Reverse velocity

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New Member

Date Joined Nov 2009
Total Posts : 1
   Posted 11/17/2009 10:48 AM (GMT -6)   
Curious about what others think about my situation.

I'm 47 years old.
No known history of prostate cancer in my family.
No prostate infection or enlargement.
My PSA levels have been:

4.24 (December 2008)
3.42 (January 2009)
2.90 (November 2009)

In Feb of 2009 I had a 12 needle biopsy, and they didn't find an anything.
Doctors say they aren't concerned, but have ordered a MRI to check the anterior side of the prostate.
Should I be concerned?

Post Edited (Nestor) : 11/17/2009 8:53:20 AM (GMT-7)

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 11/17/2009 11:24 AM (GMT -6)   

Welcome to HW, hope you don't end up meeting our member requirements, rather you never have to deal with PC. Do your doctors give any explanation of your reverse and declining PSA numbers? Are you taking any medications or OTC supplements or vitamins that could be doing a trick on yoru numbers. Your 4.24 reading would have sent most men to a urologist and probably for the biopsy for sure.

Can't say I can think of another case like yours, but everyone is so different. The MRI probably wouldn't be able to pick up anything PC related, but it sounds like a good next step for your doctor.

Please keep us posted closely.

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

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 11/17/2009 12:24 PM (GMT -6)   
Is this another case of Prostatectomy Via Biopsy???

We've seen a couple of other cases where a biopsy shows cancer but later pathology showed none.

Could be that the old needles got the buggers and now you are OK.

(Yes the idea is a bit whimsical, but some Docs will bring it up when they have no other explanation for a PCa disappearing after a biopsy).

Ask your doctor. He'll either say it is NUTS or maybe he'll agree it was possible.

(Dang, the only problem with P Via B is that your PSA was already going down even before the BIOPSY ...)
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 10/2009).
04/01/09, 07/07/09, 10/01/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray no stones.
08/09 - started MUSE@1000mcg ... pump&plump - success (alpro ache).
09/09 @500mcg +pump&plump + 2 advil - success - (less Alpro ache).
10/09 TrimixGel (500/300/100mcg): 1st:60%, 2nd:(pump&plump) 60%, 3rd(added 500mcg muse):70-80% -- (no Alpro aches!) but none @ useful hardness!

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 11/17/2009 12:30 PM (GMT -6)   

Your Q:  “Should I be concerned?”


My A:  I think you should be “educated.”  You are on the high side of the mean (average) for your age, which places you at a higher statistical probability of joining the group at some point in time, so I say the best patient is an educated, empowered patient.


If in the future you are diagnosed, there are some excellent books I could recommend, but for now I recommend this free, downloadable document from the American Urological Association called the “Prostate Specific Antigen Best Practice Statement:  2009 Update.” 


Access it at:


For where it sounds like you are right now, this will quadruple your knowledge and understanding.  One step at a time.

Regular Member

Date Joined Mar 2009
Total Posts : 39
   Posted 11/17/2009 12:33 PM (GMT -6)   
No Jim....his biopsy found nothing.  Nestor, have you significantly changed your diet?

Dx T1c in April, 2009 at 45 years old after recent PSA tests ranged from 2.93-3.25
2 of 14 cores positive at 5% and Gleason 3+3... 2 cores taken from a "protuberance" were "ASAP"
Proton radiation at LLMC May-June 2009

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 11/17/2009 1:23 PM (GMT -6)   
There is a natural thing called PSA leakage in which the prostate leaks more than the standard amount of psa. It usually levels off after a number of years.
An MRIS cannot see the interior of the prostate and is only effective in looking at the peripheral zone or the bed, A Color Doppler ultra sound is better at detecting transition zone tumors as is an MRIS with a Telsa 3 MRI. Most institutions only use a Telsa 1.5 MRI. PC normally manifests itself with a steady rise in psa over time as the tumor grows at a very steady rate doubling according to it's agresssiveness. Intermittent rises and falls in psa are usually not associatied with PC, but with outher causes such as BPH, psa leak, and infection.

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.


Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 11/17/2009 8:36 PM (GMT -6)   
Good info John as usual I must add, like your posts and information and think you are doing alot of good herein for others, looking at unique patients or protocols gives further evidence of many roads to travel in PCa, not just a few.

Little interesting study by Terry Herbert years ago, did daily psa tests and monitored them(30 days) and charted them. It is an interesting education to show that psa levels can change not only daily, but he also had taken tests on the same day for fun, also. The levels are usually not stabil and do move up and down and sometimes way more than you would believe, I mean significantly, he may have that info on somewhere. So you psa levels even fluctuate alot, so this is why you need psa testings to compare, to see trends and velocity and especially looking for doubling times. Per Dr. Strum and others doubling times in 6-12 months are red flag area, meaning further investigation and tests should be warranted, doesn't mean you for sure have PCa (atleast not yet).
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