Do we have Pca?

The story so far.

I started getting on to my husband of 28yrs in 2005, about his weak flow, and what seemed like ages for him to actually start peeing. Seemed to only happen at night. (En-suite bathrooms do have there uses). I have two sons both in their twenties, the house shakes when they pee!! So off he trotted to our G.P. It went a bit wrong with the doc I think, as he did a DRE before taking a blood sample. The DRE was positive, a lump on one side.  We then had to wait three weeks for a PSA test, as the DRE would effect the reading. We get a letter from the G.P saying he would like to see my husband as his PSA was slightly raised. 5.5 age 53. Antibiotics for an week to rule out an infection. Another PSA done. Raised to 6ish. Not sure of actually readings, as it was 3yrs ago. Biopsy performed. Told a few close family members that I thought my husband had Pca. It was a horrible time, and very distressing. Didn`t know anything about Pca then and I thought he was going to die. On a happier note the biopsy came back clear, with no pre-cancer cells. What a relief! We all get on with our lives.  The only thing requested by the urologist was he had to have a PSA test every 12 months. What happens here in the U.K is you have a blood test and if there is a problem they write to you. So we carried on with yearly PSA tests never hearing anything thinking everything was fine. This year a letter arrived from his G.P saying his levels had risen again, and could he make an appointment. To my horror his PSA was now 8.5 and had been steadily raising these last 3 yrs, unbeknown to us. So where are we now, unfortunately still waiting! We have to wait 3 months for another PSA to see what the levels are then. So PSA test will be done on the 1st May. What should happen if the levels have dropped? Will we wait another year? Cannot tell anyone this time as it`s a bit like Peter and the Wolf! So going it alone! Husband is very blase` about the whole thing, as the neg biopsy in '05 put his mind at rest. My father-in-law is 80, (according to him he has never had a PSA test!) has had BPH for years, has had 2 operations on his prostate. Could BPH make your PSA rise to this level over 3 years? Could that be my Husbands problem?

An enlarged prostate causes elevated PSA readings: the larger a prostate is, the more PSA is produced, so prostate  size should be taken into account for PSA readings to be meaningful.

Another suggestion  is to have a "freePSA" test which gives the % of PSA being produced normally and will indicate the probality of cancer.

Unfortunately there are a lot of grey areas with PC, and biopsies can sometimes not detect a cancer if, for example, the cancer is small, or only a few samples were taken.

Given all of your  information, you need to be more proactive,  and consult a medical oncologist expert in PC.

Post Edited (aus) : 4/24/2009 5:26:30 AM (GMT-6)

Hello UK,

It is most likely that if you lived over here that the doc would be doing another biopsy. There are numerous stories (on this forum) where the biopsy depicted no PC but it was there. the biopsy is kind of like moderately controlled, but nevertheless random samples and can easily miss cells.

TeddyG

Tizzal,
The following link should be helpful in determining what the next steps are. I had 12 biopsies that were negative so biopsies aren't foolproof.

http://www.prostate-cancer.org/education/preclin/StrumPogliano_EveryDocShouldKnow.html

Print out the article and show it to your doctor. Dr Strum is one of the best prostate oncologists around and I would trust what he has to say on the subject.

JohnT