Is bone metastases and a 4.6 PSA passible

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Steve Ped
New Member

Date Joined Feb 2009
Total Posts : 1
   Posted 2/24/2009 7:09 PM (GMT -6)   
High group new to the board, and is my first post, I have been reading your many informative post. Thanks all.
I have not been diagnosed yet, so I am looking for a little piece of mind.
I am currently 51 yrs old. In Oct 97, I had a 2.6 PSA  with an abnormal DRE. I then had a negative biopsy. Was told to return for a 6 month recheck. well stupid me, 6 months turned into 15 months. A recheck  of PSA showed 4.3, with symptoms of prostatitis, was given 6 weeks of antibotics (Levaquin) I just had a recheck PSA 4.6, and a free PSA of 0.08%, now I have a biopsy scheduled for next week The Doctor says I have a 40% chance of PC.
My question is, about 3 weeks ago I started having back issues (soar and stiff) and some upper leg pain near the joint. I told the Doctor about my leg and back pain. He doubted it would come from PC, bone metastases usually has a PSA greater then 10 and I had a clean biopsy 15 months ago. Should I be worried I have caught it this to late?
Many Thanks in advance.   

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 2/24/2009 7:28 PM (GMT -6)   
Welcome to the best patient to patient PCa site on the web. Nothing is set in stone with this disease with every case a little different but I believe it is generally accepted that metastases are usually not present with a PSA below 20. Is that free PSA reading 8% (in other words a reading of .08)...................08% is virtually 0. It does not really matter as 8% free PSA is suspicious and your doctor is adopting the correct approach. I don't think the 12 month delay will make a huge difference. In most cases PCa is a very slow growing disease and often does not spread at all. The biopsy will give you a much clearer picture. It might pay you to read the nearby post on "Colour Doppler Ultrasound" Good luck with the biopsy.
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)
PSA February 09 <0.01

Post Edited (BillyMac) : 2/24/2009 5:35:40 PM (GMT-7)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 2/24/2009 7:51 PM (GMT -6)   

We can say PCa is inconsistent and way to many variables, not mention the 18-variant types of prostate cancer, you might wish to have your biopsies sent directly to the short list (found on recent threads herein) of experts whom can identify much more precisely what a patient actually has.  Not meant to scare anyone but small cell prostate cancer, signet ring PCa and a few others are in a different league and not even directly comparable to the normal cases, which most of us herein are found with.  Although unlikely you have mets, no way to be 100% on this stuff. My stats below are high and my ct scan and bone scan showed clear (no guarantee necessarily) I had it reviewed also, so atleast 2 docs say so, plus I have the film to look at which is kind of fun.

Journal of Urology 2000-163:1138-1143   (Albertsen):  PSA>50 ng/ml & gleason 8 to 10 does reveal mets in over 60% of cases   (ct or bone scans being used).

I had clear scans(2002) with:  Psa 46.6  12/12 biop. all 80-95% cancerous, gleasons 7,8,9 (x2-both sides). At age 51 and felt normal, except for the urinary blockage that sent me to emergency the way still alive and pretty well and normalish 7 years later, psa Feb.-09=  .36 

"Youth is wasted on the Young"- W.C. Fields

You are probably going to be alright, just is hard to say things with 100% attached to them with PCa issues.


Post Edited (zufus) : 2/24/2009 6:56:43 PM (GMT-7)

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