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flowerchild6419
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/22/2008 3:37 PM (GMT -7)   
Hi,
 
My Dad (76 years old) had a PSA score of 6 about 6 months ago and had a biopsy, which was negative.  In September he had another PSA test that went up to 7.  He just had another test and found out today it went up to 13!  The doctor is doing another test to makes sure it wasn't a mistake.
 
I'm worried--do you think it's likely that they somehow missed cancer during the biopsy?  Should I try to find another doctor?  A nurse friend of mine is recommending someone she knows.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4018
   Posted 12/22/2008 3:57 PM (GMT -7)   

Dear Flower Child:

You don't indicate whether or not the doctor is a urologist or not but that is certainly whom your dad should be seeing. 

The additional PSA test is probably a good idea and the results will be available soon.  If the PSA is still high, there are a variety of reasons and he does not necessarily have prostate cancer.  His urologist may put him on a course of antibiotics for potential prostatitis and/or the doctor may recommend another biopsy.  Depending on the number of samples in the first biopsy it is certainly possible that the cancer was not detected and it will turn up in a second biopsy.

And, even if another biopsy comes back positive, it is entirely possible that your dad will have lots of options.  At his age one of the options could very well be "watchful waiting" aka "active surveillance" without treatment.

Please let us know what the doc says after the PSA test and I'm sure you will get lots of good advice on this forum.

 


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study done on 11/14/08
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything functioning normally.


flowerchild6419
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/22/2008 5:54 PM (GMT -7)   
Thanks for the word of encouragement.

Yes, he is seeing a Urologist, and I think they put him on a round of antibiotics the last time (prior to the biopsy). They did 12 draws on the biopsy and the results were negative.

I guess my big concern is that a big jump all at once seems to be more serious.

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/22/2008 6:45 PM (GMT -7)   
Any man your Dad's age is quite likely to have PCa. If the biopsy didn't find any, that doesn't mean he doesn't have it -- rather it means there was none in the 12 samples.
 
The encouraging thing is that with 12 samples showing negative, if he has PCa it is not very widespread. The active surveillance option may therefore be a very reasonable one.
 
PSA can fluctuate considerably from causes other than PCa, so your doctor is wise to first eliminate those other causes.
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week and 7-month PSAs: 0
Bimix injections working well 


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 12/23/2008 9:05 PM (GMT -7)   
Might get a "free" PSA added to your next PSA test.  If it is a low percent, that usually indicates cancer is present.  Keep us posted.
Dutch
Diagnosed Feb 2001  (Age 65)  Currently 73
PSA 4.8      Gleason 3+3=6      Stage   T2b
Completed Proton Therapy @ Loma Linda - 2001 - No side effects.  My journey is at: http://www.healingwell.com/community/default.aspx?f=35&m=727565
7yr PSA - 0.2
Our responsibility now is to educate men about Pca, PSA and the importance of early detection. 
 
 
 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4168
   Posted 12/27/2008 11:51 AM (GMT -7)   

You may want to ask your doctor about a PSA3 urine test. It's a new test that is more accurate than PSA or free PSA in detecting prostate cancer,

John T


Diagnosed 10-08 at 63 with PSA of 33
PSA was 4.4 in 1999 and has risen steadily.
Had 13 biopsies and an endorectal MRI, all negative until 10-08. Two cores out of 25 with a gleason 6
2nd opinion with an oncologist said cancer found was insignificant, but suspected larger tumor somewhere.
Doppler ultrasound with target biopsy indicate a large tumor in the transition zone, gleason 7.
Bone and CT scans negative.
PSA3= 43; high normal is 35
Currently evaluating treatment options, surgery is not an option as a high probability of positive margin exists.
John T


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/29/2008 10:35 AM (GMT -7)   
Hi ya John, you did not start any drugs like casodex etc.? That psa number is way high I assume you must of had some drug therapy??? Probably you should be on atleast casodex and see results while you are checking out your options. Once on these drugs it may make surgery less likely as alot of docs don't want less than a virgin gland (per se), drugs can shrink the gland and make it kind of like a sticky mess (more or less, is what I have heard).

I have heard about the urine test, it could be useful to someone whom isn't ready to commit to biopsies just.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/1/2009 4:46 AM (GMT -7)   
Clairifying what I posted, even if biopsies reveal cancer, at your dads age surgery is not really the route to take, maybe watchful waiting, some drug therapy(all depends on parameters of what is found), but for others reading this thread that are alot younger watchful waiting probably is a shorter term consideration, alot depends upon your intial stats and history records, my brother is about 4 yrs. now with w.w. and so far no changes in his psa but that does not guarantee that he is safe by doing so either it is his choice. If those psa numbers you mentioned, went up to 7 and later is at 13, highly suspicious for PCa to be found and considering his age, very likely to has PCa, the question is what are the possible numbers. If they approach what is considered indolent PCa definition you have alot of options and probably time on this.
"Youth is wasted on the young"-W.C. Fields
 
"I wouldn't join a club that would have me as a member"-Groucho Marx


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/1/2009 12:49 PM (GMT -7)   

Hi Flower,

And welcome to the best site on the web for caring and compassionate support that has helped me so very much through my cancer experience.  Your father likely needs to have another biopsy, perhaps with what is called a saturation biopsy.  This is a process where substantially more of the prostate is tested for cancer.  At least it is a good question for his doctors.  Zufus’ point about age consideration for a treatment modality is valid, however, each patient is different and if your father is in otherwise good health, and your family has a history of longevity there are many options.  But first his rise in PSA could be just an infection.  He needs to have another biopsy first and verify that this is indeed cancer.  There is no reason to place the cart in front of the horse.  And if it is, then post the information and you will find many members here with great experiences to draw from.

 

You have my prayers that it isn't cancer.  But if it is, you will a great resource here to help.

 

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!
 
 


flowerchild6419
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 1/1/2009 6:04 PM (GMT -7)   

Wow!  Everyone has been so helpful and supportive.

They did do another psa and it was 9.5 instead of 13, which is maybe a little better.  His doctor is on vacation until the new year, so he should be meeting with him soon.  I'll write down your suggestions for other tests.

He is actually in very good health otherwise, in fact, he is still working every day.  He's twice retired, but works now at a grocery store as their maintenance person 32 hours/week.  The only other problem that he has is acid reflux and slight high blood pressure, both of which are managed with medication.

My Mom had thought that the PSA only went up to 10, so was really worried about 13.  I told her that I read on the internet that it can go up to 20.  She finally went on the internet and read a little herself, so that has helped a little bit.

Do you think I should go to the doctor with my Dad?  Or is that something you wouldn't really want your daughter to do?


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/1/2009 6:15 PM (GMT -7)   
Good job Flower,
I woul not have a problem with my son going with me, and I do recommend that no one goes alone if they don't have to. Brief visits at a doctors office can make gathering information difficult to remember. In hearing about cancer, the patient has I would say has about 60% memory retention. But having a loved one with you can be extremely comforting. When you think of questions, write them down. Drop tidbits of information on them like you are, and most important ~ Help keep that attitude positive. I live with that motto and it has done me well. So did my wife at every appointment, and my friends behind me when I got home. I have seen some wonderful daughters here posting, and it makes me wish I had one.

God bless and stay positive!

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!
 
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 1/1/2009 8:35 PM (GMT -7)   
Hey Flower,

I am near you dad's age and got diagnosed with PCa in 2006. I had surgery, recovered quickly and went back to work teaching school 3 weeks later. Now I have had 0 PSAs every since. For someone who is active and in good health, eliminating surgery as an option due to age is nonsense.

Got cancer? Get rid of it!!!

Jim
Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Finished 4 cycles of chemo on 11/7/08.
CT scan on 12/2/08 - in remission!!!
Next scan on 2/26/09.
"Patience is essential, attitude is everything."


GBINAB
Regular Member


Date Joined Apr 2008
Total Posts : 203
   Posted 1/2/2009 2:54 PM (GMT -7)   

Flower , PCA is  a slow developing  cancer and as others indicated it is probably at the very start that even biopsy of 12 samples can not detect  it , i was on watchful waiting for about 18 months wit PSA  of about 8 and antibiotics as well untill the biopsy  could detect  a positive 3+3 score.. i went for  the open  surgery without much research or finding THIS INCREDIBLE SITE!!!  that is more educational than any doctor or study  have ever read....  so WELCOME as well and you wil find here mos of the answers you are loking for ...seems   that most common and bst result treatment is the DaVinci method of removing the prostate  with the best result on side effect following it ... the biggest hurdle you will have is to find the most experienced surgeon at where you reside ....

Do not panic  and keep your dad calm as well

Good Luck and keep us posted

GB


April 2007 PSA 8.4 for last 6 months biopsy shows PC 3+3=6
June 13 2007 Nerve Sparing open RP / Dr. Christopher Johnson at St. Francis Hospital NY.
4 days later home for Fathers Day, and Catheter.
Removal of catheter 10 days later , incontinence not an issue, no pads used from the get go.
1 month PSA next to not detected

ED is a longer battle:
1 month out start using occasionally Cialis and 50MG Viagra to promote blood flow with no response.
3 months and 6 months PSA not detected
ED 6 months mark starting with VED therapy and being more aggressive with meds , in addition taking Folgard supplement daily.
April 2008 : 10 month out and start seeing some serious improvements with ED while using Meds and VED , can achieve erections, Mid nights erections almost on a regular basis , and uncontrolled 90 % erections spontaneously.
1 year visit on June 13 2008 woohoooo!!!

UPDATE 1 YAER FOLLOW UP
ED: With Viagra Usable erection for intercourse , AND AT 80% without any medications !!
Fully continent since removal of catheter.
PSA one year : 0.0 as of 6/13/ 2008 BIG Wooohoooooooooo!!!!
 
UPDATE AS OF Dec 2008 (18 months out)
 
PSA  stil Undetectble!!!!
No continance issues!!!!
ED Mostly  getting better  with oral meds and the right woman  = good  sex
80% without any help   and 95% with oral Meds ... 100% with  VED
hope to keep progressing and by 24 months get back to 100% potency  WooooHoo!!!
 


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 1/2/2009 7:36 PM (GMT -7)   
Flower,
Once again, welcome to the site.
Did your Dad's uro. mention prostatitis or BPH? More tests could clear this up.
Also, what I did when I had my consultation with the first urologist was to take a small portable voice recorder(found it at Target for about $15.00). My second doc concurred with the first one's diagnosis. Occasionally I will play it back if I can't specifically recall what he said. The docs throw a lot of info at you in a short time and some of it hits you pretty hard. It was nice to have the rercorder to replay exactly what he said. Doc didn't mind at all having in on during the consultation.

Bob
 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci scheduled for Jan. 19, 2009.Dr. Scott Montgomery, KC Urology,
Shawnee Mission Med. Center. Kansas

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