Prostatitus & PSA

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nabulldog
New Member


Date Joined Sep 2009
Total Posts : 2
   Posted 9/6/2009 1:46 PM (GMT -6)   
I am 48 and have recently had a 2 month battle with prostatitus.


Background leading up to the prostatitus:

The protatitus condition started 3 days after I was release from the hospital.
Previous to the hospitalization I had a deviated septum and turbinate reduction surgery performed.
I was on antibiotics for 14 days which is required for me due to my mechanical heart valve.
While I was in the hospital I was given a different antibiotic for the 3 days I was there.

I was in the hospital for a severe post-op nose bleed(scab let loose).


Prostatitus: 5/18/09

The 1st round was acute prostatitus, which require me to be catheterized for a day, put on Levequin for 14 days, and Flowmax for a few days. After 14 days my urine culture was clean. about 7-10 following the clean culture I started burning again. This time I drank tons of water and it looked like it was working, all the way up to the point where my left kidney started hurting. I knew at that point I had to go back to the doctor. Culture confirmed that I was infected with e-coli again. I was put on amoxicillan for 14 days followed by some other antibiotic(Cepro) for 14 days.... 28 days total.
I have been clean for about a month now.

I recently had my PSA taken and the results were 4.13, the blood was drawn on 8/28/09.

My past PSA's: Dec 2006 = .76
Dec 2007 = .88
Dec 2008 = .93

The digital exam results: 1st round inflamed and tender
2nd round slightly inflamed on left side

Every since my Prostatitus experience, I have noticed when I start a stream or if I haven't drank enough water, that my urine feels hot flowing thru the urethra. It doesn't burn, but feels hot, like a hose that's been sitting in the sun. At 1st the water is hot but, as it flows thru the hose it eventually cools down.

Is this(hot) an indication that I may still be experiencing prostatius, but without the infection?
Would this or the protatitus episode cause my PSA to rise so high in a short period of time?

Previous to the Prosatitus my urine never felt hot or burning.

My family has no history of prostate cancer.
Up till Jan. of 2009 I was very physically fit/active.
My cholesterol has risen somewhat since Dec 2008.
I am finally getting back to exercizing.
I am not overweight and eat healthy.


Does the elevated PSA sound like something to be concerned about at this time?
or should I continue get PSA tests every couple months to see where this thing is going?

I am thinking wait and see.
I'm not too keen on a biopsy, since I have to go off my Coumadin and I have to get on another antibiotic.


Any thoughts?

CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 9/6/2009 4:04 PM (GMT -6)   
Greetings, Nabulldog.  Your PSA has gone up significantly in a fairly short period of time.  You normally look at doubling time, but yours has gone up 4 fold.  Yes, an infection might be the culprit, but I believe I'd be asking my doc about the possibility of doing a biopsy to see if there might be another reason.  While a biopsy is not infallible they can be beneficial in helping you know where you are.  Just a thought. David
Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 9/6/2009 4:58 PM (GMT -6)   
It seems you might still be suffering the after-effects of the prostatitis, and that might be responsible for the high PSA.

Prostatitis can certainly make your PSA rise quickly. I don't know how long it takes for the PSA after prostatitis to return to normal levels, but after prostatectomy, it is usual to allow 6 weeks before a further PSA test.

A biopsy is not without risks, so I like your idea of waiting for two months to be sure the prostatitis is really gone, then retest the PSA. If it remains high, then a biopsy will be in your (near) future.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.
14 months: Occasional nocturnal erections.


nabulldog
New Member


Date Joined Sep 2009
Total Posts : 2
   Posted 9/6/2009 5:26 PM (GMT -6)   
Did either of you have a PSA free test performed?

If so, did the results support your origional PSA results?

PSA Free Scale:
>25% Probably not cancer
<15% Possibly cancer
<7% Cancer

I am suppose to have another PSA done Oct. 13, I believe I am going to push it back to the beginning of Nov. since my wife is having surgery on the Oct 14. I want to make sure she is pretty well recovered before I get the results.

I am hoping this is nothing. If I hadn't had the Prostatitis it would be a no brainier, get the biopsy.

Thanks for responding.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 9/6/2009 5:53 PM (GMT -6)   
Prostatitis manifests itself in rising and falling PSAs. Prostate Cancer usually has a psa that is steadily increasing over time. You can't tell from one point in time as you need multiple psa readings to get a trend.
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 DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT

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