Lower 40s with PSA > 4

New Topic Post Reply Printable Version
43 posts in this thread.
Viewing Page :
 1  2 
[ << Previous Thread | Next Thread >> ]

tivmod1
New Member


Date Joined Jul 2010
Total Posts : 18
   Posted 7/24/2010 6:14 AM (GMT -6)   
I'm 42 with no family history of early prostate cancer although my dad at age 80 does have PC with a Gleason of 9 (his dr has told him he'll likely die of something else after he was seeded earlier this year.)

I pushed my GP into testing for PSA during an annual physical so that I could get a marker for future reference. I say pushed because he was very reluctant to do anything until I was 50 this despite the fact I had expressed to him that I was having urinary flow and frequency issues with some very mild infrequent ED which I had attributed to be more mental than anything.

I've always had issues at some level. I don't remember a time as an adult over 21 where I hadn't been getting up at least 1 - 3 times some nights to urinate and I've never had what I'd call a strong urinary stream unless I was drinking a lot of alcohol. I figured the increase in issues was related to getting older, less physically active and about 40 pounds heavier than I was 5 years ago.

My first PSA was taken 4/12/2010 and came in at 3.78. My GP never reviewed the results and contacted me. I figured everything was fine since I was usually only notified of other tests such as Cholesterol when there was an issue. I called and left a message 3 weeks later and got a call from the nurse early the next morning apologizing for the mistake and to let me know I should go on Cipro for 2 weeks and retest a few weeks after the final dose.

On 6/10/2010 my PSA came in at 4.86 which after reading forums such as these alarmed me due to the large increase in just two months time. I was sent to Urology but due to the Dr's busy schedule was seen by a Nurse Practitioner who apparently did most of initial consultations and DREs. Her conclusion after the DRE was that my prostate was enlarged yet soft with no sign of nodules and as she put it likely prostatitis. What was strange about her DRE was that it was very comfortable as if she wasn't even there. She ordered 4 weeks of Cipro and asked that I get retested immediately after completion.

On 7/19/2010 my PSA came in at 4.40 which while better than the previous isn't apparently what Urology had hoped for ( they wanted it to go to 0.x). This time I saw the Dr who performed a very uncomfortable DRE. His observation was that the prostate was normal in feel and size. He commented that because of my age and lack of family history with early prostate cancer I shouldn't have even been in his office until after I was 50. Yet here I was due to pushing for the PSA test and as it turns out my numbers are not in line with what is considered normal. His recommendation was to have a 10 core biopsy performed.

I cannot make rhyme or reason of the numbers since they are not steadily rising numbers that have been discussed as being related to PC. After reading articles such as the one New York Times one written by the individual who discovered PSA I wonder if I've done myself a disservice by pushing to get tested in the first place. I had no idea at the time that there was this debate occurring and was only looking for an indicator for future reference given my Dad's history along with a possible explanation for some of the symptoms I was having. To think that at age 42 I'd potentially have PC is still a bit shocking. I'm leaning towards getting the biopsy done but there is still that side of me that just wants to bury my head in the sand and wait it out.

That is my story and now I'd like to ask some questions regarding my current issues. The one that is creeping up the most lately is an urgency to urinate, especially while seated, even after relieving myself. The urgency feels a bit like a burning sensation about an inch to inch and a half in length starting at the tip of the penis and then back towards the groin. When I do relieve myself it is small quantities at a time and it almost feels as if some didn't fully come out and is now trapped in limbo. It sort of feels like the time I had what was likely a kidney stone 10 years ago and it took medication at that time to dull the pain. Some days I have this feeling and other days I do not. I was drinking at least 1 - 2 cokes a day for quite awhile and did have some last night. I'm wondering if caffeine could have this effect 12 hours after consuming it. It is this feeling that drives up the frequency. There are times during the day when I can go for hours upon end without urinating. One more comment. I have also noticed that since taking the Cipro the very mild ED problem I described hasn't really returned.

Thanks for reading.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 7/24/2010 6:34 AM (GMT -6)   
Boy how do we answer this. I can tell you that the DRE never detected anything on me. The only way prostate cancer is detected in with Biopsy. I do know that my secretary's husband who is in his 40s also went to my Uro after a high PSA and thay did the Cipro and subsequent PSA and eventually did do a Biopsy and it did come back negative. That tood a grat deal of stress off of his mind.

If I were guessing you probably have prostatitis. I would keep a keen eye on it for sure. Saying that I can also tell you we do have a history in my family and my son now 33 got his first PSA at his last physical. When he told his Dr. about the family history the Dr agreed that he should have a base line.

Always better to be safe.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 7/24/2010 7:28 AM (GMT -6)   
I'm not so sure a biospy is not a good idea given your age. It might put your mind to rest and/or give you a more complete picture of what is taking place. Then you can go about your business one way or the other other with AS or Tx. or just enjoying the heck out of life without worrying about this. Keep us posted.
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


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 7/24/2010 8:44 AM (GMT -6)   
I would say that you need to find a doctor who can spend some time with you.

If you can get a repeat PSA after the CIPRO, that would be good. If your numbers don't drop significantly, then a biopsy would be the next logical step, in my opinion.

Your PSA is too high for your age.

Good luck and stay with us here.
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,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 7/24/2010 9:20 AM (GMT -6)   
I agree with Goodlife you need to get a urologist who can spend time with you -- one who has the time and inclination to answer your questions fully. If you tell us where you are located, someone on this board may be able to recommend someone.

Your psa is very high for your age. I am 46, my psa is 1.5 or 1.6 (different assays), and that is within the top few percent of PSAs for my age. So - while your elevated psa does not necessarily mean you have prostate cancer - I would not ignore it, and I certainly would not bemoan the fact that you got tested. You did a smart thing and there is at least some chance that, by doing so, you saved and/or improved the future quality of your life.

I am not a medical professional, so take my advice (and all advice here) as just some things to discuss with your doctors, but these are my thoughts: Get a free psa test and see what the "free psa percentage" is. The higher, the better. Do not ejaculate within 48 hours before your psa or free psa test. Do not let a doctor give you a DRE prior to your psa test, since manipulation of the prostate can affect the psa reading. Consider getting a PCA3 test, another test that can provide information about the odds that you have prostate cancer. If your urologist has no idea what a PCA3 test is, or is unable or unwilling to discuss with you why this test is or is not a good idea, get another urologist. Unless both your free psa percentage and your PCA3 results indicate a very low chance of prostate cancer, get the biopsy. (Some would say get the biopsy anyway, and that would not be irrational). If doctor wants to do 10 core biopsy, ask him why not 12 cores or more. Ask doctor what he does to minimize discomfort during the biopsy. Also ask your doc whether there would be value to doing an endorectal coil MRI of the prostate with contrast enhancement, or a color doppler. These can sometimes identify problem areas in the prostate. Also ask about an MRI-guided biopsy. Your doctor should be knowledgeable about these things and able and willing to give you advice about them. I am not saying you need all this, but I would be asking about it.

Best wishes - I hope this turns out to be a false alarm for you.

Medved


Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/24/2010 9:20 AM (GMT -6)   
I would go for the biopsy with what I know now. Yeah, kind of gross and creepy. But it could answer the question at this point in your life. There are men here your age with full blown cancer, and many of us had negative DRE's time after time. I would hate to put it off for 5-10 years , and find out you had PC all along, and it had been growing and enlarging all those years. Hopefully you are PC free, and you can move on safely without giving it a thought.

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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 7/24/2010 10:36 AM (GMT -6)   
Medved is giving you some good advice, get a free PSA and a PCA3 test and if they are abnormal then by all means get a biopsy, at least a 12 core.
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


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/24/2010 12:06 PM (GMT -6)   
Many years ago like 8-10 yrs. ago the threshold of up to 4.0 psa was held out as the 'safe' range for psa being under that, that is out the window and meaningless as pointed out by Dr. Strum trying to inform patients and doctors back around 2002 era with article called 'What every patient and doctor should know about PCa'. Velocity, history, doubling times are all more important than a single number.

You might wish to do those tests mentioned prior to jumping into biopsies as mentioned by some above. When doing Cipro for prostatitis or other drugs, Dr. Strum says wait atleast 6-weeks before retesting psa levels (this is from an experienced onco doc who has seen all these issue many times). Some docs are still dumb enough to give a DRE and then draw blood for PSA tests and do other things that are beyond 'expert' levels? Must be arrogance in the water system (LOL)? Patients somewhat informed like yourself actually need to be proactive for your own best medicine and maybe early detections. Wise to know to where you stand before (blank) hits the fan! With very good insurance plans you can hire and fire docs if it is in your better interests. To plead for a psa test is ridiculous even if you are 40-ish or whatever.  You may need to get biopsies as brother Purg mentioned (some guys in 40's are found with signicant PCa),  probably further tests prior is very wise and  your doc may notice that you know more about PCa than uninformed patients they usually see and can direct as they sometimes wish.
 
Tally Ho!


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

Post Edited (zufus) : 7/24/2010 11:17:56 AM (GMT-6)


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 7/24/2010 2:25 PM (GMT -6)   
I agree with what have been said. A biopsy is the right thing to do. My son who is 43 has a PSA of less than 1.0. Yours is too high for your age. A biopsy should provide the answer. 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
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 in circumference.
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 5 months
2 months 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
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 7/24/2010 5:31 PM (GMT -6)   
Get a fPSA (free psa) and a PCA3 test. Don't stop until you know what is the reason for your elevated PSA, your age specific PSA is high. Don't bury your head in the sand, you'll just be putting off the inevitable and by that time it might be too late. If your dad has prostate cancer, I don't know why someone is claiming there no family history of it.  If putting it off, any potential tumor could be increasing in size and also becoming more aggressive. PSA testing saves lives, take advantage of it.

tivmod1
New Member


Date Joined Jul 2010
Total Posts : 18
   Posted 7/24/2010 5:36 PM (GMT -6)   
Thanks to all that have replied. I'm going to go ahead and get the biopsy if nothing more than to continue searching to the solution to my discomfort. Today has been a bad day as far as that is concerned, perhaps stress has something to do with it.

Some of you mentioned Free PSA and despite me bring it up the Urologist and GP thought it wasn't really necessary. I'm not sure why they will only do a 10 core biopsy but figure insurance and cost must be a part of it.

There were also comments about the types of things that could elevate PSA just before a test. DREs were always after the PSA draw and I refrained from ejaculation for the prescribed amount of time.

I was under the impression that PSA like many things are all relative to the patient so what might be normal for one person, lets say a 1.0, might be high for another. My family is very prone to swelling and I frequently have swelling issues myself. Hopefully my elevated PSA is a reflection of that.

As of now I'm scheduled for mid August and once the results are back I'll seek out alternative opinions.

Will keep you updated.

tivmod1
New Member


Date Joined Jul 2010
Total Posts : 18
   Posted 7/24/2010 5:50 PM (GMT -6)   
Squirm - regarding Family History comment. The GP and Urologist were focused on history involving young family members developing prostate cancer of which there are none in my family. My dad had it discovered when he was 69 and elected to take a watchful waiting approach. He just turned 80 and while it has certainly advanced to the point where he is positive in 7 out of 13 cores with a gleason of 9 he has spent the last 11 years 100% symptom free. Now that he has had seeding he's faced with all of the typical complications many have experienced.

Sadly other cancers have been in the family so I'm well aware of the pitfalls. My dad survived small cell carcinoma of unknown origin which was first discovered when he was 69 (part of the reason he never treated prostate until now). My mother past away this past year after a 1 year battle with ovarian cancer that spread to her spinal fluid. You'd think I'd be more susceptible but the doctors have said that both of those cancers wouldn't be related to prostate cancer. Having gone through the experience, especially with my mother, burying my head in the sand sometimes feels like the right thing to do. In all honesty she had better quality of life before treatment. Once treatment started it was all down hill and a very unpleasant way to spend the last remaining months of her life.

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 7/24/2010 6:11 PM (GMT -6)   
Sorry to hear about your mother. I lost my father last month but it was not from cancer. From my perspective, given the hx of cancer in the family, it would just be another reason why I would want a biopsy if the PSA remains elelvated. But keep us posted and hope this is just a false alarm.
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


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3742
   Posted 7/24/2010 6:53 PM (GMT -6)   
Before having blood drawn for your next PSA, refrain from having sex for at least 48 hours. It raises the PSA level significantly. That study is in another recent thread here someplace. If I recall, it was something like 50%. It could make a 2.8 look like a 4.2
Jeff

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 7/24/2010 7:12 PM (GMT -6)   
You have not been diagnosed with PC yet..But you should read this book. "A Guide to surviving prostate cancer" by Dr. Patrick Walsh.

With the knowledge gained, you will be able to have an intelligent conversation with your doctors..

Your SYMPTOMS sound like infection. Take a look at my history..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. A "top" radiation oncologist here in Denver, equipped with the latest IMRT/IGRT/RapidArc machine says he can do better by me..


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 7/24/2010 8:55 PM (GMT -6)   
I can't add much to what has already been posted but I would find a urologist that will spend time with you.
 
Age 48 at diagnosis
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
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue


pattersson
Regular Member


Date Joined Apr 2010
Total Posts : 97
   Posted 7/25/2010 11:14 AM (GMT -6)   
Hi

I just wanted to add that I was in a very similar situation at 42 (four years ago), PSA close to 4, and my uro worried about it. The stats do not necessarily mean cancer, but cancer is a possibility especially if the PSA is going up and you have an urge tom urinate, so a biopsy is in order. If it is cancer, it can be cured with high probability by surgery or radiation with those numbers.
Radical prostactemy 10/2006 @42, PSA 3.9, Gleason 3+4
PSA <0.2 2006-2009

PSA 0.14 01/2010
0.07 05/2010


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/25/2010 12:02 PM (GMT -6)   
Tivmod1- question about your dad, had small cell cancer or such when 69 yrs. old...I am presuming this is not PCa-small cell but another type of small cell cancer, can you distinguish which? Usually small cell PCa is associated with very aggressive PCa and lousy prognosis, cures are like impossible area in general and high gleason scores, etc. Hopefully that doesn't run in your family for possible PCa, if this type.

Some docs don't believe in using fPsa tests and some other tests, doesn't mean the tests are worthless either. Anyway, get a copy of the pathology report asap to learn the data and what it actually means, don't be shy in demanding your copy. Might be real wise to tell your doc you prefer that your pathology be done one of the select group of reknown pathology experts: Bostwick, Oppenheimer, Epstein, Grignon and few others. If not, later you can get second opinions from these types later on your slides, your case is heavily weighted upon these findings. Your doc will likely send pathology out to local guy or golfing buddy, as 'they are just as good' (not the whole truth). Friends spreading the money around is typical in the world, with referrals it common to send out to friends and pals. Don't forget to find out about ultrasound guided biopsies and optional needed anesthetic unless you enjoy pain.
Hopefully he mentioned such, my genius uro-doc didn't inform me of much of anything, he got fired later on. :-)

Best to you situation


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

Post Edited (zufus) : 7/25/2010 11:06:31 AM (GMT-6)


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 7/26/2010 1:07 PM (GMT -6)   
Although I am not a doctor, I don't think there is a sound basis for declining a patient's request for an fpsa test in your situation.  I also do not believe there is a good basis for doing a 10 core biopsy, rather than 12 (or more) cores.  I do not believe that has anything to do with the cost or insurance requirements.  I would at least consider consulting with a different urologist.
 
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/26/2010 1:29 PM (GMT -6)   
tivmod1 said...
...The GP and Urologist were focused on history involving young family members developing prostate cancer of which there are none in my family...


Family history with prostate cancer does not collate with age. I was diagnosed with advanced disease at 44 with no family history regardless of age. My fathers PSA did not become suspicious until he hit 75. Not sure why your GP/Uro would care about at what age your father had the disease. If he has it, you have genetic history of it ~ end of story.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


Jim is sick
Regular Member


Date Joined Mar 2010
Total Posts : 118
   Posted 7/26/2010 3:08 PM (GMT -6)   
tivmod1 said...That is my story and now I'd like to ask some questions regarding my current issues. The one that is creeping up the most lately is an urgency to urinate, especially while seated, even after relieving myself.
Having been diagnosed with low risk PCa recently I also experienced some of these urination issues a few years before Dx. I may be wrong, but I believe your numbers do not indicate these symptoms are from PCa. They are probably from BPH, a less severe problem. Unfortunately that's not to say you don't have PCa. Either way FlowMax can help with this.
 
If you WANT a biopsy then ask for a 32 core biopsy. It will provide the most complete "look" at the little guy. If my biopsy had been a 10 or 12 core one, it may not have caught my cancer. If I were you I would be proactive and change my diet now. Good luck buddy...
48, Caucasian, 5' 8", 200lbs, 190lbs, general good health.
PSA: 8-7-09 3.22, 11-13-09 4.25.
Biopsy: 32 cores. 3 cores reveal PCa, 10%, Gleason 3+3=6, T1C.
Diagnosed: 2-12-10.
Current Treatment: Active Surveillance, next appointment Oct. 2010. No meat, no dairy, lots of fruits and vegetables.
Preferred Treatment: I just want someone to harvest my immune cells, genetically engineer them to fight my prostate cancer, and then infuse them back into my body...


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 7/26/2010 4:36 PM (GMT -6)   
Tivmod1,
The doctors seem to have varied opinions on the "free PSA" test.
My GP got back the standard PSA, and then had the free PSA run immediately - the nurse told me what they were doing, I'm not sure there was any sense of asking if they could in the conversation. The results from that second test (I don't even know the number) had them sending me to the urologist the next day.
Interesting that the insurance did not want to pay for the second test - "too frequent". It got written off, so I wasn't too concerned about that.
My uro. did a 12 core biopsy, and again, insurance only paid 6 cores, and again the uro and lab wrote off the difference, so it must be a pretty common event.

tivmod1
New Member


Date Joined Jul 2010
Total Posts : 18
   Posted 7/28/2010 7:48 PM (GMT -6)   
Sorry been away for a few days trying to forget about this for awhile Had some nasty urinary issues last Friday. Had the sensation to go again immediately after going and had difficulty getting it out no matter how much I drank. It cleared up to some extent a few days later but then returned yesterday but not nearly as bad. I am guessing worst of it was due to very painful DRE and subsequent swelling. I've also been constipated from time to time and I'm guessing that is adding pressure.

Someone mentioned that my father's small cell carcinoma could have been from the prostate. I suppose that is true but it is very rare and Mayo (where analysis was done) indicated it was of unknown origin. They checked everywhere and could never find the source.

I appreciate all the support and it is good to hear from others my own age who are in the same predicament. I still want to believe that I'm dealing with a nasty infection along with BPH if such a thing is possible. You'd think if I had PCa it would be advanced due to the rapid jump in PSA, symptoms I'm experiencing and age. If true it would be a cruel joke after losing my mother to ovarian last August. The ups and downs of that experience are still too fresh in my mind.

And I hear you all regarding my urologist and the question of why 10 cores, why no free PSA test etc.. etc.. To be fair he may be a stellar doctor who is making all the right choices given the circumstances.

tivmod1
New Member


Date Joined Jul 2010
Total Posts : 18
   Posted 7/28/2010 7:51 PM (GMT -6)   
Patterson - Not sure you'll see this or not but was curious what prompted you to get checked given you are so young? Did you have symptoms or a family history?

tivmod1
New Member


Date Joined Jul 2010
Total Posts : 18
   Posted 8/18/2010 8:47 PM (GMT -6)   
Here is an update. My 10 core biopsy shows a mild case of prostatitis. In addition one core from left side showed a less than 5% atypical gland (?) which was being sent to Mayo Clinic for further analysis. She categorized the results as negative but of course we have to wait and see what Mayo says.

If Mayo comes back and just says it is inconclusive or atypical I'm not really sure how to take that news. Based on comments from my doctor I imagine he is going to want a repeat in 6 months to focus on that area. Given my age, the fact that I do have prostatitis, the fact that this is less than 5%, I'm more inclined to forgo additional biopsies and just watch the PSA.

On a positive note all of my symptoms have been much better after a few weeks off Cipro. The pains I was feeling are gone and I'm starting to think a result of taking Cipro for 44 out of 60 days. Of course I'm back on the Cipro now but for awhile there things were working very well in the urinary department etc... I also drink many more clear liquids and try and space them throughout the day. And while I get up at night to still go it is in very large quantities, not like I'm struggling at all. The ultrasound revealed that I was emptying my bladder so it may just be that I drink too much.
New Topic Post Reply Printable Version
43 posts in this thread.
Viewing Page :
 1  2 
Forum Information
Currently it is Saturday, September 22, 2018 9:43 AM (GMT -6)
There are a total of 3,005,663 posts in 329,249 threads.
View Active Threads


Who's Online
This forum has 161795 registered members. Please welcome our newest member, jjakefamily.
269 Guest(s), 7 Registered Member(s) are currently online.  Details
George_, jjakefamily, Chow Wan, Alxander, InTheShop, andwes, Pixie415