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JW-Worry
New Member


Date Joined Feb 2010
Total Posts : 1
   Posted 2/21/2010 5:35 PM (GMT -6)   
Great discovered this site.  I am in London uk. 
My stats:
Age:49 Oriental
Jan09-  PSA 1.83
Jan10 - PSA 5.08
Feb10 -PSA 3.42 - FreePSA0.98 (normal range 0 - 0.9?)
 
Will see a top consultant this week to show him these numbers.
I am a bit worried, any comments from the members would most welcome.
 

pigeonflyer
Regular Member


Date Joined Nov 2009
Total Posts : 85
   Posted 2/21/2010 5:49 PM (GMT -6)   
jw welcome to the site. dont worry till you have to do the biopsy. then still dont worry but arm yourself with information. you can never know too much about pc. with all the guys here someone has already been in the shoes you may have to wear in the future. wait until your diagnosis but prepare your self now. keep us informed. neil
50 years
da vinci on 9/28/09
gleeson 3+3
psa before surgery 5.1 oct/09 psa 0.06
cather out on oct 5, back in on oct 5
two more trys for cather out, still in .
cather out nov. 13/09
cystocope nov.13/09 , cather back in , out again on nov 15/o9, was taught to self cath, still pluged with scar tissue but no cather. have to self cath 6 to 8 times a day. scar tissue removed on jan. 11 2010. no cathing and totally dry. 


DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 2/21/2010 5:53 PM (GMT -6)   

Welcome JW,

Keep a calm head, take some deep breaths and relax.  With just psa numbers only it is too soon to worry about anything.  It is right for you to get further consultations.  There is a lot of concern for your well-being here on HW and we wish you the best of news. 

Hope your not here for long,

 

Dan


PSA 01/07 1.2, PSA 01/08 1.9, PSA 01/09 2.5
BIOPSY 02/24/09  PCa DX age 52
Right: 3+3=6, 3/6 cores 10% involved,PNI-Y
Left:  3+3=6, 1/7 cores <5% involved,PNI-N
LARP 04/09/09 nerve sparing. Final pathology:
GS 3+4=7, Margins uninvolved, 2 lymph nodes negative
Catheter out 04/17,1st no-pad day 05/03
Followup PSA 05/28/09,08/20/09,12/08/09 <0.1
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/21/2010 6:16 PM (GMT -6)   
Hello and welcome, HW

With those numbers alone, not much one can guess or assume. Have you had any DRE (Finger exams) along the way? Do you have a biopsy scheduled at this point?

Sure you will feel better after meeting with a consultant and coming up with a sound game plan to investigate your situation.

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: 1/10 .12
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 2/21/2010 6:56 PM (GMT -6)   
Hi JW, and welcome.

It's never too early for men to learn about prostate cancer (PC), but hopefully you are not ready to join our ranks as a PC patient at this time. Keep in mind that one doesn't "have" prostate cancer until a biopsy is performed and a pathology exam confirms PC in the tissue sample.

Your PSA is a little high, but there are several non-cancerous reasons for elevated PSA. In fact, the majority of biopsy results do NOT find cancer in patients with slightly elevated PSA.
 
The fact that your PSA went down so much in a month seems to indicate that there are "assignable causes" which might have driven January's value temporarily up. Perhaps a prostate infection (very common), possibly sexual activity the night before the test, perhaps you rode a bike, or motorcycle, or scooter the day before. Any of these things could have caused a temporary, short-term spike in PSA. Prostate cancer, on the other hand, tends to NOT cause PSA to fluctuate up & down...it's a pretty steady producer of PSA in the bloodstream, and tends to slowly increase over time as the PSA-producing PC cells continue to slowly multiply.

It sounds like you have already visited a urologist who wisely ordered a Free PSA test along with your follow-up total PSA test in February...very good step. This test result might lead to putting off a biopsy altogether.  I will provide you with a good link to read about the PSA test (and it's limitations) and also the Free PSA test. I suggest reading up on these before visiting your specialist later this week.  The smarter and more informed you can be about the terminology, the better.

In summary, the Free PSA test is expressed in ng/mL (same as total PSA), and is frequently converted into a percentage of Free PSA to be more meaningful relatative to one's total PSA.
 
It is normal to have both some PSA that is "attached" to proteins in one's blood AND some PSA which is unattached, or "free." However, as the percent of free PSA goes down, the likelihood of prostate cancer goes up—restated in different words, benign prostate tissue contains more free PSA than cancerous prostate tissue.
  • The general rule of thumb is that a percent free PSA of 25% or greater is normal and unlikely to have PC.
  • Less than 10% free PSA is a high likelihood of PC.
  • Between 10% and 25% is an intermediate range.


From your February test, you had 0.98 ng/mL of free PSA and 3.42 ng/mL of total PSA, which according to my calculator gives about 28% free-to-total PSA percentage.  If these numbers are all correct (please do re-verify with your doctor), then I would think it highly unlikely that your doctor would recommend a biopsy for you at this time. More likely that he will send you home and ask you to re-submit to another PSA in 3- or 6-months, just to be sure.

Here is a link to an excellent free, online document about PSA (and free PSA). It is lengthy, but about half of the document is the section of References. I'd say that just about everything you wanted to know about PSA is right here (it's called the American Urological Association's "Prostate-Specific Antigen Best Practice Statement -- 2009 Update":

http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf

It's never too early for men to start learning about PC because after skin cancer, it is the most commonly occurring cancer in men.  But hopefully, you will learn that it is unlikely that you have to be too worried about it at this time...

Post Edited (Casey59) : 2/21/2010 7:12:37 PM (GMT-7)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/22/2010 3:01 PM (GMT -6)   
Good info from Casey above on this. Adding education you need asap:

www.prostate-help.org
www.yananow.net

Book-'A Primer on Prostate Cancer-The Empowered Patients Guide'-Dr. Strum & Donna Pogliano
(covers all treatments, has patient cases/scenarios, covers scans, drug therapies, etc.- probably the best source written for lay persons to comprehend...get it is highly suggested even if you don't have PCa (yet) you can also educate others whom usually we men are in total denial and all these ailments happen to someother guy.  Yeah someday it is perhaps your turn to be the other guy.

IF doc says yes you have PCa-Don't be rushed into any treatment without some knowledge of what you are signing up for!!!


Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 2/22/2010 2:05:23 PM (GMT-7)

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