HGPIN positive but PSA drops 50%

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HGPINer
New Member


Date Joined Jul 2009
Total Posts : 4
   Posted 7/29/2009 10:50 PM (GMT -6)   
Nov 2008 had a PSA count of 5.3, went for biopsy in Feb 2009, two of 12 cores were positive for HGPIN. Took Vitamin D, pomegranate juice, green tea extract, Zyflamend, tomato paste, broccoli sprouts. July 2009, PSA count is only 2.7.
Will not be seeing urologist until mid August, curious about the significance of the nearly 50% drop in PSA. Thanks for any comments.

jeff_2006
New Member


Date Joined Sep 2007
Total Posts : 5
   Posted 7/30/2009 12:10 AM (GMT -6)   
sounds like me bro! went from 6.3 to 4.5 in two months by taking pomegranate concentrate, zyflamend, lots of tomatoes and beets, even the vit D, thought i had it beat, until i talked to my doc. He said it doesn't mean a thing, we're still on for surgery. I really thought he'd say keep at it and we'll check the psa again in a few months but he didn't. I think you're in a gray area where nobody really knows for sure what to tell ya. Be prepared to have you're uro tell u the same thing as mine did. Find a good surgeon with lots of experience and you'll be fine. Don't let all the worst case scenarios posted on the net get you down. u shouldn't dwell on them.

HGPINer
New Member


Date Joined Jul 2009
Total Posts : 4
   Posted 7/30/2009 12:22 AM (GMT -6)   
Hi Jeff, thank you for your comments. I was a little surprised to read that you are still on for surgery. My take is that I would prefer to stick with watchful waiting or active surveillance (or whatever upbeat phrase makes us feel more comfortable) unless there were no other alternative. The NEJM writeup a few months ago seemed to be saying that 47 out of 48 of us would be better off without the surgery, overtreatment leads to more complications etc. I do not have the references to the NEJM report but I would think you would want to review it and discuss it with your uro. Best wishes, Bob. HGPINer.

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/30/2009 9:18 AM (GMT -6)   
Almost all of the substances mentioned have been connected either to reports of populations with low cancer occurrence or with tumor shrinkage -- in both cases for cancers other than PC. It does not seem reasonable that their effect would be to lower PSA without affecting the tumor. Besides, if they did mask PC by only lowering PSA wouldn't there be an epidemic of "health foodies" being diagnosed with very advanced PC?

As to your surgeon not being interested, he has a treatment that is clinically proven to have about an 80% chance of eliminating PC. How could he responsibly encourage you to pursue a treatment with no proven effectiveness? Besides, several recent clinical studies of vitamins and other supplements have been very disappointing in terms of improved health effects.

This is not to say that you are wrong in what you are doing -- only that you shouldn't expect much support from a surgeon (or a radiation onc for that matter.)
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads


jeff_2006
New Member


Date Joined Sep 2007
Total Posts : 5
   Posted 7/30/2009 11:12 AM (GMT -6)   
The pressure from my family, my urologist and my primary doc to have the surgery was intense. They would call me at home just to remind me. In addition, PCa took my father at age 66. I was 46 at the time of dx. If i went with watch and wait and ended up with serious problems i would have felt foolish after all the warnings from so many. I was 3+3, T1C, 1 out of 11 cores was 5% so it was an agonizing decision.

Personally Bob i have no problem with your decision, just keep a good eye on it, and best of luck. If you make out ok you'll be one proud dude.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 7/30/2009 8:39 PM (GMT -6)   
HGPINer,
Just read a paper by Strum, Tisman and Scholz on PIN. HGPIN is more predictive in older people with a psa greater than 4. PIN appears to predate the appearance of PC by more than 5 years.
Their recommendations:
1. Monitor PSA and get a DRE minimum every 6 months.
2. Repeat biopsies at least every 12 months.
3. Patients with High Grade PIN should be considered as having occult PC until proven otherwise.

If supplements like pomegranites are good for those that have PC and are proven to slow the growth of PC I would imagine that they would have the same affect on HGPIN. Be sure that you have a good doctor that is experienced in AS and PC diagonostics.
You may want to Google HGPIN; a couple of months ago I ran across an article about a research center that specializes in HGPIN using some natural formulation that eliminates it.

JT

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


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 7/30/2009 9:32 PM (GMT -6)   
Having sex prior to PSA test is known to raise or lower PSA counts. It probably doen't effect the cancer at all. just the count.

PSA is an indicator of cancer cell growth. It is possible to mask the PSA, maybe even decrease the production of it, but there is little evidence that it actually stops cancer growth.

Maybe that's because there hasn't been a good clinical trial.

As mentioned, this is fairly unexplored territory, with a lot of uncertainty, and a fair amount of gambling. I certainly would have my PSA checked at 3 or 6 month intervals. John T's list looks like a great regimen .

You are taking Watchul Waiting to a new level here.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


HGPINer
New Member


Date Joined Jul 2009
Total Posts : 4
   Posted 8/20/2009 4:26 PM (GMT -6)   
Hi, got in to see my urologist today. He is no big fan of supplements but sees the 50% drop in PSA (from 5.3 down to 2.7) as a good thing.

He is referring me back to my regular doctor and I do not see him again unless my PSA rises. He said that in the event my PSA rises he would want me to get a PCa3 test. In the meantime I am staying on the supplements and avoiding red meat and dairy.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 8/20/2009 8:07 PM (GMT -6)   

HGPINer,

If it's any comfort to you, my oncologist said that 10 years ago if anyone told hime that PC could be held in check with diet he would have just laughed. After seeing many of his patients on "wierd diets" have their pc substantially reduced he couldn't ignor the facts anymore. He now recommends diet and supplements as a part of his treatment protocol.

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


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 8/26/2009 11:31 PM (GMT -6)   
HGPINER
 
I agree with JohnT's post and recommendation for HGPIN.  Ignorant me had HGPIN in a second biopsy in 2000 and went my merry way until a bio in 2008 indicated Gleason Score 10.  My new Urologist in 2004 said he would have me have a bio if I had not had one in 2000 that was negative.  I did not know enough at the time to insist on a bio because of the HGPIN.
 
Keep a careful watch with PSA and DRE and be proactive not reactive later.
 
Rich
Biopsy 1998 = Neg Bio 2000 = Neg with PIN Bio 1/10/08 Gleason 10, Stage T1C 8 of 12 samples positive all < Than 5%
Bone Scan, CTs and MRI Negative early 2008
March 2008 MD Anderson - No Surgery or Proton = No Action
Feb & Mar PET (Possilbe Lymph Node Involvement  & Prostacint Scan Negative
March 2008 U of Florida Proton Therapty Lupron & Casodek May 08 for 2 years
Completed 25 IMRT and 17 PBRT U of Florida Proton Therapy Institute 7/24/08
Latest CT June 08) showed no trace of tumor in lymph node area
7/24/2008 PSA .21, free PSA .08, Percent free PSA 38.1, testosterone 14.6
8/1/2008 2nd Lupon Shot -- 10/27/2008 PSA <.01 -- 12/9/2008 3rd Lupon Shot
12/11/08 MRI Suspicious for Metastic disease L5 & S1 -- Bone Scan 12/19/08 Indicates No Bone Mets Spinal Stenosis and Neropathy in my legs
2/06/09 PSA = < .01  -- 4/09/2009  PSA <.01 --4th Lupron shot 7/02/2009 PSA <.01 Lupron
Our Journey is on WWW.GLEASONSCORE10.COM

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