How long does biopsy affect psa readings?

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huey
Regular Member


Date Joined Jul 2009
Total Posts : 27
   Posted 8/3/2009 6:02 PM (GMT -6)   
Can anyone tell me if a biopsy will alter a psa reading 2 months after the biopsy.
My July 28, 2009 psa reading is 1.3.
My April, 14, 2009 psa reading was 2.04.
I had a biopsy on June 2, 2009.
My doctor says he doesn't have a reason.
Do I need a new doctor or am I missing something?
 
Any suggestions would be appreciated.
 
 
Thanks
huey
Age: 64
Dx: 6/2/09, Age 63
G: 3+3
PSA: 2.04
Samples: 12, 1PC, 20%
DRE:positive
Stage: t2a
Still trying to decide on treatment.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 8/3/2009 6:13 PM (GMT -6)   
Welcome to the club that we never want anyone else to join.

If anything one would expect an "insult" to the prostate to raise PSA rather than to lower it, hence the suspicion that a DRE can raise PSA.

You probably do need another opinion -- not necessarily because your doctor is bad but because your case seems strange. Perhaps a PC oncologist rather than a urologist.
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 8/3/2009 6:55 PM (GMT -6)   
Huey, two full months after the biopsy should be enough time normally to get a clean PSA test. Seems my doctor was talking about 6 weeks min. after a biopsy, I had 3 altogether.

While your PSA is low, even age factored, the one positive core and the positive DRE would keep me concerned.

Which treatment(s) are you considering at this juncture?

Please keep us posted.

David in SC
Age 57, 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
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, again
 
 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/3/2009 7:49 PM (GMT -6)   
Huey,
A biopsy will only increase your PSA, not decrease it. Was the nodule felt on the DRE biopsied or was the biospy just a standard one. Your stats indicate you are a candidate for AS, but the DRE would exclude you' I concur that a 2nd opinion from a noted prostate oncologist is warrented at this point.

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


huey
Regular Member


Date Joined Jul 2009
Total Posts : 27
   Posted 8/4/2009 10:04 AM (GMT -6)   
John T and David in SC.

Good advice. I still have a positvie DRE and core.
I will probably op for surgery but this has me baffled. I will make an appointment to see a prostate oncologist.

Thanks again for the info.


huey
Age: 64
Dx: 6/2/09, Age 63
G: 3+3
PSA: 2.04
Samples: 12, 1PC, 20%
DRE:positive
Stage: t2a
Still trying to decide on treatment.
New PSA 7/28/09: 1.3. I don't understand it???


TheoTeacher
Regular Member


Date Joined Jul 2009
Total Posts : 47
   Posted 8/4/2009 10:24 AM (GMT -6)   
Huey,

My doc told me 6 - 8 wks after a biopsy it might be affected. However, your's went the other way!
Maybe the first PSA was wrong? I know my doc asked me about my sexual activity prior to my PSA and she explained that it could/would increase the #'s a bit. So go back and think about the night before your first PSA!!!! (Or morning of the test!) ;-)
Johns Hopkins, on their web page, has some tips on what NOT to do prior to a PSA test.
Sound like a 2nd opinion is in order.
I hope it was all a mistake.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 8/4/2009 10:45 AM (GMT -6)   
huey, yes, get that 2nd opinion other than surgery. a lot would depend on what was felt during that dre, how much was felt, and where it was located, that concerns me a whole lot more than the single core found. if it were not for the dre, i concur with john t, and think that you might have been a good candidate for AS.

at your current age, and assuming your general health is good, you still have good option choices.

david in sc
Age 57, 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
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18
 
 


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 8/4/2009 11:16 AM (GMT -6)   
Huey,
 
Not to get your hopes up,  but you could be one of the extremely rare individuals who have gotten a Prostatectomy Via Biopsy!!!!    That is where the cancer was so small that the biopsy needles took out the whole thing.   Kind of unlikely if the DRE was positive tho.      P Via B is like winning the lottery for sure.    Will your Doc have you do another PSA in a month or two?  Will be interesting to see how that one comes back.    As mentioned elsewhere,  PSA rise rate from now on would be one of the items you would want to look at if you choose Active Surveillance (or even if you wanted to decide if you should choose AS).
Age 58, 195lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 07/2009).
04/01/09, 07/07/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray showed no additional stones.
Next up (so to speak) -- MUSE(1000mg) -- on 08/07/09.


huey
Regular Member


Date Joined Jul 2009
Total Posts : 27
   Posted 8/4/2009 5:03 PM (GMT -6)   
Thanks for the advice guys. I really appreciate it.

Huey
Age: 64
Dx: 6/2/09, Age 63
G: 3+3
PSA: 2.04
Samples: 12, 1PC, 20%
DRE:positive
Stage: t2a
Still trying to decide on treatment.
New PSA 7/28/09: 1.3. I don't understand it???

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