High PSA with no cancer

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New Member

Date Joined Apr 2011
Total Posts : 1
   Posted 4/23/2011 3:06 PM (GMT -6)   
I am 45 years old. For the last 7 years my PSA has risen from 2.0 to currently 39.90.  I have had 6 biopsies during this time.  The first biopsy with a 6.6 reading at the age of 39, resulted in a 2mm piece of cancer found on my prostate.   I have had 5 subsequent biopsies that have yielded negative results with  occasional  inflammation.  I haven't seen my doctor in over a year in regards to this.  My doctor continues to give me biopsies without doing anything else.  Antibiotics have never lowered my PSA reading.  Does anybody have any idea of what can be done to lower my PSA? 

Regular Member

Date Joined May 2010
Total Posts : 264
   Posted 4/23/2011 4:29 PM (GMT -6)   
If it were me, I would get a 2nd opinion of another urologist who specializes in prostate cancer. If this is something you are considering, if you post your general location, maybe some other members can suggest someone to see in your area.

Although I hope you continue to stay healthy and don't need a treatment, I think it is unusual for a uro to find a 2mm tumor on a 39 year old and not suggest a treatment. Do you remember what the Gleason score of the cancer specimen was? Or the percentage of the sample core that was cancerous?

Good luck!

Here are some of my stats:
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

Veteran Member

Date Joined Jan 2006
Total Posts : 650
   Posted 4/23/2011 5:20 PM (GMT -6)   
You might try to find a uro that does color doppler exams. By using the color doppler they find the suspect areas and then guide the biopsy to the area in question. THere is a limit, I think, when you have had enough biopsies and I think you are way beyond that. There are not a lot of places doing the doppler color biopsies but it would be past time for a road trip if it were me. Sorry to hear about your problem, by now you must be anxious with that high psa.
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent @ 12 months
ED, pre-op severe, post op total
10/10 Dr Boone, Methodist recomended AUS
AUS/ IPP performed 1/11/11 Methodist Houston
post op psa's 0.04,<0.1,<0.1,<0.01@12 mo.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 4/23/2011 6:47 PM (GMT -6)   
You really need to get a color doppler or a 3D staruation biopsy. I would go to Duke Bahn in Ventura Ca or the Dattoli Cancer Center in Sarasota. Has your psa risen at a steady rate or has it risen rapidily and then fallen? If it has been a steady rise it is indicative of PC. There are several conditions that would explain your psa. Infection, but you would have seen a lowering of your psa at some time, matastitis to the lymphnodes, a very large transition zone tumor or a world class case of psa leak. In this case you now need a medical detective and not an ordinary doctor to help discover what the problem is. There are only a handful of doctors capable of figuring this out.
I had the same issue, except I had 13 biopsies in 10 years and saw 6 different doctors, before I figured out that I was an unusual case and needed an expert. Urologists just don't have the experience or skill necessary in your situation.
Transition zone tumors are very hard to detect by biopsy and will cause very high psa reading that rise steadily over time. I have heard of only one case of psa leak at your psa levels. A deep infection can also not be ruled out. In any case you need an explaination of what is causing it and it must be done by process of elimination. I would travel to see Dr Bahn as he currently is the best in the world at detecting hard to find PC. His web site is www.pioa.org. I know what you are going through as I have been down the same road. If you are in the Mid west you can see Dr Fred Lee in Rochester MI; but I think that he just retired. Don't keep fooling around with regular urologists at this point as you need an interventional radiologist. A good medical oncologist specializing in PC would be good to have on your team, but he would just send you to Dattoli or Bahn anyway. Feel free to email me with questions, click on my profile for my email.

66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

Regular Member

Date Joined Jun 2008
Total Posts : 436
   Posted 4/23/2011 7:24 PM (GMT -6)   


Just curious wht you didnt have your removed ? It seems ost get theres removed just curious. Sorry to hijack this post

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 4/23/2011 10:00 PM (GMT -6)   
Because of the location of my tumor, Apex and transition zone, surgery woud have had a high probability of a positive margin. Also after some research I discovered that combination seeding and IMRT had a more effective rate of cancer control for intermediated risk cases as well as less side effects than surgery.
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2209
   Posted 4/24/2011 6:55 AM (GMT -6)   
Welcome to the forum Psaprisoner.

You have had several biopsies, but you do not say how many needles were used each time.
If you have had multiple biopsies, but each one has only used a few needles (eg six), then there is distinct possibility that something gets missed, especially if you have large prostate. A saturation biopsy would give a clearer picture because a PSA of almost 40 suggests that all is not well.

Age dx 48
Apr 09 PSA 8.6
DRE neg
Biop 2/12 pos
Gleason 3+3
Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
Nov 09 PSA 0.1
Mar 10 PSA 0.4 sent to RT
13 Apr CT
RT 66Gy ends 11 Jun 10
Tired + weird BMs
Sep 10 PSA <0.1
Jan 11 PSA <0.1
Apr 11 PSA <0.1
Erection OK

Regular Member

Date Joined Jun 2009
Total Posts : 77
   Posted 4/24/2011 7:32 AM (GMT -6)   
Play it safe my friend. Go for other opinions..I understand: Biopsing is not fun!
EVen after I was diagnosed, another biopsy found no cancer! It was only after my Urologist decided to 'break the tie' and do a saturated biopsy that they found it again (I wa sput to sleep for that).
On ther other hand, something else could be causing your high PSA (which will be good news no matter what that something is!).
Best wishes as you contunue to investigate.
>Age 41 (At Dx-July 05) -Psa during annual physical went from previous 2.8 to 3
>Biopsy by 'primary' Urol Aug 05 - Gleason 6 low grade. 2nd opinion at  Hopkins confirmed Dx
>Chose Active Surv (AS)- modified diet etc.
>Around Oct 07 Psa moved up to 5.5. I decide to treat at Hopkins. Not sure what kind yet. My doctor decided on re-biopsy first.
>2nd Biopsy Dec 07 at Hopkins was NEGATIVE for Pca! Nothing found in 14 cores!
>'Primary' Urologist baffled. Planned a saturated biopsy (22 cores) to settle issue once and for all. I wasn't going to do 22 cores wide awake!
>July 07 - Did MRI just for comfort. Nothing significant found. No spread. I'd live! Still in AS mode.
>July 08 - Saturated Biopsy performed. Cancer confirmed again (of course, you took 22 cores)! Same Gleason score, same grade, similar numbers but Urol says treat very soon! I am thinking not so fast - numbers are same and you told me it means not aggressive! In any case I agreed with Urol that I will go the way of the Seeds. I research seeds more and I don't like it.
>July 08 - Dec 08 I re-lapse back into AS mode but seriously researching/considering treatment options beside surgery - went on to Mass Gen and Georgetown to explore proton therapy and Cyberknife respectively. Anything but Surgery! Both experts who are about my age were unanimous in strongly declaring they will chose surgery 'if they were me'. In addition, I learn that if either if these radiation methods (and seeds too!)  failed, no backup plan (or will be complicated)! I got the message!
>Jan 09. Went back to see my doc at Hopkins. I decide to put my fate in the hands  of the 'Da Vinci Robot' then!
> May 09. Had surgery. some Pain and discomfort but normal. Pathology all clear. Gleason 6 as before. Feeling very lucky. I gambled (based on my numbers and got 4 more years!) on the slow nature of the cancer and took my time. Very happy I finally did it. Hoping for a great recovery of all 'key' functions. Great wife and family helping out.
> Sept 09 - 3month PSA - Undetectable!
> June 10 - 1year PSA Undetectable!

Veteran Member

Date Joined Jan 2011
Total Posts : 735
   Posted 4/24/2011 4:11 PM (GMT -6)   
psaprisoner said...
I am 45 years old. For the last 7 years my PSA has risen from 2.0 to currently 39.90. I have had 6 biopsies during this time. The first biopsy with a 6.6 reading at the age of 39, resulted in a 2mm piece of cancer found on my prostate.


You say "high PSA with no cancer", but in your message mention a 2mm piece of cancer...If you had cancer at the time your PSA was 6.6 and now it is 39.9 what was your Gleason Score at that time?

Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!
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