Selmer and LT-TX
Thanks for the fast responce, very much appreciated. (LT-TX let me know if this is not the way to start a new thread.) Selmer, your caring advice is appreciated and is also reposted.
Here is my history.
I am another no cancer (per biopsy), but high psa velocity person. Rarely have Symtoms (great diifficulty with urination start, high urges, and long time finish 3- 5 minutes). However, they are brought on by heavy lifting (ex, lift and drag logs to clear land for 3 hours). Age is 66. Father and Uncle had prostate cancer at 75, PSA = 4.5, father had Lupron for a couple of months was taken off it and the PSA droped and the cancer shrunk and remained dormant, died at 78 from heart attack. Uncle had radio active distruction of his prostate and is 82 and living.
PSA History 11/2008 = 9.5, 5/2008 bisopsy showed no cancer for 12 cores, 5/2008 = 6.2, 4/2007=4.5, 3/2006 = 3
DRE normal, No measure of free PSA was done, Small volume prostrate, no density measure
11/2008 - Uro gave 7 days of broad spectrum antiibotics (levenquin ??) to eradicate any urinary infection that would impact PSA
My internet has me second guessing my urologist, who is not that communicative. (He would not discuss odds, LT strategy, etc)
Please add your pros and cons to the following:
1 - If high (>9), he will want to do another biopsy. Do you know of any other reliable tests AMAS, ECPA, protate MRI, ....
(I was pushing for an AMAS test via Oncolab and wanted to know his recommendation, cost to me $165 instead of a ..........biopsy, this is praised by some doctors and considered worthless by others, .... my uro-doc never heard of it....he also ........... does not measure free PSA, ....why not? his answer is we don't do that??)
2 - I read that if the PSA is high, one should be on 30 days of antibiotics because unrinary infections are difficult and timely to ..........eradicate. Please comment. ( If high I think uro-doc should employ 30 days of antibiotics, and find a more reliable test ..........other than biopsy)
3 - What are the odds of me getting protrate cancer in the future with this high velocity PSA?
4 - Is my uro-doc OK?
5 - John Hopkins sends me email on latest break-thus, but they want to sell books to us in order to get that information. Do you know where else I can get latest breakthur information such as the diet we should be on.
You seem to indicate you already had a biopsy. When was that and what were the results? What is your age?
Did the same urologist do that? [no cancer, 66, same uro-doc]
If you don't communicate well with your urologist, and you think it is his fault, then you should get one you can put faith in. On the other hand, perhaps you just feel he isn't saying what you want to hear. [ might get a new one, if he wants an immediate biopsy. Based on your statement below, I think 6 more months need to pass before the next biopsy to allow normal PSA settling to occur ]
Some doctors give 7 days of antibiotics, some 14 and some 30. Realize that most prostatitis is non-bacterial and the antibiotics don't affect it very much if at all.
Having said all of the above, and being a person who normally looks for a way to avoid unnecessary biopsies, your PSA numbers appear to be on a steady and increasing march. If its not caused by some other reason then you need another biopsy. Looks like the velocity is taking off.
Again, how many biopsies and when did you have them previously?
After you get your next PSA back.....see what it is........then if needed get a quick second opinion, and make a decision. Lots of first time biopsies, like you apparently had, can easily miss cancer. Think of the cancer, if it exists, like some olives in a loaf of bread. You stick 12 probes into a loaf of bread, and you could easily miss even several olives. Some people go from zero positive cores on the first biopsy to perhaps 4 of 12 on the second biopsy. Hit or miss.
Good luck, but I suspect your PSA isn't gonna drop back below the prior 6/2 reading from May, 2008.
Let us know.......and if its back to 6.2 or below, perhaps you could request a free-PSA from another urologist, although you may well find him/her suggesting you do the biopsy anyway.