Ellevated PSA reading

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desertman
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/22/2009 12:35 PM (GMT -7)   
Hello all
I recently had a PSA reading, the lab came back with a score of 57 - took it to the docs, he was scratching his head and advised me to get another test - awaiting results - he did a DRE but could not find anything.
I realise PSA readings can fluctuate and depends on many things - I am a vegetarian (30 plus years) have been very fit (used to be a triathlete), non-smoker non drinker, daily swimmer etc, aged 62
Has anyone else had a similar experience?
Many thanks
 

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/22/2009 12:44 PM (GMT -7)   
Hi desertman ~ from Las Vegas,
Welcome to HealingWell. Should tests require a biopsy, you have come to the best place on the web to share and receive information on prostate cancer. I am sorry to say that a PSA of 57 would be the highest I have seen that wasn't prostate cancer, but still, I have seen many surprises with this disease. Some that have worked out very well. Do you have any history in your family with PCa? If so, you can be as fit as a fiddle and still be high risk for a positive test. Much has been argued about exercise and diet, but in two and a half years, I have seen it not matter for much. Simply put, if it's in the genes it's in the genes. Out of curiousity, when was your last PSA test?

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


desertman
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/22/2009 1:04 PM (GMT -7)   
Hello and many thanks for your reply.

My original first PSA test was just over a month ago, and my recent test was last friday - I should get the results by wednesday.
As far as I am aware there is no PC in my family but will be checking on that.
Searching around, I have seen PSA's of 140 and more...
Who knows!?
I will let you know the results

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 6/22/2009 1:16 PM (GMT -7)   
I don't think I understand why you went to a location other than your doctor/urologist's office to have the test and why you had to bring the results back to the doctor/urologist's office rather than the laboratory communicating directly with the doctor/urologist.  Test results do differ by laboratory, because no one protocol is employed when doing the analysis - this is something commented on at this forum from time-to-time.   Given the high score being suggested, I'll be surprised to learn that your physician hasn't already gotten you an appointment with a good urologist in your area.  The "get another test" suggestion from your doctor would worry me, also - because that physician should probably be drawing the blood in the office and managing the process.

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0

 


desertman
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/22/2009 1:41 PM (GMT -7)   
Hi
The first test was part of a 'well being' health screening at the university where I work - when the results came back the clinic suggested I see my doc - the lab that do the tests happen to be the same lab used by my GP, hence why the suggestion for a re-test etc
Thus both tests will have been carried out by the same lab - we will see what transpires!!
Hope that clarifies the situation

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 6/22/2009 1:45 PM (GMT -7)   
Thanks for the clarification. 

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0

 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 6/22/2009 1:52 PM (GMT -7)   
desertman,
while your lifestyle is commendable, none of that diretly will keep you from having or not having PC, or any other kind of cancer. if you get another reading in that range, and your dr. doesn't feel like it's related to non-cancerous prostate problems, then I would opt for a biopsy as soon as possible. As far as DRE, I wish it was as easy as that being a positive test for PC, but it isnt. I had about 10 DRE's and 3 biopsies performed before my PC was official, and I too had a steady rising PSA, with no other symptoms of prostate problems. Hopefully, your next PSA test will be at least consistent with the others, and the next step can be determined. Hoping the best for you.

david in sc
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/22/2009 1:59 PM (GMT -7)   
You should get to a good urologist as soon as possible. You dont need the results of the new test to start looking and making appointments.

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)

1/8/2008

33.90

1/11/2008

29.50

1/31/2008

38.20

2/21/2008

32.00

3/13/2008

26.20

4/3/2008

26.60

4/24/2008

20.60

followed by RRP at Duke (Dr. Moul) on 6/16/2008

Pathology

Gleason downgraded 4+3=7

  Duke: T2c N0MX, one positive margin

  Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then

2/6/2009

0.10

4/26/2009

0.17

5/22/2009

0.20

6/11/2009

0.27

6 Months ADT started 6/12/2009

IMRT to start mid-Aug


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4168
   Posted 6/22/2009 3:32 PM (GMT -7)   
If your psa does come back at 57 I would skip the urologist and go directly to a prostate oncologist. They understand more about psa and PC than any urologist ever will.

JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/22/2009 3:34 PM (GMT -7)   
John,
He needs a biopsy first. It could be a severe case of UTI.

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 6/22/2009 3:36 PM (GMT -7)   
I agree with you Tony on this one.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 6/22/2009 7:22 PM (GMT -7)   
I'll third that motion. Get a biopsy. I just had a follow up with my URO (haven't seen him in a while, --I do my six months check ups with my oncologist). He said because of me he has changed his protocol for elevated PSA. Normally, when you come in with a really high PSA (see my sig), they'll put you on anti-biotics for a month and re-take. He said he stopped doing that because when I went back in after the antio-biotics, my PSA had jumped to 39. He said his philosphy in medicine is to manage for the worse case scenario and try to beat it. Makes sense. GOOD LUCK!
Sterd82
Age 49 - pre-surgery PSA 39 (at age 45)
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
PSA as of November 29, 2007 undetectable
PSA as of May 14, 2008 undetectable
PSA as of November 25, 2008 undetectable
PSA as of May 22, 2009 undetectable


desertman
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/24/2009 11:05 AM (GMT -7)   
hello all
Many thanks for your comments
I had the 2nd PSA test back today - and taking into account I had a rectal a few days prior to the test it came back as 65.4 - however I note the ug/l reading was <4.5 UG/L which I understand is just over the 'cut off' for my age - does anyone know how they score the readings of 65 for example from this?
Anyway, I am being referred to a urologist for further testing - will let you know the outcome
H
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