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crankycrink
New Member


Date Joined Nov 2008
Total Posts : 6
   Posted 11/24/2008 2:11 PM (GMT -6)   
Hello.  My husband is 61.  He had his first PSA test 1 year ago.    It was 7.6, He went on antibiotic for 2 weeks, re-tested it was 6.9, then six months later 7.8, then this past September it was 11.0.    My husband has a colostomy and severe scar tissue around his rectum and just inside, with severe nerve pain when touched, prodded down in that area.  For this reason, the urologist was unable to do a DRE, and he also decided to wait and see the velocity of the psa before scheduling a biopsy under anesthesia.  Well, after the 11.0 reading, a biopsy was set for November 14th.   On Nov. 21 the nurse called home and spoke to my husband and said "no malignancy was found", and that was all she told him.   Of course, we are thrilled at that news.  My husband is very skittish about even talking about the subject, and after reading this forum for several weeks, I have a few questions.  We never saw the doctor on the day of the biopsy (after it was done), so I don't know the findings of the DRE, or how many core biopsy was taken.  I've been trying to contact her, or the doctor since last week, to get some answers as to why his PSA level would be high with no malignancy.  They have not called me back - I've left 3 messages.  
 
In reading this forum for approx. 6 weeks, I know that sometimes biopsies don't find PCa right off.  I just don't want my husband to have received a false negative and I can't get any answers.   Please help to direct me as to what I should do now, and some reasons why his PSA would be so high.
 
Thank you.
Happy but still worried Wife

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 11/24/2008 2:59 PM (GMT -6)   
Crankycrink,
Congratulations on the biopsy result. There can be many reasons for an increased PSA quite apart from prostate cancer (enlargement with age, infection, etc). The biopsy is the surest method of determining if there is cancer present but occasionally the biopsy needles can miss small areas of cancer although this depends on the number and range of samples taken. My advice would be to rejoice in the good news but maintain a close watch on the PSA. Do ensure you get an answer from the doc ( some practices can sometimes be a bit cavalier with their patient's concerns and communication; make sure you obtain a copy of the written biopsy report and maintain your own records.
A little information can be found here:
www.phoenix5.org/Basics/PSAmenu.html
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Post Edited (BillyMac) : 11/24/2008 2:11:49 PM (GMT-7)


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 11/24/2008 3:52 PM (GMT -6)   

Hi Cranky:

It's good news indeed that the biopsy came back negative and you both should feel good about that.  However...if it was me and I was treated the way your urologist is treating you...I would find a new doctor.  You are entitled to see the biopsy report and have it explained to you in detail  Also, the PSA is definitely high and you deserve a doctor's opinion about that issue. 


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study done on 11/14/08
Brachytherapy scheduled in early December


VaFan
Regular Member


Date Joined Mar 2008
Total Posts : 203
   Posted 11/24/2008 6:49 PM (GMT -6)   
I think knowing what we do now (knew not a thing about prostate cancer before diagnosis) I would get a second opinion just be on the safe side. Being comfortable with your doctor is very important and there is no reason to be treated without respect through the entire time. You deserve a return call. Maybe it is nothing but I stick to my thoughts of getting a second opinion.
Cindy
Age 51 Kent Cindy 49
January 08 PSA 5.2 round of antibiotics went to 4.3
February 08 another round of antibiotics went to 4.2
March 17,08 had biopsy, 2 days later told cancer was on
one entire side of prostate.
Gleason 3+3
Doctor thinks its best to get the whole prostate with Perineal  Prostatectomy.
Surgery scheduled for this Thursday April 10th. Only took 1 1/2 hours. In recovery 1 hour.  Both nerves were spared.
Home 4-11. Cath out 4-22. Incision looks completly healed on the outside by 4-25.  Incontinence "a thing of the past" as of 5-28
lst PSA 0.04 June 3. YAY!!!
July 08 (3mths post op) Cialis 10 mg every other day. Right now, things are not looking so good in that department. Back on Viagra and ordered the pump 11-08
Aug 08 PSA 0.04 Yay Again!!
Nov 08 PSA 0

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