PSA Down/Free PSA up Cautiously Optomistic

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newtopc
Regular Member


Date Joined Dec 2009
Total Posts : 90
   Posted 1/11/2010 1:00 PM (GMT -6)   
Just got updated PSA/FPSA results. PSA has dropped from 4.61 to 3.95, free psa has increased from 4% to 16%. These markers a still concerning for my age but could it be Prostatitis and not cancer? I am miffed at the swing in these numbers. Waiting to hear from my doctor, maybe I should be taking the anibiotics and testing again. Still seeing urologist on Feb 18th. 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


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 1/11/2010 1:18 PM (GMT -6)   
Greg, the PSA swing is not unusual.  There was a thread here a few weeks back that linked to another site where a patient had daily PSA tests and there were significant variations.  Your free PSA test at 16% is very much in the grey zone that really tells nothing (the 4% was problematic).  I understand your desire to re-test...I went through that stage before going to the urologist.  But, no matter what another test says, going thru with your uro appointment is probably the best bet.  Bottom line is that you need to find out what is going on and the urologist is most likely better equipped to discover that than your PCP.
 
Good luck,
 
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"!

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 1/11/2010 1:33 PM (GMT -6)   
Greg,
I agree with Tudpock, might not be anything of concern but your urologist can help rule that in or out. Might be a symptom of the other medical problems you have, but be safe. Take care.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 1/11/2010 1:39 PM (GMT -6)   
At the very least, you need to have a Digital Rectal Exam. This will be an aid to the diagnosis. This may well be followed by a biopsy, but with this disease, knowledge is power.

Good Luck. Keep us posted.

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 injection
No pads, 1/1/10


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 1/11/2010 3:12 PM (GMT -6)   
In my case the DRE from the Uro was a lot more intense and thorough than the one from my PCP who "thought there might me some firmness". The Uro got in there and really poked around. So much so, that at one point I squirted on the table. He identified all kinds of things before the biopsy and knew where to punch when he did it. (He also found my 2008 pocket notebook that I misplaced the previous year. :-) )
It is worth going to an expert.
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? See Uro 1/20/10
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
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
1/11/10 6 months: Still 3 pads but leak is now 320 ml (5 day avg.)
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 1/11/2010 4:22 PM (GMT -6)   

Jeff...you must have been a stand up comic in your previous life!  You are one funny dude...love your posts as they make me laugh out loud!

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"!

newtopc
Regular Member


Date Joined Dec 2009
Total Posts : 90
   Posted 1/11/2010 7:35 PM (GMT -6)   
That was a good one Jeff, expect I will give him my notebook when I go for my appointment! I am going to call the doctor tomorrow about the free PSA number going to 16%, sounds too good to be true, I think they gave me the free psa and not the total to free psa ratio. Be assured, I will not be cancelling my appointment with the uro, I expect a DRE and I would be surprised if a biopsy is not scheduled after that visit.
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

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