Two questions: Bactrim DS... *and* PSA > PSA-f

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MikeMiller
New Member


Date Joined Oct 2010
Total Posts : 13
   Posted 11/2/2010 7:06 AM (GMT -6)   
First: Found new doctor who did a full exam including a DRE and said everything appeared perfectly normal. The doctor prescribed Bactrim DS to deal with any possible infection that could be causing the inflammation. Naturally, I hope he is right. Does anyone have any experience wit this?

Second: After the dose is completed he will do a standard PSA test and await the results. My understanding is that if the PSA is 2.5-10 a PSA-f (free PSA) will be done. However, if the PSA is over 10, a PSA-f will NOT be done. Can anyone tell me why that is?

If anyone can add or recommend anything, I'd be very interested in hearing your thoughts.

Thanks for reading.

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 11/2/2010 9:54 AM (GMT -6)   
What Dr Lee prescribed for my husband was 2 wks on antibiotic [bactrim],2 off then check psa again,this was in conjunction w/color doppler. We saw the whole prostate gland w/CDU and Dr Lee explained all he was seeing spotty inflammation and some calcification,the inflammation was noticeably less 6 wks later with the course of antibiotics. His psa  also dropped 2 pts in that time. Dr Lee's words to us as we were leaving were do not let anyone biopsy you and he said my husbands psa ran a little high. At no time did he say there is a area he needed to biopsy[inflamed,blood flow,dark area etc...] That's why I don't to this day understand WHY anyone would have biopsy without CDU. That was our experience.........   Cooper   

MikeMiller
New Member


Date Joined Oct 2010
Total Posts : 13
   Posted 11/2/2010 5:04 PM (GMT -6)   
cooper,

I appreciate your reply here and in my previous thread.

I'm trying (hard) to push things in this direction. But people are so easily swayed by the "normal SOP" They plug you into their flowchart and where you fall is where you fall. There is no longer (or little) any kind of personal one-on-one diagnosis going on. You're just a number on an insurance card. Sad.

I've been trying to gently push my father into vigilantly researching the doctor(s), etc. and have repeatedly told him to seek out Doctors like Dr. Lee -- he found a "new" doctor -- from the sounds of it, he is better than the last, but IMHO not progressive to the point of the Dr. Lee.

All I know, if it was my prostate, I would be following a course of action very much like what your husband did.

My mother was a nurse so she already has the "mindset" that you just do what the doctor says and that's that. So it's a gentle battle of being "nice" and trying to direct him toward what is the best care. But sadly, as is often the case, the children are the idiots and get just a smile-and-nod. Sort of sad since we're the ones that are looking at it objectively.

I've told him several times about the "Invasion of the Prostate Snatchers" book -- and to my knowledge, still hasn't been bought or read.

Oh well -- you can lead a horse to water, eh?

Again, thanks! :)

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 11/3/2010 7:42 AM (GMT -6)   
Good luck with your Dad. I know from a family member dealing w/parents can be a delicate matter,especially with the mindset that docs know best! Sometimes true but.....
Anyway I hope he finds good answers,at least the new doc sounds better!!I usually try & post when I see someone new hoping they realize there are other ways to approach elevated psa. Myself and a few others believe CDU is very valuable. Hope all goes well,keep us updated.     Cooper

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 11/3/2010 10:08 AM (GMT -6)   
Although I do not know for certain, I suspect the answer to your question is (1) fpsa is used to help determine whether to do a biopsy; (2) fpsa has not been determined to be reliable where total psa is below 2.5 ng/ml; and (3) with total psa > 10 ng/ml, most docs would suggest a biopsy regardless of fpsa (in which case the fpsa result would not be useful). But I'm no doctor (and I didn't even stay at a Holiday Inn Express...)
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
 
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