psa 3 to 13 in one year!

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bill-VA
New Member


Date Joined Sep 2008
Total Posts : 2
   Posted 9/20/2008 4:58 PM (GMT -7)   

I have a "weird" situation. (I think.)

In January of 2007 I had a psa test that showed a value of 4.1 Biopsy was "recommended" but I wanted to wait. (Why poke and prod based on one "data" point.)

In June of 2007 a psa test showed a value of 3.3 Things seemed "OK"

In late July of 2008 an annual psa test showed a value of 17. <--!!

A repeat in early August showed a psa value of 13.

DREs (at each psa test date) showed smooth, no lumps, nodules or enlargement. No infections present at each test. No symptions of pain. No uninary problems (Stream is stready. No waking up or urgent need to urinate during the night).

Any thoughts, experiences, references that might relate to, or explain, this sequence: 3.3 -> 13 over the period of one year?

Urologist just says "it could happen".

  


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 9/20/2008 5:07 PM (GMT -7)   
There are other things that can cause this, but if you want my advice, get the biopsy.  GOOD LUCK!
Sterd82
Age 47 - pre-surgery PSA 39
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
PSA as of November 29, 2007 undetectable
PSA as of May 14, 2008 undetectable
Next PSA November of 2008


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 9/20/2008 5:34 PM (GMT -7)   
I agree, I think a biopsy is in order. With a PSA that high there is something going on. Please keep us posted as to what you find out.

peace and love
Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
cancer in 4 of 6 cores
92%
80%
37%
28%
 


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 9/20/2008 6:03 PM (GMT -7)   

 

...Yep'...I'd say it's time for a biopsy. Good luck and stay in touch..


 
   age: 53
   Pre-0p PSA  Feb. 08, 5.0
      4.22.08, 4.1
      PSA  spiked once about 8yrs ago to 5.0 three months later
      back to 2.9...then into the 1.2 range until my re-scheduled 
      "missed" appointment this past Feb.
      Biopsy 5.1.08 
      Gleason-3+4=7
      T2a
      5 of 15 cores positive
      Da Vinci scheduled..7.29.08..as I read somewhere on this 
      site....."the first show of the day"
       DaVinci completed 7.29.08, Bladder Sling installed, hernia repair 
       completed during surgery.    
        Sent home 30hrs,  JP drain in place 7days,
       Path report "cancer fully contained"....Margins clear
        Cath removed 8.8.08(ten days)...one lightly used pad 24 hours
        ED therapy begins 8.9.08. 100mg viagra three times a week,
        pump everyday and hold for ten minutes.
        8.16.08 switched to Levitra 20mg.......whahoo, got lucky...
        immediate results..... 
        9.15.08 pad free at night, one thin (light) pad during the daytime
        hours. Just because I'm chicken..!
         9.18.08 1st post-0p-PSA-Undetectable...Zero's!  Yes!
 
           ..."just tryin' to reason with hurricane season"..
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
       


Tony1951
Regular Member


Date Joined Jul 2008
Total Posts : 50
   Posted 9/20/2008 6:04 PM (GMT -7)   

The only way you're going to know what is going on, is to have a biopsy.  My DRE's were and are negative in that the prostate is smooth, there is no nodule, I have no symptoms of any disease - urine flow and frequency is fine.  I thought for sure my biopsy would be negative -- I was placed on Zoladex 3 weeks ago and will begin IMRT in about a month -- the earlier you start treatment the better your chance of recovery.

I wish you well,


Name: Tony  Born: 1951
Diagnosed PCA 7/23/2008;  Prostate Volume 19 grams
Cancer Location: Right Mid and Right Apex 2 of 12 cores positive
Percentage of tissue involves 14%  Gleason 3+4=7 4+4=8
PSA levels  6/08/08 7.7;  6/30/08 6.8
Began HT Zoladex 8/26/2008
As of 9/11/08 I am waiting to start IMRT IGRT
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/20/2008 6:06 PM (GMT -7)   
Hi Bill,
I wished I woulda known you a year ago. I would have said do it then. But that's here nor there. My first PSA history showed drops in every test up to surgery. And I have advanced diease. Go figure. You need that biopsy. I Guess I need to throw out some good news too. I know, personally three people that have double digit PSA's and the biopsies were negative. If you are interested, my PSA history is on the front page of my blog until Sunday.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Navy corpsman
Regular Member


Date Joined Aug 2008
Total Posts : 61
   Posted 9/21/2008 7:26 AM (GMT -7)   

Bill -

Something is definately going on with your prostate.  Do you have any symptoms?  How old are you?  A large increase in the psa should encourage you to have a biopsy regardless of your age.  The biopsy really is not that big a pain in the ass. 

Take care and stay in touch.

- John 


Age:  44
We have a family history of PCa.  My Dad and uncle died from it at 65 and 53. My PSA velocity increased in the last 2 years and I had to talk my GP into refering me to a urologist.
Biopsy results:  5 of 11 cores positive, all 30%. Gleason 6. T1c. PSA 2.53  Date of biopsy 15MAY08.
Open RRP at Johns Hopkins with Dr. Partin on 09JUL08.
Pathology report:  Gleason 6, pT2, neg. margins, 0 lymph node and seminal vessical, organ confined, I lost 1 nerve bundle and 22 lymph nodes.
As of today, about a month after surgery, I feel at about 80%. Urinary control seems to be improving. Little Elvis has taken a nap and has not awakened yet. I hope when he wakes up he is well rested because he is going to get one heck of a workout.
 
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2268
   Posted 9/21/2008 11:41 AM (GMT -7)   
Get a biopsy. This is nothing to mess around with.  If it's not prostate cancer, wonderful.  If it is prostate cancer, you will probably catch it early enough for treatment to effect a cure.
 
Most prostate cancers are symptomless when still confined to the prostate.  You want to find it before it is outside the prostate, when it becomes more difficult to treat.   
 
Glad you're here.  This forum is a wonderful group of men and women who are supportive and knowledgeable about prostate cancer.
 
Take care and keep in touch...Tim


Age 59  PSA quadrupled in 1 yr (0.6 to 2.5) 
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 2006 
Organ confined pT2a  Gleason 5   
Cancer-free for 2 years  PSA's undetectable 

Post Edited (TimG) : 9/21/2008 12:44:20 PM (GMT-6)


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 9/21/2008 12:45 PM (GMT -7)   
I will echo what the others are saying. have the biopsy. My PSA went from 2.6 to 3.5. the doctor put me on 30 days of antibiotics and the PSA came back a 2.0. 4 months after that it was 3.8. i had the biopsy and and it cancer. you may be fine but something is happening.
 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
4 week and 6 week PSA >.04 (undetectible)
12 week PSA <.04
continent at 10 weeks (no pads!)
kegel's twice a day 20 reps


goody5
Regular Member


Date Joined Mar 2008
Total Posts : 66
   Posted 9/23/2008 3:47 PM (GMT -7)   
There is no doubt in my mind that you should have a biopsy.  Look at my signature regarding my uncle. 
Better to be safe than sorry 
Cheryl
Father diagnosed 13 years ago @ age 63
Watchful waiting until PSA jumped from 6 to 10
Cancer found in 1 core
Gleason score 6
Seeds implanted
PSA has been low since (don't know exact numbers)
 
Uncle (mother's brother) age 68
PSA jump from 2 to 8.6 in 18 months (2/08)
DRE was normal (2/08)
Biopsy (3/08) Cancer found
Bone scan (clear) 
Fine Needle Lymph Biopsy (Positive)
Gleason Score
(2) 4 + 3
(1) 3 + 3
(4) 3 + 4
7 of 12 cores positive
Pelvic Radiation started 6/2/08
Started Casodex and Eligard
First PSA on 4 weeks of hormones (.2)
Radiation completed 8/08
Second PSA: UNDETECTABLE! 8/20/08
 


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 9/23/2008 4:54 PM (GMT -7)   
bill-va, do you mind sharing your age with the group?
 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
4 week and 6 week PSA >.04 (undetectible)
12 week PSA <.04
continent at 10 weeks (no pads!)
kegel's twice a day 20 reps


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 9/23/2008 5:23 PM (GMT -7)   
Bill, Don't be alarmed, Don't be scared, Don't be in denial...Go have the biopsy, and then plan accordingly.. Things will work out...Di
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Waiting for activation October 21 2008


bill-VA
New Member


Date Joined Sep 2008
Total Posts : 2
   Posted 9/24/2008 3:01 PM (GMT -7)   

All,

Thank you for your kind (and rapid!) feedback and support. As you can see below I am "in the game". I guess now my next decision is "Which treatment?".

While *survival* is paramount, I am getting married shortly so ED is of "high" interest. :-)

While trying to filter out the PR and hype, it appears that all forms of treatment to be considered: seeds, external radiation, open and laproscopic (including robotic) surgery have similar survival and side effects (ED, IC) rates.

Surgery side effects seem to be primarily related to the surgeon's skill and experience. Thoughts on finding the "best"? The existance of more long term survival rate data on surgery patients seem to give it (as of right now) a *slight* edge over radiation. So I am inclining toward surgery. open vs laproscopic vs robotic? But definitely have not made a firm decision.

I have an appointment with the Center for Prostate Disease Research folk at Walter Reed Army Medical Center to discuss the next steps.

Bill

-------------------------------------------

Diagnosed 9/24/08 at age 64

Biopsy 9/17/08

1 of 12 cores positive: 10%

Gleason 3 + 3 = 6

PSA: 2002 2.0; 1/07 4.1; 5/07 3.8; 7/08 17; 8/08 13

Totally healthy. Weight, strength, flexibility, etc, "super" (per a June 2008 physical).

 


KC9AOP
Regular Member


Date Joined Jun 2008
Total Posts : 85
   Posted 9/24/2008 3:08 PM (GMT -7)   
Bill,

I was very much against doing a biopsy unless there really, really was a specific indicator that it should be done. It is an invasive process and sounds very uncomfortable. I started a thread titled "Just trying to get the straight facts" in which virtually everyone said to get the biopsy. Of course I had a shorter history and I needed to verify my PSA level again before I would agree to the biopsy. I did a lot of research and a lot of pushing back when people simply said "just get the biopsy because there is no other choice."

Well guess what I found out? They were basically right. There is no other choice if you want a true diagnosis. Now you have to decide that you are ready and need to take care of this. There is simply no other way to know what is going on. Personally, I opted for a high-density biopsy (42 samples instead of 12) or as it is sometimes called a saturation biopsy. I had my reasons and it made sense for me. Talk to your doctor about what would be best for you. The procedure I had was called a Stereotactic Transperineal Prostate Biopsy and is a procedure done under general anesthesia. This is not for everyone but with 42 samples and a 40 gram prostate, I had a higher comfort level with the test results.

Good luck and take care of this when you can.


Jim
I am age 47 - Father, Paternal Uncle and Maternal Grandfather had/have Prostate Cancer.
Father 74 years old, PSA = 10.6 Gleason = 5 + 5 = 10 (very aggressive) and high involvement in all cores. Seed therapy is the only option. Father died cancer free.
06/04/08 - At physical DRE normal, PSA test returns 4.4
06/20/08 - First Urologist visit. DRE and ultrasound finds nothing conclusive. Doctor says biopsy is the only safe way to go. Prostate volume is 40 grams.
07/11/08 - PSA test returns 4.1. Scheduled the Stereotactic Transperineal Prostate Biopsy for 7/21
07/21/08 - Had the biopsy.  Not so bad but sore on day 2. Back to work tomorrow
07/23/08 - Pathology comes back NO CANCER DETECTED!
08/01/08 - Urologist calls and says High Grade Prostatic Intraepithelial Neoplasia ("PIN") was found in my biopsy (read pre-cancerous leisions)


chrisinmaine
Regular Member


Date Joined Aug 2008
Total Posts : 31
   Posted 9/24/2008 7:06 PM (GMT -7)   
I truly believe in the grand scheme of things while the biopsy might seem foreign, scary and uncomfortable it will be a tiny blip on the screen compared to the end result--whatever it may be. Good luck in your decision. My hopes and thoughts are with you.
Age 51
March 08 PSA prior to biopsy 6.65
PSA caught in life insurance exam.
Completely asymptomatic.
April 08 Biopsy: Gleason Grade 3+4=7
Tumor in 5 of 13 cores
July 22, 08 Radical Robotic Prostatectomy
All nerves spared
Pathology: Margins clean, Seminal Vesicles negative for tumor
Gleason Grade 3+4=7 Percent Gleason Grade 4-20% no Gleason grade 5.
First post-op PSA scheduled for 10/08
Very minor incontinence since catheter removal on 7/29
ED assisted by low dose of Levitra. So far so good.
I feel very, very lucky.


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 9/25/2008 5:34 AM (GMT -7)   
Bill,
It is good to see that your biopsy only shows 1 core and that a gleason 6. Not to be Mr. negative, but sometimes these things can show more cancer than the biopsy once the pathology is done. But, it appears you have caught it early and this gives you great advantage in treatment choices.

One thing that I would question the Urologist on is your PSA numbers and the manner they have shot up and moved around. PSA 13 is high, and it sure got there fast. There may be other problems with the prostate that are causing the numbers to move, but the Urologist should know that based on the biopsy, and other exam info.

Be sure and do a lot of reading here and on the internet. It will guide you on all your decisions. God bless.

RB

Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA .04
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