Elevated PSA for two years

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pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/10/2011 5:20 PM (GMT -6)   
Hey folks,

First of all let me start by saying, you're my heros. My hat is off to everyone and wish you all the very best.

I'm reaching out to the community to get some thoughts on my condition. I've been diagnosed with an elevated PSA level for over two years now and it is very concerning.

My PSA history...

33 years old now

4.5 - May 2008 [Symptoms, frequent urination, fever, back aches]
3.9 - July 2008 [CT Scan revealed mildly inflamed prostate, took Levaquin for some time but didn't finish the course as symptoms went away]
3.1 - Nov 2010 [Went to see Urologist and he put me on two weeks of Cipro - finished the course and waited for a week to do PSA]
2.6 - Dec 2010 - Free % PSA 28.8 [Urologist thought possible infection, gave me another two weeks of Cipro]
2.7 - Feb 2011 - Free % PSA 25.5 [Waited two weeks after Cipro and reading went up by .1]

I am really anxious and am definitely going to get the biopsy done but in the mean time any thoughts? Any thoughts, suggestions would help me a ton!

Thanks,
Pablo

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/10/2011 5:25 PM (GMT -6)   
Hello and welcome, Pablo

For starters, do you have any history of prostate cancer in your family, i.e., father, brothers, uncles?

Do you have a biopsy setup yet? Your free PSA makes it look more like an infection or inflamation issue, but not a doctor.

You would way, way young for a PC diagnosis, but it certainly not impossible.

Please keep us posted.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/10/2011 5:35 PM (GMT -6)   
Thanks for the quick reply. I have no family history of prostate cancer. Have not set up a biopsy yet but want to get it done as soon as possible.

Thanks,
Pablo.

Kongo
Regular Member


Date Joined May 2010
Total Posts : 36
   Posted 2/10/2011 5:36 PM (GMT -6)   

Hola, Pablo

I understand your anxiety but I think it might be misplaced.  From what you've described you seem to be suffering from a series of either urinary infections, a chronic prostate condtion (prostititis), some other type of infection which has inflamed your prostate, or perhaps a combination of all of these.

Any of these conditions can cause your PSA to elevate (as well as sex before the blood draw, some over the counter medications, or other physical activities that could put pressure on your prostate.  Your free PSA is in the so-called "normal" range.

Frankly, I see no reason to push for a biopsy.  While infections from the biopsy procedure is rare, I have had two friends in the very recent past who have now ended up with sepsis following prostate biopsies which landed them in the ICU for several days each and cause long lasting ill effects.

While it's technically not impossible, it is extremely rare (almost unheard of) for a man your age to be positively diagnosed with prostate cancer that requires treatment.

Of course the choice is yours in consultation with your urologist, but I would continue on with the treatment course your doctor has you on.  The small PSA rise you seem to be worried about from the February 2011 PSA can easily be accounted for given the infections that seem to be plaguing you.  Chronic prostititis may require a long course of antibiotics.

Good luck to you.


pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/10/2011 5:52 PM (GMT -6)   
Kongo,

Many thanks for your note. It makes me feel a little better :)

I've been reading quite a bit on the web about this now and it seems that chronic prostatitis should be treated with 6 to 8 weeks of antibiotics. My Urologist gave me two weeks of Cipro and then I waited for a week and then did Cipro again for two weeks. I want to discuss the long course of antibiotics but he seems to be leaning on biopsy. I'm okay with the biopsy as after all it is for my benefit but I am also debating if I should see another Urologist and try a longer course of antibiotics.

The only other thing that correlates with my condition is a chronic strain in my groin muscle due to an injury I picked up playing soccer. PC thinks it is not relevant so I'm not sure if this could be causing the inflammation.

BTW, the Urologist did the DRE and felt the prostate was normal but slightly enlarged.

Pablo

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 2/10/2011 6:35 PM (GMT -6)   
Hi there Pablo what you describe makes me think of an enlarged prostate, I would get another opinion from a different Urologist and then think of further action.

Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA from 30th April 08, until now range- 0.5 to 0.6, I am now 70

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 2/10/2011 11:43 PM (GMT -6)   
At only 2.7 I would look for another opinion. As others have said, this does not look like a PCa profile. Let me also suggest that you take a deep breath -- you are here among cancer survivors but you are not yet close to joining the club and we all hope that you will never do so.

pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/11/2011 5:24 AM (GMT -6)   
Geezer99,

Thank you for the note. This episode has opened my eyes and as I pray for the best; I'll keep you all in my prayers. Medicine has come a long way and hope we will see a permanent cure to cancers. I understand it is extremely challenging but we've come this far and hope we can make it all the way.

Thanks,
Pablo

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 2/11/2011 6:37 AM (GMT -6)   
fwiw, I had a UTI that was resistant to 4 weeks of cipro. diagnosed as prostatitus and epididimytous (some day I'll spell these accurately).

My new urologist put me on Bactrim and it worked like a charm.

Like the others have said, there is a lot for you to rule out before you convince yourself that you have PCa.

Good luck.
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci prostatectomy scheduled for March 4 at Yale. Lets hope attempt 2 at this goes better than my first try.

pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/11/2011 8:53 AM (GMT -6)   
Dave,

How old were you when you had your bout with Prostatitis and do you remember what your PSA trend was like? Did you have biopsy done?

Thanks
Pablo

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 2/11/2011 12:28 PM (GMT -6)   
pablo33 said...
Dave,

How old were you when you had your bout with Prostatitis and do you remember what your PSA trend was like? Did you have biopsy done?

Thanks
Pablo


Pablo, yes I had a biopsy. Anybody with the stats that show up in their posts (like mine) would have to have had a biopsy to know this info.

PSA trend 2.9, next year 4.1 and 2010 3.5

My epididimytous and/or prostatitus may be as a result of the biopsy. Docs will prescribe 3-4 days worth of a very strong antibiotic, which I took, but wound up with a UTI anyway.

If you are worrying to the extent I suspect you are, demand a biopsy (which does hurt, in spite of what others say tongue ) The only way to know for sure.
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci prostatectomy scheduled for March 4 at Yale. Lets hope attempt 2 at this goes better than my first try.

pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/11/2011 12:38 PM (GMT -6)   
Thanks Dave,

Good luck with the surgery and I wish you a quick recovery.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4226
   Posted 2/11/2011 1:53 PM (GMT -6)   
Pablo,
It sure sounds like you have prostatitis, which can sometimes take a long time and a few courses of antibiotics to cure. A biopsy is not without risks and should only be taken when there is an indication of PC and the abnormal psa cannot be explained by anything else. In your case the most likely explaination for the rise in your psa is prostastitis.
JT

tvwohio
Regular Member


Date Joined Sep 2010
Total Posts : 172
   Posted 2/11/2011 3:28 PM (GMT -6)   

Pablo

I had history of prostatitis and didn't think anything of it.   Found out later my father also had prostatitis and he never mentioned it.

Some of us, unfortunately, have a urinary system where prostrate acts as a dam and causes problems.  Prostratitis is some of the problem you may incurr.   Suggest you talk to urologist and discuss your problem - GP's are fine but sometimes may miss something.

I had prostratitis until 50 when I found I had PC so be careful.

Don't go balastic just be wary.

Tom


pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/11/2011 3:45 PM (GMT -6)   
John/Tom,

This is great advise, I'm glad I joined the forum. Thank you very much. I sure hope it isn't too serious and will certainly be careful down the road.

Thanks,
Pablo.

yobiks
Regular Member


Date Joined Feb 2011
Total Posts : 39
   Posted 2/12/2011 9:04 AM (GMT -6)   
While it's technically not impossible, it is extremely rare (almost unheard of) for a man your age to be positively diagnosed with prostate cancer that requires treatment
omg will you look at this? Am I reading this out of context or what? Just look at the stats and see what age these guys(me included) are. What your situation is I do not know. I am no expert or md. Best advice MAYBE is to get another opinion if you are unsure. 
sept 28 psa 2.1 jan10 '11 gleason 3+3 t2b

pablo33
New Member


Date Joined Feb 2011
Total Posts : 8
   Posted 2/12/2011 11:00 AM (GMT -6)   
Thanks Yobiks,

I plan to get a second opinion and will most likely see someone that has experience with both prostatitis and prostate cancer.

Pablo.
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