New and looking for some help

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/6/2010 7:28 PM (GMT -6)   
Hello,

I am new to the forum and have been lurking for about a week now. The reason I am here is obvious, I'm sure.

I am 55, I have type 2 diabetes (Under control) and feel OK physically.

1 Year ago my PSA was 1.2. - DRE normal
1 month ago it was 3.66 - No DRE performed
Last Thursday it was 4.4 - No DRE performed

My blood count was normal.

One month ago, after the PSA of 3.66, my doctor put me on Cipro for 2 weeks and retested my PSA.

I have had prostatitis for about 8 years now with no medication. In the last year or so, I've had weak streams, difficulty starting, starting and stopping, dribbling, and in the last month or so, I've experienced about 3 hot flashes. All of these symptoms have been intermittent. No symptoms have been consistent.

Last Thursday I was referred to a urologist for further evaluation. I have an appointment with his PA on Thursday. He was booked up until the middle of January, but I took the PA appointment to get into the system and hopefully have some tests done.

Of course, I'm on an emotional roller coaster of anxiety, mild depression, and fear.

What can I expect at the initial appointment? Will they do a biopsy on the first visit? How long until they will know if anything is wrong? That's all I can think of for now. If you need more information, let me know.

Thanks, Dave

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 12/6/2010 7:41 PM (GMT -6)   
Dave, sorry you have to be here but welcome.  I'm sure you will find lot of help and support here.  Hopefully your issues will turn out to be non-cancer related...we are all pulling for that.  If they are not, there are lots of options and you generally have time to examine them thoroughly...do not panic!!!
 
My main piece of advice now would be get in to see a urologist asap...not a PA.  I'm not too impressed with your PCP already by the lack of DRE but maybe your PCP can get you to the head of the line or refer you to another urologist who isn't too busy for you.  If not, perhaps you can seek some references from friends or neighbors - even better if they are in the medical field.  Assuming you have friends around your age you can bet some of them have had to see a urologist for one thing or another.  I guess my bottom line at this point is to get in to see a physician...a urologist not a PA.
 
Once in you can certainly expect a DRE, perhaps another round of cipro or maybe a recomendation for a biopsy.  If the latter, come back here and ask plenty of questions...but the first thing is to see a doctor asap...IMHO.
 
Good luck.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/6/2010 7:47 PM (GMT -6)   
Thanks Jim,

That is good advice. I will go Thursday and see if the Doctor will participate. I will probably have to switch if I can't get any attention.

Dave

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/6/2010 8:06 PM (GMT -6)   
Dave,

Prosatatitis is notorious for raising PSA levels, and with your history, there is still a possibility that the PSA levels are being caused by irritation of the prostate. The weak streams, etc, could also be caused by BPH, which also could be a cause for higher PSA levels.

At a minimum, you need to get a digital rectal exam, which if it is abnormal, should be followed by a biopsy.

I guess my point is that you should try not to assume anything until you get to see a good urologist. I am not sure I would choose to see a PA at this point. You need to see a competent doctor.

Good luck, and stay calm. Hopefully your stay here at HW will be brief.
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

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3065
   Posted 12/6/2010 8:07 PM (GMT -6)   
Dave,

The DRE will provide more information to your doctor(s)...so that's a must.

I have a friend who has an elevated PSA and his doctor is also doing a new urine test called PSA 3. The result of this test gives a level of PC risk.

The doctor may want you to get a biopsy, which is probably the only sure way to know. You won't get one on the first visit. You must prep for it. It takes a few days to get your results afterwards.

Stay calm...in any event - you've come to a great place for information and support.
Jerry L.
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Robotic Surgery
Jan. 2010 T3b, Gleason 9
Feb. 2010 Adjuvant Radiation

PSA History:
-----------------
Nov. 2009 4.30
Feb. 2010 <.05
May 2010 <.05
Aug. 2010 <.05
Nov. 2010 <.05

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/6/2010 8:12 PM (GMT -6)   
Thanks for the thoughtful and encouraging replies. It is mainly the uncertainty that eats away at you, but your replies help a lot. When I found this web site, I knew I had found the right place.

Thanks again, Dave

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 12/6/2010 10:50 PM (GMT -6)   
Dave,
As already mentioned, your elevated PSA may be caused by prostatitis and/or BHP. The antibiotic should clear the infection. The urologist may order another PSA and free PSA test and do a DRE. If the PSA is still high and the free PSA is under 25% he will probably do a biopsy. I wish you the best.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18 months) undetectable
Latest PSA test (21 months) .005

Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 12/6/2010 11:29 PM (GMT -6)   
Somehow I don't think a biopsy while you have prostatitis would be a good thing to do.

One google search showed this:

"Prostate biopsy is contraindicated in patients with suspected acute bacterial prostatitis (ABP) because of the potential complication of seeding the bacterial infection in adjacent organs."

And of course there are plenty of cases where a Biopsy seemed to cause prostatitis (sometimes revving up what they call Chronic Silent Prostatitis into a full blown acute version).

Your doc will be sure to know about such things.

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 12/7/2010 10:34 AM (GMT -6)   
That is exactly what Dr Fred Lee told my husband,while sorting out why his psa no. was elevated! Cooper

TTaylor
Regular Member


Date Joined Nov 2010
Total Posts : 102
   Posted 12/7/2010 6:37 PM (GMT -6)   
Dave
In my humble opinion get a urologist and have the biopsy. Prior to my robotic prostatectomy I had 2 lazer turp surgeries for BPH. I was in and out of the Drs office during this entire period..I had a very similar PSA count as yours and had prostititis for 25 years and still had Gleason 8 cancer in 8 lobes of the prostate. I wish now I had gone the biopsy route sooner because one of my Gleason 8 capsules erupted and caused adipose tissue invasion. The surgeon was unable to remove all of the cancer and now I have to take Harmonal therapy and radiation. If only I had gone the biopsy route sooner I may not be faced with continuing treatment. You are among friends here and we wish for you the very best. Please keep us posted on your treatment and condition.
Stay well and blessed
TTaylor
Age 67. Robotic prostatectomy 10/26/2010, due for HT and RT in Janury 0f 2011. Eight of 12 lobes positive. Gleason Score 4+4=8, Margin envolvement was present with adipose tissue invasion and perineural invasion, glandular and stromal hyperplasia present,pT3 pNO and no evidence of metastatic adenocarcinoma.

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 486
   Posted 12/7/2010 8:06 PM (GMT -6)   
We all understand your anxiety very well. You will receive much advice based on the experience and knowledge of this great group of guys. You will have to sort through it all and make the best decisions that line up with your circumstances.

Were I in your situation, I would call my PCP, and ask for an immediate "Free PSA" test. This is a simple blood test, doesn't take long, and you can do it while you're waiting to get into the urologist. Google "Free PSA" and you'll learn about this test, and what the results mean.

When you call the urologist, TELL them what your PSA velocity is. A PSA velocity of 3 within 12 months definitely suggests that something is awry.

At this point, you do not know whether you have cancer or not. Certainly BPH can cause the same symptoms you are experiencing.

If you post the closest large city to where you live, there may be someone on this forum who can suggest a uro.

Good Luck, God Bless, and please keep us posted.

k
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
Biopsy, 7 of 18+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg, Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed
10/20/10 OD'd .5cc trimix, after 3hrs, neo synephrine shot
tried .15 & .17 cc neg, next .2

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/7/2010 8:24 PM (GMT -6)   
I'm in St. George, Utah


Thanks, Dave

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4110
   Posted 12/7/2010 8:34 PM (GMT -6)   
1387D, The guys have given you great advise. I really don't have anything to add. Know that the guys here are like no other place always to give you their thoughts. Many times they are the one place that help us keep ourself together.

Cajun Jeff
Louisiana
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3786
   Posted 12/7/2010 9:04 PM (GMT -6)   
You run into these problems when you need medical attention "during the holidays"..This is a time-frame when many doctors take a few weeks off...It's bad enough if you get sick on a Friday...

You really won't know anything until you have had a biopsy..See if the PA can make that happen...
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

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/8/2010 10:54 PM (GMT -6)   
Tomorrow's the first exam......

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/9/2010 12:48 AM (GMT -6)   
Thanks for the optimistic comment questionaboutit. I am praying that it is a stubborn infection and not cancer. I guess I'll know shortly if the PSA has changed. I'll post the results.

Thanks again to everyone for the comments and concern.

Dave

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/9/2010 6:38 PM (GMT -6)   
UPDATE:

I had my appointment with the PA who explained a lot of things to me and took the time to make sure my questions were answered. I also made an appointment with the Doctor next month.

The DRE was performed and the prostate was smooth but enlarged. No Nodules - at least on the side he felt. He said it was about 40 grams. He said the normal prostate is about 25 grams.

That was good news.

He took blood is is having a Free PSA Test done. He said the results will be in on Friday or Monday.
I'll post the results when I get them.

He said, given my history of BPH and the symptoms, that he estimates there is about an 80% chance it is not cancer.

During this past week, I've lost about 7 pounds, my blood pressure has dropped to 118/80 and my blood sugar was 101 this morning. I guess depression does strange things to you, like suppress your appetite.

Thanks everybody for the kind words and thoughts. I really appreciate them and this web site. Although I'm not completely out of the woods, I feel better than I did a week ago.

On a side note, my friend and neighbor just got back from his physical and they found a nodule on his prostate. Now he is worried. I'll share this web site with him if he needs a place to go.

Dave

teallen
Regular Member


Date Joined Sep 2010
Total Posts : 38
   Posted 12/9/2010 7:05 PM (GMT -6)   
Keeping your spirits up is sometimes hard to do,but PC is not the worst thing that could happen a person.Keeping my fingers crossed that BPH is all thats causeing your trouble.I would really rather you did'nt have to be one of us PC guys, but another friend is always great. Tell your friend that there is a world of knowledge on this sight and he is Welcome to join .
Age 42 PSA 7.4 4+4 G8
Davinci Sept.8 2010
No incontinence issues but ED issues
1st post surgery PSA <.008

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/9/2010 8:09 PM (GMT -6)   
Thanks Teallen!

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/13/2010 5:35 PM (GMT -6)   
Hello again,

The blood test results are back in.

My PSA actually dropped to 3.7 (From 4.4 on Thursday 12/9), which is good news.
My Free PSA Test came back at 15.7. I was told by the PA that "Normal" is between 20-30. I was concerned about the low level, but I was told to get re-checked in 6 months. I still have an appointment in about a month with the Urologist.

Any thoughts / suggestions / comments?

Thanks, Dave

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4110
   Posted 12/13/2010 5:45 PM (GMT -6)   
1378D, You are now in the Drivers seat. Really pleased that you are on line to see the Urologist. He will probably keep a close watch you one and moniter what that walnut is doing to you, The news does sound good.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/13/2010 5:50 PM (GMT -6)   
Thanks, I have conflicted feelings towards the FPSA test. I don't know if that fluctuates like the PSA level does. I guess keeping an eye on things and being aware of changes is the course of action.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 12/13/2010 8:37 PM (GMT -6)   

Dave, "probably" everything is fine.  However your FPSA score in the intermediate range really tells you nothing.  My last pre-biopsy PSA was 4.2 with FPSA of 17.  Assuming that the PA guessed right on the size of your prostate, the better news is that your PSA density (PSAD) is relatively low (PSAD is PSA level divided by the size of the prostate).  For example my PSAD was .155 (4.2 PSA divided by 27cc prostate).  Your PSAD is .092 (3.7 divided by 40).  I recall that one of the Johns Hopkins health bulletins stated that PSAD over .15 indicated a high risk of PCA.

However...I'm not a doc...but the last time I looked "PA" didn't mean "M.D." either.  If you are depressed and losing weight over this I guess I still don't understand why you don't insist on seeing a urologist (not a PA) ASAP.  Again, "probably" everything is ok...but don't you want a physician to tell you that instead of an "assistant"?  Just my take.

Tudpock (Jim)


Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 12/13/2010 10:44 PM (GMT -6)   
A low free psa is also associated with prostatitis as well as prostate cancer............Cooper

1387D
New Member


Date Joined Dec 2010
Total Posts : 12
   Posted 12/14/2010 12:15 AM (GMT -6)   
The PA was the first opening. I took it and let him order the tests I wanted to have done. The anxiety began with the doctor's report and not knowing anything. I felt confident with the PA and felt he knew what he was doing. I would have gotten in to see the doctor if the latest test results went up. I will be seeing the doctor in about a month. My depression is in remission (After the initial shock, it slowly diminished as I talked to friends with PCA, people on this forum, and doing some research on my own) and my appetite is back. Hell of a way to lose a few pounds.

One thing I have discovered is that nothing is for sure. False positives / false negatives, differing opinions of test results, and a million other variables make a positive or negative diagnosis out of the question until they actually get in there and have the whole thing biopsied.

What a roller coaster. My heart goes out to all of you who have been through this. Just being on the fringe makes me go nutty. I have nothing to complain about and everything to be thankful for, including the kind and supportive responses I've received here. I don't know what the future holds, but being here is something I'll never forget.
New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, July 22, 2018 2:18 AM (GMT -6)
There are a total of 2,984,129 posts in 327,184 threads.
View Active Threads


Who's Online
This forum has 161973 registered members. Please welcome our newest member, saadiansnw01.
249 Guest(s), 5 Registered Member(s) are currently online.  Details
alunke82, whatdoigotDOC!, Girlie, F8, huneri