no infection scream for it. When I say waste time , I do not mean you need to be in a hurry for treatment it is primarily a slow moving disease. I mean , whats the point of going thru hoops to see if you need to go thru hoops. A biopsy is a minor irritant. Insist on many pokes of the needle , make sure it is at least sonar guided. At 73 , you probably have it, but you will be treated and die of something else. Hey thats my take, do what you will with it.
Diagnosed 8/14/09 psa 8.1 66,now 69
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough ED penatration at 2 years with cialis/viaga. < .1 at 33 mos " Hypocrisy is vices homage to virtue "

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/12/2012 7:38 PM (GMT -6)   
Hi , Went to urologist rectal exam and bladder scan, 82 cc/ suggested biopsy, so set up for Thursday 18th .Have to prepare with Bactrim, Valium and fleet enema/ Is all this necessary, takes 5 mins. for a lot of pain I guess. Not sue how long it takes to get over it. Well at least we rule out anything serious .....I hope. . . . Let you know. . .. . Out for now.

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/12/2012 7:55 PM (GMT -6)   
Forgot to mention , I suggested to the Uro. that we wait a week or so and take another PSA test to see if the the reading would change. Said it would not change. The Biopsy would be the only way to detect a problem. I'm out for now. Thanks

walkbyfaith
Regular Member


Date Joined Jan 2012
Total Posts : 211
   Posted 10/13/2012 12:09 AM (GMT -6)   
I think the valium is good. My husband despised the biopsy and wished he had something to relax him during the procedure. After, it wasn't too much of a big deal. He seemed fine after, although he did relax the rest of the day. Fortunately, he did not suffer any adverse side effects, and was pretty much back to normal within a few days, except for some brown blood. Good luck.
~walkbyfaith~ Hubby, age 45, DX 12/23/11, PSA 17.2
Biopsy, Gleason: RIGHT SIDE: 3+3, (10 or less volume) LEFT SIDE: 3+3, 3+3 (both approx 10% volume or less) 4+3, 4+3 (30% volume)T1C, Bone - Neg, CT - Neg
RALP: 2/2/2012 POST-OP: ORGAN CONFINED: Primary Pattern, Grade 4, Secondary Pattern: Grade 3 = 7 (19% prostate tissue involved) PNI/present, SVI/neg, MARGINS/clear, LN/neg, t2C
PSA, <0.1, 4/2012

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/13/2012 11:21 AM (GMT -6)   
Thanks for input, I am being skeptical because of articles about ultra sound and MRI screening. Are these procedures able to detect any cancer cells or is the biopsy still the best we have to work with for detection. I keep researching the subject and at my age level I am wondering if I should do the watch and wait relating to after effects and procedures possibly redirecting the cancer cells ( if any) to other parts of body.
I am not concerned so much about the procedure as the side effects, infection, pain and mt Doctor and Urologist quick decision to do a biopsy as, ( noted a million biopsies done and 750,000 negative), which relates to a rush in unwarranted biopsies. Would I be remiss to tell my Urologist to wait after i already set appointment to perform the biopsy..
Thanks for input As you can see I am not well versed on medical procedures as always been healthy and never required a Doctors care

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2354
   Posted 10/13/2012 11:56 AM (GMT -6)   
Your PSA jumping from 5 to 10 means the biopsy is NOT unwarranted. After the procedure, there will be blood in your urine for a couple of days and also in your ejaculate. You may wish to purge yourself (give it a few days) to get rid of that...ALL men will get prostate cancer if they live long enough so don't be surprised...The good news is it's usually very slow growing and most men live to die from something else..While you are waiting, learn about the Gleason scoring system used to assess how aggressive the cancer is likely to be. This more than anything will determine your treatment and prognosis. Read Walsh's book......Best of luck to you....
Age 70
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5,
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA <0.1 10/'11, <0.1 2/12, <0.1, 4/12 <0.1, 9/12, 0.8

gunfighter
Veteran Member


Date Joined Sep 2012
Total Posts : 1218
   Posted 10/13/2012 4:52 PM (GMT -6)   
inpower--NO, don't delay the biopsy--it only costs $1200 and medicare will cover it--after mine I was drinking a cold beer 2 hours later--we had one member of this forum whose psa went from 2 to 33 in 11/2 years and now he's in trouble!! This is my take so the best to you..Get it done--it only takes 30 minutes and I didn't have any problems..
Age 70 now--4.89psa at dx--t3a gleason 8 with extra prostatic extension..not good--could have been caught earlier. Bill

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 3733
   Posted 10/13/2012 5:41 PM (GMT -6)   
Inpower,
It's totally your decision. A 5 point jump in psa in one month is certaintly not indicative of prostate cancer. But as Casey pointed out because of your age alone you have a 70% chance of having some prostate cancer cells in your body that a biopsy may or may not detect. You can wait a few months and retest using both free psa and PCA3 along with the psa score to make a biopsy decision or get the biopsy now. A few months will not affect any treatment outcome one way or another. It is beyond me that your doctor did not do either a free psa or a PCA3 before recommending a biopsy.
The real issue is if the biopsy shows a low grade cancer, which is a high probability given your age. Now you will have a critical decision, live the rest of your life knowing that you have cancer or treating it and living the rest of your life with side effects and or complications that come with treatment. Just realize that the survival benefit over 20 years is 1.8 months more with treatment compared to doing nothing.
The main disadvantage to a biopsy before all other cause for a high psa are eliminated is opening this can of worms, which will lead to one of the most stressful times in your life and a much higher risk of a cardiac incident within 30 days of a cancer DX.
By all means if other tests indicate a high probability of PC then a biopsy is necessary to detect aggressive cancer; but a one month jump in psa is not a good reason alone to biopsy immediately. Prostate cancer is usually indicated by a slow and consistant rise in psa over time; not a 100% point jump in one month. This would indicate a doubling time of one month which is very rare even with the most aggressive cancers that have already matastized.
JT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 3 years of psa's all at 0.1.

mr bill
Regular Member


Date Joined Sep 2010
Total Posts : 476
   Posted 10/13/2012 7:51 PM (GMT -6)   
It may certainly be to your advantage to wait and retest.
 
I had four biopsies before dx. The urologist performing the procedure makes all the difference.  The wondering is actually worse than the test.
 
 
Daisaku Ikeda

Big Mac
Veteran Member


Date Joined Jul 2012
Total Posts : 1456
   Posted 10/13/2012 8:32 PM (GMT -6)   
Inpower,
I would get the biopsy and hope you are one of the 750,000 negative ones. It only takes 20 minutes, is only "uncomfortable" not painful. You will bleed some afterwards and the week or so following the procedure. But it is worth the time and inconvience to be sure instead of guess work.

I never had to have an enema before a biopsy but I can see the valium could be useful.

You have been blessed with a healthy life so far. Be grateful for that but no need to gamble on your future.

This goes for all others out there who are afraid on the dreaded BIOPSY! I have had three of them in 12 years and the third one was positive. Believe me, I enjoyed hearing the negative reports much better than the final positive one.

Good luck and I hope you get a negative report.

Bill
Age 61
Jan. 2001 PSA 6.1 Biopsy 1/23/01 - Neg.
Oct. 2004 - PSA 8.9 Biopsy 10/19/04 -Neg.
Feb. 2012 - PSA 18.5 Biopsy 4/27/12
Positive 10 of 12 cores, orginal Gleason 6
DaVinci Surgery 07/17/12 Dr. Vipul Patel, cath removed in 6 days, pos. margins, bladder neck involvement.
Gleason 3+4=7, involving 50% of gland, weight 57 g. Stage pT3a Lymph node involvement: 0/4
1st post op PSA 8/30/12 <01

Post Edited (Big Mac) : 10/13/2012 7:35:48 PM (GMT-6)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5913
   Posted 10/13/2012 9:06 PM (GMT -6)   
inpower,
 
No one here can tell you what to do, simply because we all have different experiences, and there is no "buy these socks, they fit all" solution. As you are seeing, the big discussion about "over-treatment" is a hot button that comes to no good.
 
Get as much information as you can, and yes, the free-psa test is valid. A rapid doubling of PSA is an indication that you have a problem.
 
You asked about MRI and other scans. Scans can find clear problems, which will then provoke a biopsy. But scans don't find much in the early stages, which is when you want to find it if it is there.
 
Your age will influence what treatments are offered to you. My surgeon will not do a prostatectomy on anyone 70 or over, for an example.
 
I suggest that you continue to do the research, and take the time you need to make an educated decision.

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/14/2012 4:44 PM (GMT -6)   
Thanks for your comments. I am still researching the problem,but i will probably go ahead , have a couple of days to think about it.

Might be better to get it over with Will advise later, Have a great weekend.!

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/16/2012 1:04 PM (GMT -6)   
Hi, In researching this topic, I have decided to WAIT and ask for another PSA test, I am not sure at my age I need to go through the possible after effects of the Biopsy. There is no history of family prostate cancer in our family. I thought the DOCTOR and Urologist were quick to act to do a biopsy. With that in mind . I have no urine problems and I want to know if cypro or antibiotics could elevate an enlarged prostate in 3 weeks. I got an alergic reaction from Cypro and stopped taking it after 3 weeks and they put me on bactrin for a week , then had a psa test which showed an elevated psa score to 10.5. i want to see the results of psa tests to see if they are accurate in there prognosis.Perhaps I am reading to much into this. Maybe I am having to much disrespect for The Doctors decision. I am not one to believe all that they tell you. Darn internet. To much information and controvercy. Thanks

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 10/16/2012 1:38 PM (GMT -6)   
Several times you've mentioned reading and researching. A caution here- if your reading is coming from the Sunday supplements, People mag., the Star or Nat. Examiner, you might want to reconsider making major medical decisions based on those sources. There's a lot of controversy going on right now about effectiveness or needs for psa tests and other procedures, so take the time to see who is making the recommendation and even what they may have to gain by doing so. Sticking to mainstream medical sources is the best approach, imo. In the meantime, if you are still waffling, you will eventually have to decide to find, choose and trust a uro. to help guide you thru the decision process. Eventually we all have to decide who and when we will trust our health to. Find a good uro that you can trust and work WITH him/her. Good luck, keep us informed as to the outcome of this, so we can all learn.
James C, 65, A Better Man /Injections? Read This
4/07: PSA 7.6, 3/16 PCa, 5% inv, lf. lobe, GS6
9/07: open RP, Path: pT2c, 110 gms., Prob. micro.inv.-left apical margin -GS6
5 Yrs: .04 'til 4/10-.06, 12/10-.09, 5/11-.08, 9/11-.14, 2/12-.10, 7/12-.13

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/16/2012 3:01 PM (GMT -6)   
Thanks for input, Just apposed to bodily intrusion and making the situation worse when I may not even need this procedure. As you have said its my decision to make. I wonder if waiting and get a psa test again , if it would show a different psa level. Later

BillinChicago
Regular Member


Date Joined May 2012
Total Posts : 76
   Posted 10/16/2012 3:35 PM (GMT -6)   
I didn't find the biopsy a big deal. Sure it's not pleasant, but it's more the idea of someone poking around back there than real pain. There are risks associated with it. Not big risks but risks you should be aware off. I was glad to have it done though. Get a definitive answer then and can start thinking about the next steps should it come back showing pca.
age at DX 57
PSA Aug 2011 4.0
PSA Sep 2011 3.9
PSA Feb 2012 4.6
Biopsy Mar 2012, 12 cores, 4 of 12 positive for CA, Gleeson 6 (3+3)
DaVinci 4/16 stage pT2a Tumor involved less than 5% of gland, margins clear, perineural invasion not identified.
Catheter removed 5/2; 4 to 5 pads per day.
Completed 8 wks of pelvic floor therapy on 7/31/12. Pad less now 8/24 for a week.
PSA 9/25/12 under 0.1

inpower
Regular Member


Date Joined Oct 2012
Total Posts : 34
   Posted 10/18/2012 9:36 PM (GMT -6)   
Hi, Biopsy done, not a really big deal accept for the probe up the you know, what was pain full . The Valium was a little help full.
just waiting on results.Felt like they only probed 3 or 4 times, but wife says 12 ?? was quick procedure. Bleeding after word , but mild.

Now just waiting ! later Guess i am glad I did it.
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