Cause of Rapid PSA Rise

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sobeit
New Member


Date Joined Dec 2010
Total Posts : 10
   Posted 12/14/2010 11:20 PM (GMT -6)   
Hi, I'm new to this excellent and obviously very helpful forum.

I have a family history of prostate cancer (brother) and so for last 6 years have been getting an annual PSA. Up up until this year they varied (no trend) from 2.36 to 2.87. However, last week I (and my local doctor) were really surprised when the result came back as 12.77 (free to total ratio of 13%). Prior to the tests, I always make sure I have not done anything for a few days that may lead to a temporary rise in PSA. My local doctor did a DRE which revealed a slightly enlarged prostate. She then referred me to a well known and recognized prostate cancer specialist in a nearby capital city. He has recommended I take noroxin (antibiotic) for 4 weeks and then have the PSA re-tested prior to a possible prostate biopsy in mid-February. I guess I'm wondering whether anyone has had a similar rapid rise in PSA and what it was due to? Clearly the prostate specialist is wanting to rule out prostitis before moving to a biopsy. The only symptoms I have are needing to go to the toilet 3x at night, urgency and frequent urinations. I don't have any pain when urinating, a fever or blood in the urine.

Any insights or thoughts would be most helpful. I am worried I may have an aggressive prostate cancer but know this will not be confirmed until I have a biopsy in mid-February.

Bob

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3804
   Posted 12/14/2010 11:31 PM (GMT -6)   
Bob -- it's common to have prostate cancer and no symptoms.  that was the case with me.  but remember that if you do go to biopsy the probability of you having cancer is only like 30%. i had two PSA tests about a month apart and then the biopsy.  you can see the results in my signature.  i believe your doctor is acting responsibly and i wish the very best for you.
 
ed
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 12/15/2010 12:30 AM (GMT -6)   
Bob I think you are going about this exactly the right way, I must admit the unusual jump in the psa to 12, would worry anybody. But obviously stay calm and lets not jump to conclusions just yet, there is still a good chance it could be an infection or similar. The only symptoms I had before my diagnosis was a slight dribble after urination. Apart from that I thought I was fighting fit, I actually went to the doctor with a sore knee. Thank God for my sore knee. Good luck Bob and keep us informed please....Rgds Kev.

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 12/15/2010 1:19 AM (GMT -6)   

I too had NO hint of a problem, but most certainly had a significant cancer.

My brother, who had PSA tests (previously negative), had an early test, and he too had the same severity of cancer.

As the others have suggested - just go with it...

I suspect that you are on the antibiotics to ensure that there is no urological infection that has spiked the PSA..

 

All the best and Merry Christmas !

..



Nov 2009 = First-PSA 5.3 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-'10 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May-'10 = RRP-Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED -85%, Cont -5%
+17W First 'DRY' day. ED -90%

sobeit
New Member


Date Joined Dec 2010
Total Posts : 10
   Posted 12/15/2010 5:07 AM (GMT -6)   
Hi - thanks heaps for your feedback.

My apologies for my initial posting being ambiguous. Saying the 'only symptoms I had were....', I mean't symptoms of a urinary infection / prostitis, not prostate cancer. I thus wonder whether this (urinary infection / prostitis) is really the cause as I have no pain or burning etc when going to the toilet but do appreciate the need to rule it out because of the very sharp increase in PSA.

Again, thanks for your responses.

Bob

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 12/15/2010 8:56 AM (GMT -6)   
I had symptoms of prostate problems, but shrugged them off as symptoms of BPH, which may have been true, since my prostate was very enlarged.  The symptoms included urinary frequency, and esp. urinary urgency.  When I had to go, there darned well better be a toilet or a bush nearby, because I simply couldn't control the urge.  Whether those symptoms were in anyway associated with the cancer, I can't say, but they led to the PSA testing, which led to the DRE, which led to the biopsy, and so on.
 
Your doctor's plan sounds like a good one to me.  Rule out prostatitis first.
Age 65
Dx in June 2010.
PSA gradually rising for 3 years to 6.2
Biopsy confirmed cancer in 6 of 12 cores, all on left side
Gleason 7 (3 + 4)
Bone scan, CT scan, rib x-rays all negative.
DaVinci surgery late August at Advocate Condell, Libertyville IL
Negative margins; negative seminal vesicles
5 brothers, ages 52-67 ; I'm the only one with PCa
Continence OK after 7 weeks. ED continues.

TTaylor
Regular Member


Date Joined Nov 2010
Total Posts : 102
   Posted 12/15/2010 10:27 AM (GMT -6)   

Bob

You are wise to have the biopsy. Prostititis and an enlarged prostate have nothing to do with keeping you from having prostate cancer. I have had both for 25 years and discovered I had prostate cancer which required a robotic prostatectomy. The fact that your brother has been diagnosed with prostate cancer is a signal by itself that you need to be checked thoroughly. I wish for you and your brother the very best in future health. You are among friends here.

Stay well and blessed

TTaylor

 


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 12/15/2010 10:47 AM (GMT -6)   
I agree with the others. Give the antibiotics a chance to knock down any infection. Prostatitis can be symptom-free too...Read up on it....

You MIGHT get another PSA test in a couple of weeks just to verify the first one was not an aberration and the PSA level is moving downwards and not still climbing...But this will have little effect on your overall treatment time-line..
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

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 487
   Posted 12/15/2010 10:49 AM (GMT -6)   
Bob:

I think that the urologist has prescribed the anti-biotic for the same reason that you refrained from activity that would affect your psa results. He wants to be sure that all possible other conditions are neutral before moving on with a biopsy. It is possible that there was/is a latent infection which has caused this rise and which the biopsy would not detect, and could possibly spread through your system as a result of the punctures necessary for tissue removal. All in your best interest. I consider his actions good medicine.
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