tPSA up more than 1ng in one year

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Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 9/22/2009 3:55 PM (GMT -6)   
46 yr. old, white, no family history for PC. For the last few years, 2004-2008 my PSA was between .6 - .75 with the last values on June 2008 .61. Free ratio was .57. Annual check up on June 2009 said PSA 1.75 and frees ratio .27. Seeing the urologist on July 2009 he said that I should have a biopsy, which it is coming on October 5th, 2009. In the last six years, I had asymptomatic microhematuria in urine, which disappeared for a while and coming back. Always traces no small amount. The specialist performed cytoscopy on July 2005 and June 2009 and he did not found any reason for hematuria. I have a discomfort on my pelvis, no back pain, no joint pain only burning on urethra after urination. That happens when I drink a lot of water on short time and I need to go to washroom more often. Over night going out one time and not on every night. Starting with 2005, the specialist put me on Flomax which helped to remove the symptoms on the beginning but on 2007 the doctor said to take one in the morning and one in the afternoon. I am still on Flomax, once a day for now how the specialist prescribed. End of July 2009 the urologist performed DRE and he told to me NAD - supposed to means that nothing detected. I will go for transrectal ultrasound on next week. Now, on September 09, 2009 I ask my family doctor for one more PSA and free ratio to see the evolution over three months. The result scared me like crazy because PSA came back 2.25 and frees ratio .33 - this values bigger than June 09 does. The first result did not scared too much because I supposed that I was lucky to catch something pretty earlier, but the second one make me crazy. I am taking prescribed pills for sleep and also pills for days, so I can be able to concentrate at work. The DRE was done on July 25, 2009 and it was a hard one because the doctor used a lot of pressure to try to catch something on my prostate. As I already told you, NAD. Can the result from September 09, 2009 be not so accurate because of the DRE done on the end of July 25, 2009? Or the disease is aggressive? Also, can I have other symptoms? I asked urologist couple of years for a biopsy but his answer was NO because my entire test. This year, he asked me directly if I want to have a biopsy or I want to stay and watch. I choused biopsy but I am really scared. Can somebody tell me something from own experience and has an advice? I am dealing very hard with this situation. Thanks a lot

Fat Sailor
New Member


Date Joined Sep 2009
Total Posts : 7
   Posted 9/22/2009 4:10 PM (GMT -6)   
Gog,

We're kind of in a similar boat except my DRE found a nodule. I'm not a medical doctor, but my GP said that any increase more than about .5 in a year for guys our age (I'm 47) should have a biopsy. Your urologist didn't find a nodule so that's a plus point. My reading of the literature so far (just a few days) confirms what my GP said- an increase of about .4 in a year for someone in their forties warrants a biopsy. It is your decision, but the potential downsides of a biopsy seem pretty small compared to the downsides of not having one to me.

This is scary- no doubt. I'm in the same boat with you. I'm just trying to collect information and make the best choice for myself and family. I can't control this, but I can manage it to the best I can.

Hang in there and keep us posted. You are not alone.

Bill

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/22/2009 4:36 PM (GMT -6)   
Welcome Gog, to Healing Well, Prostate Cancer group. Your current fears and worries are normal and expected at this point, so don't feel bad or alone.

You definitely need a biopsy at this point, good advice from your doctor. If your doctor felt something, and with your psa velocity, it's the right thing to do. And keep in mind, one biopsy doesn't always detect cancer. If it comes back clean, doesn't mean cancer isn't there, means it didn't find it on that pass. I had 3 biospies before they hit pay dirt. I believe someone else here had 10. Not saying that to scare you.

If it comes back positive, the good spin to it, is that is early detection and that is always good not only with prostate cancer but with any cancer. And if it comes back with a low grade case of prostate cancer, you will have many if not most primary treatment options in front of you.

Not going to tell you there's nothing to be afraid of, we all face our fears everyday when dealing with cancer. We are a great support group, lots of experienced men, and men new to our world. We support each other and look out for each other.

Please keep us posted.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 9/22/2009 4:51 PM (GMT -6)   
The other thing to keep in mind, and you will find in various internet posts that irritaion of the prostate will also cause a rise in psa. Prostatitis, or BPH or other things that may be causing your oither symptoms, could also be causing your PSA increase.

I'm saying this to help put your mind at ease a little until the doctor has a definitive diagnosis. Rising PSA doesn't always mean prostate cancer, particularly at your low levels. Keep on learning about PSA and other prostate issues, keep seeing your doctors, and wait and see what they say. Second opinions are a good idea in this world as well.

Stress and worry are counterproductive at this point. Just relax a little and see how all of these symptoms, diagnostic tests, and diagnosis play out.

Good luck, and stay with us here !
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
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)
5 month PSA <.03 (undetectable)


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 9/22/2009 5:03 PM (GMT -6)   
Yes it is scary but take a deep breath. First of all there are reasons other than prostate cancer that your PSA might rise. Second, if it is prostate cancer your PSA is in a very low range which would mean that you had lots of time and mny good options. Remember that PC is a very curable cancer -- not a death sentence.

At your level it is very very likely that you would have no symptoms and a negative DRE, but the thought of PC can cause the mind to find all sorts of things.

I think that the biopsy choice is a reasonable one, You might want to search this site for what to expect

Everyone here can relate to how stressful your situation is. We have lived this, It is no fun, but you will survive. You may want to look at the permamant links above for some recommended reading -- especially some very good books.

Remember that if it turns out to be PC, we are here with you and for you.
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


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 9/22/2009 8:15 PM (GMT -6)   
I agree with have been said. A biopsy is a small price to pay for peace of mind. Your PSA velocity warrants it. I also have heard (I may be wrong) that Flomax may lower your PSA so your initial low numbers may in fact be higher.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 10/6/2009 5:46 PM (GMT -6)   
Hi everyone,
Thanks for your word and for giving me help with this one.
I can be a little calmer right now but still worry about the final result.
I got the result from the ultrasound and it is came back negative and with a prostate volume 29 cc. Four years ago the volume was 20.8 cc. The report stated that the size is normal (I read that the cut-off value is around 30 cc, so I am pretty close) and no other abnormalities detected. Yesterday I went under biopsy and cytoscopy also, but my only concern is that the doctor did not made an ultrasound biopsy because he said that it is not necessary at this time. I was told that he will use DRE and he will perform the 12 points biopsy based on his DRE. I do not understand why he did on this way and checking around I found good words about him. I really do not know how accurate the biopsy can be without ultrasound. I am thinking that he used the ultrasound done before and he did not think that it is necessary at this moment. Can somebody help me with that?
I am also researching to have another option making everything again at Ford Hospital in Detroit. I am living in Windsor, so it is not far from my house. Can somebody help me with some information about doctor's name to choose for a second opinion? Please, I need more information so I can speed up the process in case that the biopsy it is not accurate.
Thanks again for all your good word and God helps all of us.
Gog
 

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4226
   Posted 10/6/2009 6:41 PM (GMT -6)   

Your doctor must be old school. There are very few doctors that do a biopsy the old way, it's called "natural aspirated biopsy". Most doctors use ultrasound as it can identify suspicious areas and also take pictures of the prostate. I don't know if there is a major difference if he is taking 12 cores.

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


califguy
Regular Member


Date Joined Sep 2008
Total Posts : 72
   Posted 10/7/2009 9:23 PM (GMT -6)   

Hello!

I am so sorry you had to join our club here, but we are glad to have you! There is so much good info from the members and the moderators. Don't be scared to ask any question. The best results come from informed men who know their options.

I am in California and had my biopsy done in a small office. The doc used a black and white ultrasound. He did find several areas of cancer. Then they referred me to Univ of Calif San Fran and there they used a color doppler and found even more.

So I am a supporter of color ultrasound. And also it is good to get a second opinion. Since I am not from that part of the country, I am sure others will read and suggest a place to go in the Detroit area.

I was panicking that I might have prostate cancer and what if I would lose my erection capabilities, be incontinent, or whatever. Well, not that 15 months has passed by since surgery, it was not that bad..... And having the cancer gone is better than getting an erection whenever I wanted one. I have no problems, especially if I use Viagra.

So take it from the ones who have been there, it can be scary, but gets much less scary when you know the facts.

 


Don't get discouraged!!
CalifGuy
 
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008  Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01
Five month PSA less than 0.1  Lab did wrong type of PSA test so this test was not as accurate.
Eight Month PSA less than .01  Yeah!!!!1


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 10/8/2009 5:48 AM (GMT -6)   
Gog,

I can't add much to what everyone else has said. You have gotten some really good advice here. I wouldn't expect anything else from these folks. They have certainly helped me throughout the last three months since I was diagnosed.

Your question about the Henry Ford Medical Center - you can call the Vattikuti Urology Institute. The number is 1-888-881-1117 an extremely helpful woman named Arletta will answer. I know this from personal experience.

I live in Orlando yet chose to go to Detroit for my treatment because of the reputation and successes of the the Institute and the head, Dr. Menon. This is not a commercial for for them, it was just the decision I made and felt it was the right one for me.

Take a deep breath, know that you have lots of time to research and try not to add stress and anxiety to the situation.

As an aside there are at least six other reasons that can cause a short term rise in PSA -BPH, Prostatitis, Biopsy, Recent Ejaculation, DRE and bicycle riding.

God Bless you and your family, our prayers are with you,

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
ALL NERVES SPARED
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero


Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 10/8/2009 8:51 AM (GMT -6)   

Hello,

Thanks for your good advises. I was talking with my GP and his advice was to wait for the results from the biopsy and we will go from there. I asked him if I should look for a second opinion and he agrees with that. The only thing is that here (Canada) it is taking 2 - 3 months to get an appointment to urologist and so on. I do not know if it is a good idea to wait so long or it is better to go for a second opinion to Ford Hospital. Because the urologist did not perform a TRUS guided biopsy, I am not sure about the accuracy of the procedure. I made all kind of calculation relating tPSA (2.24), f/tPSA ratio (33%), PSAD (0.77), prostate volume (mine is 29 cc) and estimated tpsa (volume x 0.12) and the results did not showed up to be so bad. The only thing worrying me is the velocity and I am not sure if all the calculations should be accurate when you have a high velocity. Please, can somebody help me with my worries? Also, I started to go more often to the washroom but not for nothing. My wife advised me that it could be from the stress because she did not recall worrying about this before getting the second result on September.

Do you know how long can take for the result to come back? The urologist left a notice for me after the procedure stating for an appointment in four weeks. It is look like a long waiting time for me. Is it possible to call me back faster if the result is positive?

Thanks again,

Gog


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 10/8/2009 9:16 AM (GMT -6)   
Gog, you might want to look into a PCA3 test.

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 10/8/2009 9:19 AM (GMT -6)   
I was under the impression that fPSA could only be tested if the PSA was at least over 4 (maybe I'm wrong with that, but that was my understanding).

Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 11/9/2009 10:36 AM (GMT -6)   
 

Hello everybody,

I am back with a lot of news, bad or good and also a lot of question.

Before the biopsy, like a week, I had an transrectal prostate ultrasound stating that prostate is normal in size and echogenicity with a volume of 29 cc. No suspicious lesions were identified. The seminal vesicle demonstrated some cystic change but is otherwise unremarkable. The urinary bladder appears normal.

First of all, I had my biopsy on October 5, 2009. I would like to ask people here what they think about how the procedure was done and also how the pathology report was obtained. The biopsy was performed with a flex cysto and it was a finger guided prostate needle biopsy. My concern is regarding the accuracy of the biopsy.

The specimens were from right and left prostate sides.

Gross examination:

  1. Specimen: right prostate biopsy, consists of seven strips of biopsy tissue ranging in size from 0.4 to 1.6 cm in length. All tissue is embedded in one cassette.
  2. Specimen: left prostate biopsy, consists of seven strips of biopsy tissue ranging in size from 1.4 to 2.1 cm in length. All tissue is embedded in one cassette.

Microscopic Examination:

  1. B) Slides examined.

Pathological Diagnosis

  1. Right prostate, needle core biopsies: Portions of benign prostatic tissue; no tumor seen.
  2. Left prostate, needle core biopsies: Portions of benign prostatic tissue; no tumor seen.

Comment: Immunohistochemical stains are performed using antibodies to AMACR and CK34BE12.

I am asking you people if you can help me with some advice regarding my whole procedure. How accurate can be? Do I need to take another one, biopsy? I am thinking to schedule an appointment with Dr. Lee on Rochester in order to have a color Doppler US and maybe biopsies on necessary point. Does anyone have experience with color US? Also, should I retest my PSA and fPSA ratio because I have the latest from beginning of September 2009 and I am almost 6 weeks from the biopsy? If I will have biopsy with color US I will not be able to get another PSA for two months from now.

I still have problems when urinating, pain around the base of penis which is gone after urination, sometime burning after urination. They are worse when I'm sitting or laying on the couch but not so bad when I am standing. The urologist prescribed me Flomax and Xatral and he told to me to take the one doing better job. It is looking for me that Flomax is doing better, but I am concerned about the Flomax and the PSA value. Also, I used to take Flomax for a while but when I stopped it the symptoms coming back. The concern for me is the PSA velocity but my GP and urologist does not pay to much attention to it.

Please, I need some answer because I already into depression so I do not really what can be the right thing to do. My wife and my friends keep telling me do not worry how long the doctors said that is no cancer and they keep telling me that I have a head problem and everything is generating inside of my head.

Thanks,

Gog Goga


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/9/2009 11:46 AM (GMT -6)   
Gog...not sure, but I was of the understanding that if the free PSA was 25% or above...then that was an indicator of BPH...which is what your biopsy reported. At this point the only other thing you could do, is to have your biopy samples re-read by another pathologist to confirm the original results. It won't hurt to get a second opinion on this before attempting any more tests.


You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 11/9/2009 12:58 PM (GMT -6)   
Take a deep breath
You have just had a trip on the "I have cancer and I am going to die" roller coaster and that is quite an experience.

Let's look at the facts: you have a low PSA, a negative DRE, and a negative biopsy. Yes, you could still have prostate cancer but that would be a rare event. In the words of my old statistics professor; "Rare events DO happen, but only rarely."

On the other hand you have an ongoing history of urinary problems and that unexplained hematuria. You are still a medical puzzle, but probably not one that fits into PC

When I read that you had an ultrasound that showed nothing a week before the biopsy it helped me to understand your doctor's decision not to use ultrasound for the biopsy. He already knew that the sound wasn't going give him any hints as to where to put the needles.

We hope that you don't belong here and will be able to look back on this all as a horrifically worried few months that led to nothing.
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
6 mo. PSA 0.00 -- 1 light pad/day


Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 11/9/2009 1:31 PM (GMT -6)   
Thanks for your answer,
LV-TX, I just talked with the laboratory and it is no problem to consider a second opinion on reading the slides. I just need to find good laboratory but I still have some doubt because the biopsy whas finger guided.
geezer99, your words made me feeling better but I am still worry.
As I already said, a lot of people around me think that it is coming from my head.
So, is it a good ideea to take a blood test, PSA and fPSA and one more color doppler ultrasound followed by biopsy if the US shows up something on the screen?
I know that they have a color one in Rochester, MI but I do not know if they have it @ Vattikuti Urology Institute. Any suggestion and how reliable those tests are? Also, can you point out for a good doctor to do the tests?
Thanks,
Gog Goga
 

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/9/2009 4:47 PM (GMT -6)   
Well Gog...you are probably right in your statement that your second reading of your biopsy will show the same results. In my opinion only...I really think you have either BPH or protastitis in some form which caused the elevated PSA levels. Not uncommon and if it is protastitis it can be very difficult to clear up and different drugs might have to be tried in order to get it under control.

I certainly wouldn't continue looking for cancer as the cause of your PSA at this point. Hopefully you will never have to deal with prostate cancer, however your trip here and in your research if you should ever get the diagnosis of cancer, you will be better prepared than most men when they were first diagnosed.

Best of luck
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 11/9/2009 6:43 PM (GMT -6)   
In general, prostate cancer is fairly slow growing.

Why don't you try to take some deep breaths, believe the biopsy results, and give it 6 months, then have another PSA test? If the test comes back lower, or at the same level, give it another 6 months if you just can't wait.

You may want to see a counselor also to help alleviate your fears. Stress and anxiety can be just as harmful to you or maybe even more than low level prostate cancer.

We will try to help you here, but without lab results, or pathology, it is hard for us to know what to recommend.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 11/10/2009 8:38 AM (GMT -6)   
From what I read, the poster had an unorthodox, at least the way we get ours, biopsy method and is worried that this method may not have been as through as the ultrasound, rectal wall penetration biopsy that we all know and love...lol. I haven't heard of the method he describes, and I suppose I would wonder if I had gotten an accurate sampling if it were me. Hey, I'm just saying................... smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN

Post Edited (James C.) : 11/10/2009 7:44:53 AM (GMT-7)


Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 11/10/2009 9:04 AM (GMT -6)   

Thanks all of you for replies.

James C. got my point here regarding my concern about the way how biopsy was conducted. Checking on the internet, I found out that is a way to have the biopsy using a flex cysto. I do not know how accurate this one can be and if it is taking samples from whole prostate or just a little bit of it.

Right now I don't exactly know if the uro accessed the prostate glande through the urethra, using a lighted scope with a small cutting loop inserted into the urethra to collect the samples or he used the flex cyto to view the prostate and he took the samples using fingers to guide the core needles but through rectal wall.

Now, if he gone using the first method, was he able to perform accurate sampling with samples from all around the prostate or he took samples just from where the urethra passed the prostate. 

Before the procedure, I ask him if he will do a TRUS prostate biopsy and he told that he will use the finger to guide the needle.

Can somebody give me more explanation about these situations?

Thanks,

Gog


Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 11/10/2009 9:17 AM (GMT -6)   
I supposed that he did it using urethral path. How accurate is it?

Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 11/11/2009 5:54 PM (GMT -6)   
Updates after meeting with GP
Now I am clear because I have the operative report. The biopsy was transrectal and guided by rectal exam. The samples were from suspicious area and random areas from lateral medial apex, middle and base from both sides. Total of 12 biopsies. The report specifies that digital rectal exam found irregular prostate!
Can somebody tell me what irregular prostate means because the biopsies came back negative for cancer but benign portion of tissues?
Also, the ultrasound done a week before the biopsy did not show any abnormality in the prostate.
What you guys think about this?
Thanks,
Gog

O Buddy Boy
Regular Member


Date Joined Oct 2009
Total Posts : 106
   Posted 11/11/2009 7:19 PM (GMT -6)   
My biopsy was performed the same was as yours was. 12 sticks even. Same way.

Only I had a decent-sized lump and you don't have one. So take a deep breath and relax you are ahead of the game. My biopsy came back pretty serious as you see in my siggy. Again you are ahead of the game.

You may have some kind of infection. I had them for years. Doesn't mean you'll get cancer because you have infections. My infection covered it up -- PSA was relatively low and in line with prostatitis.

As the other fellows have mentioned, PCa is slow growing and even if there is some cancer there you have a lot of time. Use it.

Love your wife madly.

Every night.

Two or three times.

More if you're both up to it.

Nobody is guaranteed tomorrow.

There may be a bus with your name on it, coming for you.

OBB
55 yo
Dx:9/29/09
DRE: Susp
PSA: 3.5
Gleason: 3+4/7
6/12 Cores Positive; Sextants were 1%, 3%, 8%, 15%, 12%, 0%
RALP: 10/09/09
PATH:
Margins: Clear
Lymph Nodes: Clear
Seminal Vesicles: Clear
Gleason: No increase from biopsy 3+4/7
Some perineural and capsule invasion.
T2c,NO,MX
Incontinence: Minor. 1 light pad a day. Some days don't need it.
ED: Natural with encouragement. 20mg Cialis and pump just makes things more fun.


Gog
New Member


Date Joined Sep 2009
Total Posts : 9
   Posted 11/12/2009 12:42 PM (GMT -6)   

I do not understand why the urologist did not tell me about the irregular prostate. When he performed a DRE back on July 2009 he stated NAD and now he wrote down about irregular prostate on the Operative Report. Also, he stated that he took samples from suspicious area and came back negative. Is it possible for that the pathologist not reading properly the samples? Also, why he did not put the samples on separates cassette?

Seeing my GP yesterday, he gave me some med for depression and also he did not want to give me paper for PSA test.

Thanks,

Gog

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