very rapid psa increase

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twotall
Regular Member


Date Joined Nov 2009
Total Posts : 47
   Posted 11/14/2009 12:35 AM (GMT -6)   
Brand new member, I found this site after my latest doctor visit today.  Brief history:  One year ago I had a blood test ordered by my doctor, psa was 9.  My Psa  had always been very low.  I made an appointment with a specialest.  After an exam he said that I didn't have cancer but prostities.  He gave me meds to correct that and said to have another psa test in a month.  The next test was 11.4.  The doctor did a bisposy (12 core) which showed no cancer.  I was given more meds and told to return for another psa in six months.  This test showed a psa of 15.9.  I was given another round of meds and told to have another psa test in a month.  The test results today, Psa of 20.  All digital exams were normal.  I am starting to get worried that something is being missed here.  Can an prostate infection cause a very rapid rise in the psa levels?  I told the doctor I was ready to have the prostate taken out, he said it could not be done unless evidence of cancer was found.  His latest thoughts were that is a very aggresive cancer or some sort of infection.  I have thought about a trip to the Mayo Clinc.  Any suggestions?  I did talk to a second doctor and he said that cancer had to be found before any treatment could be started.
 
Thanks

sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 11/14/2009 1:02 AM (GMT -6)   
Weird. I think I'd opt for some place like Mayo....I can't recall a rising PSA/ no cancer story like yours, but what do I know? I HAVE heard of cases where a couple of biopsies were needed to finally find the cancer. But you'd think with a PSA on the move like that, IF there would be cancer, there'd be a lot of it and they'd never miss it on a biopsy. My PSA went from 24 to 39 in a month (with the original thought being a weird infection), but once the biopsy was performed they found 8 of 12 cores positive...and my post surg pathology showed a boatload of cancer...(take heart, I'm doing GREAT 3 1/2 years later...)

Regardless, you've come to the right place--- and you'll get more knowledgeable responses than mine....again, Mayo seems like a good idea to me. 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


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 11/14/2009 5:47 AM (GMT -6)   
That is an interesting problem. I have a friend in similar situation as yours and to this day even with a rising PSA no cancer has been detected even with a saturation biopsy. I am a skeptic when it comes to this. I personally would go for the second opinion and if no cancer is present I think you deserve to know why your psa is rising so fast and why antibiotics are not healing it. Keep us posted please and thanks for finding the forum.

peace and love
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11

PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 11/14/2009 8:42 AM (GMT -6)   
Why not get the PCA3 urine test, or a fpsa test for 'free' unbound prostate antigens levels=the percentage level may be an indicator, the PCA3 test may reveal high enough positive to atleast say yes you have PCa and not prostatitis or weird bph going on. There are 3 types of prostatitis you can read about...not easy to detect on patients. Might as well start reading up. You could try the more enhanced guided biopsies method that exists, too. Or go to a biopsy level of 20 samples. Get the actual pathology does it list high grade PIN  (usually precursor to PCa cells forming).
 

www.bostwicklaboritories.com
www.marinurology.com
www.wmfurology.com
www.prostatelab.com
www.prostateoncology.com

Post Edited (zufus) : 11/14/2009 7:57:15 AM (GMT-7)


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 11/14/2009 8:43 AM (GMT -6)   
I had PSA go from normal to 28 in a space of a couple of years. My physician sent me to Uro at 4. Like you, I had several rounds of meds followed by biopsy, then another and another. A total of five saturation biopsies did not reveal cancer. Then I went to Duke for a second opinion (should have done it a lot sooner), and they found a ton of cancer on a first try.

Don't be lulled into a false sense of security by negative biopsies. Get a definitive answer why you PSA is so high. Inflamation would show on biopsy...
<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Father died from poorly differentiated PCa @ 78 - normal PSA and DRE<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'"><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">5 biopsies over 4 years negative while PSA going from 3.8 to 28<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'"><o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8<o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'"><SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">PSA prior to treatment<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'"> on <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">1/8/2008 is <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">33.90, bounced on 1/31/2008 to <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">38.20, and down at the end of the treatment (4/24/2008) to <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">20.60

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'"><SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'"><SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">RRP at Duke (Dr. Moul) on 6/16/2008, <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Gleason downgraded 4+3=7, <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">T3a N0MX, focal extraprostatic extension, two small positive margins<o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">PSA undetectable for 8 months, then <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">2/6/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="COLOR: black">0.10, 4<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">/26/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">0.17, 5/22/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="COLOR: black">0.20, <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">6/11/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="COLOR: black">0.27<o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, 10/21/2009-<0.05, T<10, salvage <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">IMRT to prostate bed and pelvis. 72gy over 40 treatments finished 10/21/2009.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/14/2009 9:31 AM (GMT -6)   
I am the vicitm of rapid PSA rises over time, it took 3 biopsies spread over 1 1/2 years before they found the cancer. I had no prostate problems, every DRE ever had was negative. My uro knew inside, that there had to be cancer there, and I am glad he never gave up till he found it.

Definitely want to find a higher grade "second" opinion. If your rise is not from infection or other obvious prostate problem, it is more than likely cancer, and the longer it remains active and growing, the harder it will be do deal with it.

Keep us posted please.

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% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 11/14/2009 10:06 AM (GMT -6)   
I had a similar experience. My PSA rose from 4 to 12 over 1 4 year period and I had two rectal biopseys. Then in July his year I had another rectal and a urethal biopsey. That is when the cancer was found. Have another biopsey. As for infection, yes it cetainly raise your PSA levels. The dr. should have you on antibiotic. If after the antibiotic the PSA still goes up you might have a problem.
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09: <0.0
 
 


twotall
Regular Member


Date Joined Nov 2009
Total Posts : 47
   Posted 11/14/2009 6:13 PM (GMT -6)   
Thanks for the replys from everyone. I spent most of the night doing "research" on the computer because my mind would not stop working overtime on the high psa level. You have given me several good questions to ask at the next doctors vist on the 20th of this month. If I do not get some real good answers/reasons on the rapid rise of the psa my next stop will be the mayo clinic in Arizonia.

Thanks
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