psa decline after 2 weeks of cipro

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thefras
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 3/2/2010 6:53 PM (GMT -6)   
Hi everyone. I am a 61 year old male with a history of prostatitis dating back 25 years and BPH dating back 15 years with the usual symptoms. My first bout of acute prostatitis was misdiagnosed when I was 32 years old and I had my appendix taken out in error. Because of my ongoing urological symptoms I have always monitored my psa and gone for annual DRE. My psa last year was 2.0 . Last November I fell off a ladder and landed on my sacrum. The MD i saw was examining  my coccyx for fractures when he decided to do a DRE and indicated it felt different. I was referred for a new psa but came down with the flu and had to delay having it done until January 2010. Although the flu was mild I did take flu medication including antihistamines. My psa score came back at 6.9 and I was referred to a urologist who did his own DRE and said he felt a 'nodual' and subsequently has referred me for a biopsy on March 10th. In speaking with my GP I suggested a trial of Cipro given my history of prostatitis even though my urine test had come back negative for bacterial growth. He agreed and I went on Cipro for 2 weeks. Within 48 hrs I began feeling better and my urinary symptoms declined. After the 2 weeks I was retested and today received a psa score of 3.7. I still intend to go forward with the biopsy, but felt that the psa decline was significant and a positive indicator. Both the urologist and my GP believe that it is unlikely that I have PC and that it is more likely that it is related to my historical issues and or calcium deposits. I would appreciate any feedback on this. I did post here once before in mid January just after my psa spike to 6.9 and found the feedback to be supportive. Thanks in advance for your comments.

Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 670
   Posted 3/2/2010 7:00 PM (GMT -6)   
If it were me, I'd want to have the biopsy to be sure, but I agree -- the PSA drop with the cipro seems favorable to this not being PC. Let's hope so.
Jeff
Gleason, 3+4; PSA, 7.9
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
pT2c, prostate 60.2g, margins: negative; perineural invasion: present; lymphatic invasion: present; 3 lymph nodes removed, clear; seminal vesicle invasion: absent; Gleason 4 comprises 5-10% of carcinoma
PSA consistently <0.1 since surgery until Oct 09, 0.1; retested Oct 09, <0.1,
Jan 10, 0.2
retest Feb 1 confirmed 0.2
CT scan, bone scan Feb 10 both clear


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/2/2010 7:34 PM (GMT -6)   
Prostatitis(info sites) & can give flu like symptoms you can read about such at probably:
www.wmfurology.com

www.marinurology.com

Before biopsies you could get various non-invasive tests: fpsa, PCA-3, pap, pyrilinks and maybe something else, if you look into what is out there in testings.
Youth is wasted on the Young-(W.C. Fields)


thefras
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 3/3/2010 8:31 AM (GMT -6)   
thanks for these replies....the interesting thing in Canada is they do not offer the fpsa or pca-3 testing....its pretty basic medicine here for the masses...you can of course pay out of pocket for these tests both here and or in the US...if diagnosed you have the full array of conventional options but the public purse often dictates pre diagnostic investigation or many of the more advanced treatments..but i will go ahead with the biopsy as planned...

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 3/3/2010 8:39 AM (GMT -6)   
Without the results from the biopsy, we'd only be guessing.
 
My PSA never went over 1.3 - but I had nodules....I too was told about maybe its just calcium build up.....The rest is history.
 
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.


newtopc
Regular Member


Date Joined Dec 2009
Total Posts : 90
   Posted 3/3/2010 8:51 AM (GMT -6)   
The PCA3 test is not available in Canada but the fpsa is standard when the doctor wants additional information on PSA. Once you have your initial PSA test done at a cost of $30.00, any follow up PSA tests are covered by OHIP when ordered as a follow up. They like to see the total to free psa ratio of at least .10 or 10%, anything under is suspicious. Under 7%, biopsy is completed. As they say, you don't have PCa until the biopsy says you do. Wishing you all negative.  I have my biopsy scheduled for March 16th. Greg 
47 Year old male, smoker, healthy
Routine physical May 12, 2009, PSA 4.12
Follow up PSA October 27, 2009, PSA 4.61 / Free PSA 4% (Not good)
Referral to Urologist Feb 18, 2010
Follow up PSA January 7, 2010, PSA 3.95, Free PSA 4% (still not good)


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 3/3/2010 8:52 AM (GMT -6)   
Thefras
 
I would go for the biopsy.
 
In Ontario where I live, if I get my PSA done at my regular lab it costs $50 a pop even when required every 3 months after surgery.
 
However, if I go back to the hospital for blood testing, the PSA is done for free.  Never knew that before the surgery.
 
Worth the extra 10 minute drive over the hospital every 3 months.
 
Let us know how things go with you.
 
Skeener


Age:  63 
Biopsy: May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason Score: 3+3.
RRP on Oct 23/09 in London, Ontario.  Excellent surgeon. 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
Pathology:  Unremarkable 
First followup PSA and Visit: Feb 11/10 - 0.0.
 
Next PSA May
Next doctor's visit in 6 months      


thefras
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 3/3/2010 9:29 AM (GMT -6)   
I've seen a number of people post that following surgery, even robotic surgery with nerve sparing they have ED....yet when you look at the profiles of treatment options, they seem to report a success rate of up to 87% of resolving ED issues with these procedures...does ED resolve over time after RP or is this claim bogus?

thefras
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 3/4/2010 10:48 PM (GMT -6)   
saw my GP today and he confirmed that I definitely do have prostatitis .....he said the decline in the psa to 3.7 from the previous 6.9 after only 2 weeks on Cipro was a very good sign....he has put me back on Cipro for 30 days....I asked about the free psa testing and he said that doing it now would not alter our intended plan so there would be no purpose...he still felt that the biopsi was necessary both to rule out pc and also to possibly shed light on what is causing the prostatitis..

I have a mild sedative/muscle relaxant that I intend to take the morning of the biopsi...other than that no other sedative has been offered....I've heard conflicting reports ranging from 'no big deal'.....to 'hurt like hell'....any comments on this would be appreciated..

alex1
Regular Member


Date Joined May 2008
Total Posts : 29
   Posted 3/5/2010 11:22 AM (GMT -6)   
THEFRAS:

For whatever it may be worth to you, you ought to hear my history. I acquired chronic prostatitis in 1987 and fought it for over twenty years with antibiotics, which would reduce symptons but never relieve them or eliminate it. In 2007, PSA started to climb, and my Uro hesistatingly suggested biopsy "just in case". It came back with Gleason 3+3 PC with estimated 5% involvement. I went the robotic surgery route ( a much easier decision, given the twenty years of difficult urination and pain) and have never looked back. I have been really glad to have gotten rid of the *@$% thing-now I pee like a fifteen year old. Definitely get the biopsy.
58-year old attorney, no family history of PCa
Biopsy 12/29/2007 with 1 of thirteen samples positive; estimated 5% involvement
3+3=6 Gleason
TR2C Stage
RRLP on 2/21/2008 with excellent prognosis (no evidence;margins and other tissue clear) on cancer clearance and sparing of both nerve bundles
Post-OP:Actual involvement 15%, one lobe only; PCa fully contained in prostate-no involvement with other tissues and margins clear
Catheter out on 3/2/2008; fully continent by 3/31/2008
Undetectable PSA on 3/31/2008
Working on ED: 20MG Levitra every other day; Vacuum pump almost daily; some improvement, but not there yet. Started using MUSE with some success, 11/1/2008
2d undectable PSA on 7/21/2008
3d undectable PSA on 10/30/2008


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 3/5/2010 2:32 PM (GMT -6)   
I will share my experience with you. We are all different but my PSA went from 2.8 to 3.8 over a 12 month period. The doctor put me on Levoquin for 30 days. After 30 days, my PSA went down to 2. I always thought that was a fluke. How can it go below the 2.8? Anyway, I was tested 4 months later and the PSA was close to 4. I had the biopsy and they discovered cancer.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
20 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


thefras
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 3/11/2010 9:27 AM (GMT -6)   
I had the biopsy yesterday....the biopsy itself was no big deal, the only uncomfortable part was the 2 days of enimas required for the preparation and spending half the night running to the washroom the day before and then half of the day of the procedure itself. Mild soreness the day of the procedure, feel fine today.
 
I had a very supportive radiologist; Patrick Lewellan at Lions Gate Hospital in North Vancouver. They have a great prostate center at this hospital with some of the latest diagnostice equipment and specialists. Anyway..the radiologist said that the ultrasound showed 'nothing suspicious'...they took 8 samples in all. Now the wait for results. My call back appointment with the urologist is March 24th.
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