My dear friend just had his psa checked, 18 ??

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BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 4:42 PM (GMT -6)   
Hi Folks.. as bad as having to participate because of my own situation, a dear friend just confided in me that he had his first psa test done 2 weeks ago. 18. He is otherwise a very healthy 51 year old.
 
His primary did an exam, and felt either a lump or growth.
 
What do we think?

Trepidation
Regular Member


Date Joined Feb 2011
Total Posts : 173
   Posted 3/7/2011 5:10 PM (GMT -6)   
 He needs much more testing. Did his digital exam precede any drawing of blood?
 
Please tell him not to panic and to educate himself as much as possible.

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 5:50 PM (GMT -6)   
I understand he went to his primary, had his 1st psa test, it was 18. His primary referred him to a uro, but had him take a 2nd blood test for that uro appt, also 18. So the 18 sounds like a correct #.

So the blood test, the digital exam, then 2nd blood test.. then uro.. to biopsy scheduled this week.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/7/2011 6:08 PM (GMT -6)   
Bob,
I think it brings back memories...

He needs to get with the urologist and have the plumbing checked for UTI and such before a biopsy. Hopefully he'll be luckier than I was...

Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 3/7/2011 6:15 PM (GMT -6)   
Bob, What a shocking PSA. You can never assume. UTI can bump it up like that but so can the big C. Do keep us posted as to his progress. Have him get as educated as possible while finding out what is going on.

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
2 year PSA <0.1
Only issue at this time is ED but getting better

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 6:16 PM (GMT -6)   
Wow thanks Tony, that's a great point.

Trepidation
Regular Member


Date Joined Feb 2011
Total Posts : 173
   Posted 3/7/2011 6:25 PM (GMT -6)   
TC-LasVegas said...
Bob,
I think it brings back memories...

He needs to get with the urologist and have the plumbing checked for UTI and such before a biopsy. Hopefully he'll be luckier than I was...

Tony
 
How great would it be that anti-biotics would drop that sucker to .1 or less? Prayer coming for that result.

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 6:30 PM (GMT -6)   
Yup, here's to a prayer to my dear friend that he never joins this club!

And while i'm at it, another one that each of you join the zero club.

Cape Bob

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/7/2011 6:30 PM (GMT -6)   
Trep,
It would be even great if his PSA dropped below ten. My PSA up in that vicinity was indication that I had a more severe case, and the surgery proved it. I know he has a positive DRE already so it is unlikely that he does not have some sort of issue. But he should be on antibiotics first then a retest followed by biopsy if the antibiotic doesn't help enough..

At least that is a pretty standard protocol around here...

Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 6:40 PM (GMT -6)   
Tony, so you think the antibiotics 1st? Because you think it might be a false positive, or because you think a biopsy could actually allow pca cells to escape, or what?

*BTW if you knew how hard I was linign my eggs ug for us to move back the LV.. hope to meet you there one day soon.


Bob.

Trepidation
Regular Member


Date Joined Feb 2011
Total Posts : 173
   Posted 3/7/2011 6:41 PM (GMT -6)   
TC,
 
Can you have a DRE that has lumps and still a healthy prostate? I mean are all prostates created the same?
 
I have looked up some of your work BTW and all I can say is WOW!
 
Del

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3994
   Posted 3/7/2011 7:41 PM (GMT -6)   
imo, a confirmed PSA of 18 and a positive DRE is all you need to go to biopsy.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/7/2011 7:57 PM (GMT -6)   
@F8,
Typically you may be right. But if that PSA is elevated, a positive biopsy might still get an overreaction if the true PSA is say 5. Not all lumps are cancerous...

@ Trep,
Yup, like I just said to F8, sometimes lumps on a prostate are benign. And as I understand it an infection can indeed harden a prostate or a portion of it. Palpability is just one of the tests. But more information may be attainable than the PSA such as PSA velocity.

Guys it is standard protocol to check for infection before a biopsy. It would be controversial to skip that step in diagnosing a patient...

Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3994
   Posted 3/7/2011 7:59 PM (GMT -6)   
my doctor didn't check for infection.  he did a second PSA test and then scheduled me for biopsy.  he said i had a 50% chance of having cancer and if the DRE had been abnormal he would have upgraded me to 75%.
 
ed
 
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/7/2011 8:09 PM (GMT -6)   
F8,
Of course the odds of 50% are worth checking for infection. Why put a man through biopsy when it might be unnecessary?

But that stated, your doctor did the right job in getting you diagnosed.

But there is another reason to check for infections ~ they can get very exacerbated by a biopsy. Some guys can end up hospitalized when poking through with a needle and the infection get's worse. In fact, when some doctors wait and see that they can confirm an infection they will hold off on a biopsy until the infection heals...

At least that is how it was explained to me.

Tony

Post Edited (TC-LasVegas) : 3/7/2011 6:13:10 PM (GMT-7)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3742
   Posted 3/7/2011 8:16 PM (GMT -6)   
Are you talking about me? No symptoms. Healthy. PSA was requested for a life insurance physical. 17.8 My gentle GP thought there was a "firmness" on one side. I started Cipro and few weeks later repeated the test - 22. Went to the Uro. He did a much more thorough DRE that caused me to ejaculate on the table. "Most likely the entire left side is involved". Redid the PSA a couple of weeks later - 23. Scheduled the biopsy...
And the rest is history... :-(
Jeff
Age: 58, Mar 35 yrs, 56 dx, PSA: 4/09 17.8 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Gleas 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 4/10 .04, 7/10 <0.01, 12/10 <0.01
AdVance Sling 1/10/11

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 3/8/2011 10:06 AM (GMT -6)   
Another reason to first treat a possible UTI is that a biopsy performed on an infected gland can lead to extraordinarily bad side effects of what should be a reasonable office procedure. The anti-biotic is good medicine.
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