Just got PSA/Free PSA scary

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newtopc
Regular Member


Date Joined Dec 2009
Total Posts : 90
   Posted 12/23/2009 2:39 PM (GMT -6)   
I just was told I should see a uriologist. Healthy 47 year old, first ever PSA in May/09 4.12, tested in Oct/09 4.61, free PSA is very low at .04. Appointment in Feb, long wait. I have been all over the internet researching. Based on my age and the very low free psa test I am convinced I have PC. My feelings are all over the map on this. Hard to talk about.

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 12/23/2009 3:32 PM (GMT -6)   
Welcome to the Site and Sorry you have to be here....
 
Try and have a nice holiday and then see the Uro in Feb - go from there is all you can do.
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 12/23/2009 4:16 PM (GMT -6)   
Hi newtopc

Sorry you had to find us also. I know exactly how you feel at this point and all I can add is to take a deep breath and try to relax until Feb. Remember PSA or fPSA are not cancer specific, just indicators and right now only a biopsy will actually confirm cancer. I would imagine your urologist will want to take one more PSA test before moving forward with a biopsy. He might also want to use a round of antibotics to rule out infections or inflamation. Was your DRE negative? Meanwhile keep reading and ask any questions that come to mind. There are a host of laypersons here that are extremely knowledgeable to answer questions.

Welcome
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 


BoisePSABantam
Regular Member


Date Joined Apr 2009
Total Posts : 20
   Posted 12/23/2009 4:21 PM (GMT -6)   
Take a deep breath. Your PSA is still pretty low. You'll just have to go thru testing and be ever so glad your PSA isn't 200+ (Or worse); or that you don't have pancreatic, brain, bone, lung, or something ending with 'sarcoma'. PC is not great, but I've known people who'd switch places in a heartbeat.

Take it easy and be thankful for today.
Pre-Surgery PSA: 4.92
age: 45 at DX.
DaVinci 5/07
1st PSA 0.07 8/07
2nd PSA 0.04 11/07
3rd PSA 0.04 02/08
4TH PSA 0.04 7/08
5th PSA 0.08 2/09
6th PSA 0.08 5/09
7th PSA 0.07 9/09


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/23/2009 4:32 PM (GMT -6)   
Hello and welcome. You may or may not have PC, the waiting will drive anyone nuts. Why so long for an appointment? Are you in the USA or somewhere else? Only a biopsy would finally determine your status, so try to enjoy the holidays ahead, unless you can find another doctor that you can see sooner.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


cocrgolfer
Regular Member


Date Joined Oct 2009
Total Posts : 171
   Posted 12/23/2009 5:11 PM (GMT -6)   
My PSA went up from 4.1 to 6.5 in a year and my uro told me I only had a 1 in 11 chance of PCa.

Lucky me, but it's far from certain you have it.

Take it easy if you can.

Steve

donnathewife
Regular Member


Date Joined Oct 2009
Total Posts : 27
   Posted 12/23/2009 5:14 PM (GMT -6)   
Has anyone here actually heard of a Free PSA of .04?
 
I just think this must be an error! 
 
newtopc, the Free PSA is a new test, I'm thinking something went wrong with yours.
 
Please don't let it bother you.  (if you can!)
 
You rise in PSA level is normal, my husbands went up and down like crazy, within .50 anyway.
 
Good luck, and scram yeah  have a nice holiday, and get that Free PSA re-tested ~ at another lab.  No sex or running 2 days prior to testing...
 
Ya know, I know a guy whose PSA was 14. and he just had BPH, he lowered it by taking Bactrim, to 4.  He's real happy to only be 4. !!
 
 
 
 
..

Post Edited (donnathewife) : 12/23/2009 3:19:52 PM (GMT-7)


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 12/23/2009 5:31 PM (GMT -6)   
donnathewife....I haven't read much on fPSA...but .04 is 4% and anything below 7% (.07) is a high indicator of PCA. I would suspect that his test is probably accurate.
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 


T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 12/23/2009 5:57 PM (GMT -6)   
I was in pretty much the exact situation you are in last June. The positive here is you got checked and all indications at this point are that you caught it early. The 4% is a significant indicator of PC so you have reason to be concerned. I had my first psa result in May of 09 and my follow up with a DRE in June. I went 8 weeks from diagnosis to having surgery so it was a three month period from first suspecting a problem to actually dealing with it. It is hard to accept it let alone talk about it when you are in your 50's and 60's so when we get it in the 40's or even younger it just doesn't compute. Good luck and I hope you beat the odds and simply have an infection.
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Uro recommended Robotic for someone of my age. My research confirms.
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 12/23/2009 6:11 PM (GMT -6)   
I know how you feel. I was tested in Nov/08 and my free PSA was 11%. I was told to see a Urologist and had my biopsy 12/30/08. It was not a very nice holiday for me. Hang in there. There is nothing that you can do. You may not have PC, so enjoy the holiday and deal with it in February. Good luck.
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
8 months PSA test 10/9/09 result <0.1


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 12/23/2009 6:22 PM (GMT -6)   
Hey Newtopc,
Welcome. Although it's too bad you're here. I'm sure you have already done quite a bit of homework and study on the subject. You have found a great site. By looking at signatures you will see other guys in your same situation and will gain some understanding of the typical timeline. Most likely your uro will want to do a biopsy. With those results you can decide if you want to worry about the next steps or not. For now, consider you have at least two solid months to get in shape and get your house in order.
No matter what treatment option you decide on, you will be on a better footing if you are in shape.
Start now. And empty that prostate as often as possible.
Good luck to you.
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next?
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
. 9/27 2 months: Still 3 pads per day.
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day Experimenting with Nyquil for 10 days: Can sleep through the night but withdrawal is bad. Stopped 12/20.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 12/23/2009 6:27 PM (GMT -6)   
I think all of us know how you feel. It's kind of an unreal feeling.

But, it will be all right, even if the free PSA is correct. You have many options, partriclulary since you are catching it early.

Just enjoy the holidays, love the ones you are with, and let Feb deal with the issues then. All the worry in the world won't change it.

Believe me when I say, it is easier said than done, but all of us have to come to grips with these feelings, or they can tear us aoart.

Really sorry you have to go through this. You have found one of the best sites on the internet to help you through the jungle of terms, procedures, opinions, options, recovery, atc.

Good luck in your journey. Have some fun during the Holidays !

Goodlife
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


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 12/23/2009 6:46 PM (GMT -6)   

Newtopic:

 

Is there any way you can get a quicker appointment, for your own peace of mind? I've gone through exactly what you are going through (including everyone telling me to calm down -- LOL!!).

 

If you check my signature you will not a similarity in PSA results. You might want to ask about the new PCA-3 test. It's basically a urine test (immediately after a DRE) and it is VERY specific for PC. The other tests are influenced by anything that swells the prostate (eg: BPH, prostatitis, other activities).

 

Mel


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.  
History of BPH/prostatitis. PCA-3 test: 75.9 (bad news, guaranteeing I have to do....): Biopsy on 11/30/09. Result of biopsy:

5 out of 12 cores positive. Gleason 4+3. More specifically: 2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C

REVISED BIOPSY REPORT: The previous was read by Umich. Slides were then sent to Dr. Menon at Ford Hospital. Here is their report (much better) -- changes in bold print below:

5 out of 12 cores positive. Gleason 3+4. More specifically: 2 cores were 3+3 (one 5% and the other 20%) on one side. On the other side, 3 cores were 3+4 (5%, 5%, 20%)

 Latest: Surgery with Dr. Menon at Ford Hospital, set for 1/25/10

 


DX_010508
New Member


Date Joined Mar 2008
Total Posts : 3
   Posted 12/23/2009 10:59 PM (GMT -6)   
Hi newtopc,

2 years ago right now I was in a similar frame of mind to the one you are in now. We're about the same age, had about the same initial PSA. Due to family history, I was also expecting the worst prior to biopsy. I have been lurking on this site daily for two years now. Feel fortunate that you have found this site early in your journey, you have already heard some great advice in this thread. At first it will seem that following the threads is sort of like watching improv theater, but the rub is, now you're one of the actors.

Of course you think you have PC. Yes, your feelings are all over the map. You have made a great first step, however, in starting to talk about it. I hope after a biopsy you can bookmark this and visit only every now and then; however, if you wind up joining the club, remember that TODAY you began to fight the good fight, and that you will WIN, and that you will hear more reasonable things here than anywhere else.

In theater, the starring players have more complex parts, more lines, and louder voices. This group follows suit. You will see any number of gentleman and ladies whose lives have been truly upended by prostate cancer, and have faced more trials, complications and setbacks than one can imagine. There are a number of members here to serve as example that no matter what you will face, they have already endured and conquered it, and so can you. Remember, please, that you are not in the script for such a role at this time, until proven otherwise. Remember also, that the majority of men who deal with this disease do not have extreme test results, symptoms, treatments, or side effects. Yes, some do, and my hat is off to them. But most don't, we are nothing but bit players with a few lines in the script.

My advice? Hit back hard and fast. You have a PSA issue at this point, nothing more. Accelerate your learning curve. Data becomes information, information forms into facts, facts become knowledge, knowledge becomes understanding, understanding leads to wisdom. Wisdom gives you hope, faith, and guts to make a plan and execute it. I'd start in the morning.

From your post, I surmise that you don't have an urologist and therefore have made an initial appt. for February with one. I agree with others who say there is no big hurry, but having to wait 6-8 weeks for an initial consult seems long to me. You don't have prostate cancer until a biopsy indicates it, you need a urologist to get a biopsy, and you need a consult to confirm & schedule the biopsy, so you need to shake hands soon with a really good urologist in your area. Don't worry at this point whether he'll be your surgeon, just take the first step. Network with older friends, family, neighbors, church members, to see who they recommend. Remember, all you are looking for is a thorough exam and perhaps a biopsy. This leads to step two:

Use the holidays to celebrate being alive and healthy. I intend this to mean, embrace your new journey AND celebrate the holidays. Just the fact that you are posting today indicates that you probably aren't able to just let this go, so realize that you CAN do BOTH, and you can do them both well. Tomorrow is Christmas Eve, that means much to many of us, it may not to you; but please be aware that you can have a really great Holiday season as well as a great start on your journey of discovery regarding PCa, AT THE SAME TIME. I did.

Start making notes. You're on a computer, grab a notepad or Word file and start typing. Dates, phone numbers, appointments, websites, snips of advice, family histories, chronologies, feelings, everything. When you feel organized, sort it out. When you are tired, just dump it in and hit "save". In just a couple of weeks, you will read things you have written and be grateful you did it. After a few months, you will be REALLY glad you did it. Start your sig file tonight. Mine is below.

Research now, but don't obsess. Focus on the consultation. Educate yourself about that and biopsies, and do that well. Worry about all the rest of the research involving treatment if and when you need to. If you don't need it, you wasted your time, if you do need it, you won't really be prepared until you have your biopsy results. Either way, a couple more weeks won't make a difference. Read pertinent threads, bookmark other sites, read about the basics involving prostate biology, BPH, infections, biopsies.

Involve your SO now, if you have one, if things turn out for the good, which we all hope, that's great, if they don't, well, it can be a wild ride, and it's usually easier to get on the roller coaster when it's not moving.

Please keep us filled in regarding your plans. I'll post more in reply as appropriate.

Best of luck to you!
Age 48 at diagnosis and surgery
5'8", 220 lbs., overall very good health
Oct. 2007 - 4.25 PSA score from Wellness Exam at work
Dec. 2007 - 1st prostate DRE, results normal; some BPH, no infections, no other symptoms
Jan. 2008 - 4.15 PSA score, 15 Free PSA score (done before biopsy)
Jan. 2008 - biopsy done; stage T1c, Gleason 3+3 in 2 of 10 cores, one 3% and one 5%
Jan. 2008 through March 2008 researched options, decided on standard RRP surgery
April 2008 - June 2008 took care of family, job, lawn; went fishing
June 2008 - nerve-sparing RRP. Catheter stayed in for 11 days.

Pathology:
2 lymph nodes removed & tested, both fine
adenocarcinoma confirmed, still Gleason 3+3
T2C
tumor volume 15-20% of prostate, tumor present in both lobes
capsular penetration, but not perforation
clean margins & seminal vesicles
perineural invasion
31.6 gram prostate is gone!
both nerves spared

Continence:
--used 39 pads over the 5 weeks following during the day, no pads & dry at night
--IC "drops" only when sneezing, lifting, or moving awkwardly
--Went without pads starting 7-30-08 all day, saving remaining 13 pads for family gag gift
--Balance of 2008 slight IC sensations only while sneezing when lifting something awkwardly
--No continence issues throughout 2009, staying 100% dry under all circumstances!

ED:
--enjoyed most of one vial of Trimix as prescribed starting in early August 2008
--Trimix no longer really needed now (Fall of 2009) with a little help
--vial is still in fridge (nudge nudge, wink wink)

PSA tests:
--followup PSA's at 3 mos. and 1 yr. both undetectable


newtopc
Regular Member


Date Joined Dec 2009
Total Posts : 90
   Posted 12/24/2009 9:17 AM (GMT -6)   
Thank you all for commenting. My DRE was normal. I also have read that fpsa under 7% is a high indicator of PC so 4% is bad. I live in Ontario and the urologist assigned to the local hospital works from an office about 30 miles from here. I have contacted his office to advise that I am available if there is an opening or a cancellation in his office at any time. I work with a fellow who had PC two years ago and went to the same urologist. I also checked with some contacts at the local hospital to get the low down on his reputation. Both indicate he is one of the best. My coworker had PSA 5.1 and free psa at 5%, he was confirmed and had the surgury. He is cancer free now. I have not discussed this with any family other than my wife (2nd marraige, 4 yrs ago) given the holidays and all. She isn't saying much, thinks I am ahead of myself.  I am going for another PSA and free PSA test prior to my appointment. I will post my results. Merry Christmas and Thank you all. Greg

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4271
   Posted 12/24/2009 9:35 AM (GMT -6)   

Dear Greg:

Welcome to our site and I know all of us here hope you do NOT have PCa.  Having said that, however, your PSA is high for your age and your free PSA at 4% is an indicator that you may have PCa.  IMHO, there is no good reason you should have to wait until February until you get your next data point.  If I was in your shoes (which I have been), here is what I woudl do:

1.  Get another PSA and free PSA test immediately.  Do not do anything to stir up your prostate prior to that test (e.g. don't have sex for a few days prior).

2.  Do as some others have said and network to find another urologist who can get you an earlier appointment.  Having lived in Canada at one time, I am somewhat familiar with the delays that can occur.  But, if you press and call around, you can get a quicker appointment.

Tudpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 12/09.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 664
   Posted 12/24/2009 9:45 AM (GMT -6)   

We have a great group of Canadians on this sight.  I am sure that several of them will post soon.  Me…I can’t add much as I believe that what DX_010508 posted was perhaps one of the most well written and comprehensive blogs that I have seen to date about PCa on any site anywhere.  I do agree that this is one of the best communities on the Web.  My brother who is 47 popped a 4.8 PSA.  I called my urologist office on Dec. 10th and he did the initial office visit and biopsy last Thursday the 17th.  Brother got the call yesterday. Not surprising he has prostate cancer.  I’m going to print the post by DX_010508 and hand deliver it to him tomorrow.  Best to you and your family…

Hero


Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. 75% of one core.
da Vinci at Wash U, Barnes on 11/02/09
Pathology Changed Gleason to 4 + 3 = 7. Gleason 7 present in all 4 quadrants
All(4)periprostatic Lymph Nodes Negative, All(10)pelvic Lymph Nodes negative
Seminal Vesicles tumor free. No prostate extension


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 12/24/2009 11:58 AM (GMT -6)   
This is how I spent last Christmas. Makes for some rather mixed emotions as you celebrate. I too was told nothing was definite until there was a biopsy. The kicker, of course, is finally seeing the urologist and getting a lump of coal. Lets hope for fun stuff instead.
Diagnosed at 54
PSA 8.7 Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7 Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09 Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence Pad free week 5
PSA 6/6/09 <0.1 PSA 9/10/09 <0.1


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 12/24/2009 12:14 PM (GMT -6)   
Go to the YANA web site and read "PSA 101". The Prostate Cancer Research Institute web sit has a paper by Stephen Strum" What Every Doctor that Treats Male Patients Should Know"
These two articles will increase your knowledge base to the point that you will probably know more than your doctor does about psa. You will surely know what questions to ask and be more able to evaluate your doctor.
JT

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


DX_010508
New Member


Date Joined Mar 2008
Total Posts : 3
   Posted 12/26/2009 12:22 PM (GMT -6)   
Hi Greg (newtopc),

It was good to see your post written on the 24th. Looks like a good plan to me! Hope everything turns out explainable and minor. I trust that you and your family enjoyed a fine Christmas. By my calendar, it appears that you have a good 5-6 days to plan one heck of a New Year's party, with lots of great reasons to do so. I'm sure that many of the other members posting are on track to do just that. Me? I'm glad to be around for all of 2009 and ready to jump on 2010. I have much to be thankful for and much to look forward to.

Hero, thanks for the kind words. I hope all goes well for your brother, your situation is similar to mine. I'm sure he will benefit greatly from your experience and guidance.

BoisePSABantam, right on, you nailed it. Couldn't agree more.

T40, wow, you sure took the fast track! Maybe we could form a young dudes PCa group. No, wait, I just turned 50, guess I'm living in Geezerville already, you'll have to do it. smilewinkgrin

Jeff (Worried Guy)--2 great points! 2 months to get your house in shape, and empty that prostate often! Greg, may I introduce a followup suggestion that one of the more important things that you can do now, regardless of what the future holds, is to get in the habit of going for walks? Many of us know how powerful it is after surgery. I'd proffer that it's one of the best "hedge your bets" things you can do. Great activity to burn calories, keep fit, turn your mind to useful thoughts, sleep better, check out your neighborhood, and get some quality "me" time. Might want to take your sweetie along sometimes too. That's one of my New Year Revolutions (because resolutions are just so boring).

Dan
Age 48 at diagnosis and surgery
5'8", 220 lbs., overall very good health
Oct. 2007 - 4.25 PSA score from Wellness Exam at work
Dec. 2007 - 1st prostate DRE, results normal; some BPH, no infections, no other symptoms
Jan. 2008 - 4.15 PSA score, 15 Free PSA score (done before biopsy)
Jan. 2008 - biopsy done; stage T1c, Gleason 3+3 in 2 of 10 cores, one 3% and one 5%
Jan. 2008 through March 2008 - researched options, searched for surgeon, decided on standard RRP surgery
April 2008 - June 2008 took care of family, job, lawn; went fishing
June 2008 - nerve-sparing RRP. Catheter stayed in for 11 days.

Pathology:
--2 lymph nodes removed & tested, both fine
--adenocarcinoma confirmed, still Gleason 3+3
--T2C
--tumor volume 15-20% of prostate, tumor present in both lobes
--capsular penetration, but not perforation
--clean margins & seminal vesicles
--perineural invasion
--31.6 gram prostate is gone!
--both nerves spared

Continence:
--Used 39 pads over the 5 weeks following during the day, no pads & dry at night
--IC "drops" only when sneezing, lifting, or moving awkwardly during those weeks
--Went without pads starting 7-30-08 all day, saving remaining 13 pads for family gag gift
--Balance of 2008 slight IC sensations only while sneezing when lifting something awkwardly
--No continence issues throughout 2009, staying 100% dry under all circumstances!

ED:
--enjoyed most of one vial of Trimix as prescribed starting in early August 2008
--Trimix no longer really needed now (Fall of 2009) with a little help
--vial is still in fridge (nudge nudge, wink wink)

PSA tests:
--followup PSA's at 3 mos. and 1 yr. both undetectable

Post Edited (DX_010508) : 12/26/2009 10:29:08 AM (GMT-7)


chinito
Regular Member


Date Joined Dec 2008
Total Posts : 28
   Posted 12/26/2009 7:32 PM (GMT -6)   
so does it always mean the cancer is returning if your psa goes up after surgery....undetectable for 3 tests and now .050 and they said possible some cancer cells escaped during surgery and will need to test again and then consider radiation after going up 3 times...does this rise always mean next step radiation? or does the psa go up and down and doesnt really mean that much at this point
Age 56
DOB 9/02/52
DX Prostate Cancer 12/2/08
Double Bypass Heart Surgery 8/08
Gleeson Score 3+4=7
9 out of 12 cores were postive
PSA was 7.71 rose to 12.2 week of surgery
DaVinci surgery 2/06/09
Cath out 2/17/09
Path staging PT2c Bilateral disease, stage 11
PERINEURAL INVASION, present and extensive
vENOUS (large vessel) absent
LYMPHATIC (SMALL VESSEL) invasion SUSPICIOUS FOR LYMPHOVASCULAR INCASION (C5, C10, C20) (16) no evidence of malignancy
ADDITIONAL PATHOLOGIC FINDS High grade prostatic intraepithelial neoplasia, which is extensive
3 month post op PSA undetectable
6 month post op PSA undetectable
10 month post op PSA rose to .050 need to return for more testing


newtopc
Regular Member


Date Joined Dec 2009
Total Posts : 90
   Posted 12/29/2009 10:56 AM (GMT -6)   
Added signature line with medical history. Got through Christmas, it was tough sledding, my sister noticed I wa a little off, called me two days after Christmas wanting to know what was up. I gave her my numbers and explained the potential outcomes. So now my wife, my best friend and my sister know. My wife finally said something to her friend, she was crying. Other than that she has not talked about it much. I hope to go to her doctors appointment on Jan 6th with her, I think if we talk to the doctor together it will help. I am off on holidays until Jan 4th so its good to be out of the public arena for a while. Thank you for all your well wishes. Greg
Age 47, smoker, healthy, previous surgery May 1999, cecal ulcer, part of bowel removed, no cancer
Colonoscopy Jan 2009 - One polup, no cancer
First PSA test during regular physical May 2009 - PSA 4.12, colesteral elevated
Follow up PSA Oct 2009 - PSA 4.61, free PSA 4% - under 7% indctes high probability of cancer, diet changed colesteral better, liver count very high in all three areas, liver count retested Nov 2009, alll levels back in line
Next Psa test in Jan 2009
Urologist appointment Feb , 18, 2009


Sonny B
New Member


Date Joined Jun 2010
Total Posts : 1
   Posted 6/20/2010 6:04 PM (GMT -6)   
Hello
         I would like some simple answers as to what my bloodwork results mean, in 4th grade language. I am 57 and my latest (May) results are as follows: psa 5.7 complex 3.6 and whatever the last test is, it came back 11.7.  I have had a biopsy two years ago with 14 samples taken all negitive. My friend told me about this forum and said it is a real relief.

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 6/20/2010 7:31 PM (GMT -6)   
Sonny,
I am not a Doctor but your PSA is high and it might be something else causing the reading. Do you have a family history of Prostate Cancer? Get with youur Dr and take your questions with you and a tape recorder. Take care
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Mink1001
New Member


Date Joined Feb 2018
Total Posts : 3
   Posted 2/26/2018 11:22 AM (GMT -6)   
I got my results today.

Jan 2017 PSA 2.7
Feb 2018 PSA 4.12 fPSA .33 Ratio .08

So, it looks bad right now, but there are some things to consider.

I didn't know about all the things not to do ahead of a psa screen, and as Murphy's Law goes, I did them all less than 24hrs ahead of the test.

I was 4 days into a 10 day Cipro regime for a UTI, I get them pretty easy due to a urethra stricture.
I had sex (the morning of no less)
There was some, umm cough cough, rectal/prostate stimulation in above said activity too.

I'm not messing around though, I have my appointment to the urologist tomorrow. My question is this:

I have read PSA results can move quite a bit, especially considering my activities ahead of the test, but what about fPSA?

Even if my PSA drops to 2.5 or so, with my current fPSA level of .33 I'd still be about pretty high on the ratio at about 13%.
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