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rlg
New Member


Date Joined Nov 2010
Total Posts : 11
   Posted 11/22/2010 5:45 PM (GMT -6)   
Hi Everyone,

I am new to this. I have been on Avodar for several years and my PSA has been around 1.5. My PSA jumped to 2.1 in 6 months and the urologist wants me to have a biopsy. I had a biopsy on January of 2003 to check for some abnormal growth but the biopsy was negative. I am concerned to say the least.
Any suggestion as to what type of biopsy should I ask?

Thanks!

rlg

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/22/2010 6:11 PM (GMT -6)   
rlg,
Has your urologist suggested the possibility of other causes to the jump in PSA? Urinary Tract Infection (UTI), prostatitis, to name a couple. Most of us immediately before a biopsy were given an antibiotic first.

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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3893
   Posted 11/22/2010 6:14 PM (GMT -6)   
How did they do your first one?? Things may have changed a little in 8 years, maybe not.. Today, it's done with an ultrasound wand inserted through your rectum..Bring back any fond memories?? First they use the probe to map your prostate, take a good look at it, determine its size, then they "numb you up" with a couple of shots of anesthetic and then click, click, click, twelve little clicks and it's over..(sort of over)

So to answer your question, the standard biopsy today is the 12 core ultrasound guided biopsy.. They divide your prostate up into 12 sections and take a sample from each section. If you have PC, 90% of the time the first biopsy will find it..Sometimes, the doctor will take a couple of extra samples from suspicious areas..The 12 cores get put in little glass tubes, are marked, and in a special container are sent to a pathology lab. If cancer is found, they know exactly where in your prostate it came from..

Let us know how all this turns out ...I hope we have helped you..

This forum can move pretty fast..If you can't find your thread, click on the "2" at the bottom to go to the second page..

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 11/22/2010 9:02 PM (GMT -6)   
I'm not a doctor, but it does not look like an alarming increase.
 
My suggestion: antibiotics for 4-6 weeks and then test again.
 
Even better might be to do a PCA-3 test. That is designed to see if a biopsy is necessary.
 
It's an easy test (urine test after a DRE)
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06

rlg
New Member


Date Joined Nov 2010
Total Posts : 11
   Posted 11/23/2010 12:03 AM (GMT -6)   
Thanks so much to TLC, Fairwind and Complier for your valuable input.

I went to see the u because I had some pain in my right testicle (I had the same symptoms for years due to prostatitis and inflammation of the epididymis). After ultrasound and rectal exam he put me in antibiotic for 2 weeks. At the same time he run a PSA that gave a reading of 2.1. It looks like that I should have another PSA before deciding on a biopsy, since the PSA reading reflects the situation before starting the antibiotic. I finished the antibiotic a few days ago. Should I ask for a second PSA before doing the biopsy or is better to go ahead with it.

Thanks for your help, rlg

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 11/23/2010 12:33 AM (GMT -6)   
As I said, ask about the PCA-3 test
 
Mel

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3893
   Posted 11/23/2010 12:57 AM (GMT -6)   
Since you are on Avodart, any PSA reading must be doubled..But if it responds to the antibiotics in a meaningful way, I might hold off for a while on the biopsy. Any time your PSA is going down, that's a negative indication for PC..But again, Avodart and Proscar can muddy the water and make PSA testing even less certain than it is...

But if you just want the reassurance and can tolerate a biopsy without to much trouble, have it done...Then you know with 90% certainty if you have PC or not..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

rlg
New Member


Date Joined Nov 2010
Total Posts : 11
   Posted 11/23/2010 8:24 AM (GMT -6)   
Thanks again for the valuable advice.
I think I will go for the biopsy and get over with it.

Wish me luck!

rlg

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3893
   Posted 11/23/2010 12:21 PM (GMT -6)   
Best of luck to you..I agree with your choice
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec
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