Free PSA observation

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Sagittarian
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Date Joined May 2011
Total Posts : 546
   Posted 5/12/2011 7:21 AM (GMT -6)   
Lab test results were always saved, from annual checkups.
The data was carefully reviewed, reguarding PCa.
It was discovered the free PSA should have raised a flag.  For some reason
one lab report (many years ago) had a free PSA, and others did not.
The low free psa should have triggered the refferal to a urologist, not
the PSA.  Buy the time I did see a urologist, he said he would of recomended
a biopsy when the PSA was in the three's.   Upon insistance to the PCM,
two months of antibiotcs were taken.  Dropped from 4.8 to 4.7.  After the negligable
drop, I saw a urologist for the biopsy.  Lesson learned ?, perhaps.  According
to the tables, a Free PSA below 10% indicated 56% chance for cancer, many years
before the PSA decided to push past that 4 marker.  
DOB = DEC-1957
PSA History
2002 = 1.83
2006 = 3.18
2007 = 3.09
2008 = 3.20
2009 = 3.50
2010 = 3.50
2011 = 4.70
2011 = 4.20
Free PSA = 7%

Biopsy, 12 Cores, April 2011
4 Positive, 2(3+3), 2(3+4) All Left Side
% on Positive Cores, 2(40%) 1(70%) 1(90%)
PNI = Not observed

Da-Vinci Surgery = 23 May 2011

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3741
   Posted 5/12/2011 1:25 PM (GMT -6)   
Should-a could-a...Hindsight is always 20-20....I didn't know what free PSA was until I read about it in Walsh's book..My history reflects a less the perfect diagnostic path..Most of us are that way....
Age 68.
PSA age 55: 3.5, DRE normal.
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 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6947
   Posted 5/12/2011 1:53 PM (GMT -6)   
Because of my ultra-high deductible, a Free PSA was not even considered until the GP was concerned with the standard PSA. It is an extra $125+ for most of us, unless you can get a deal at a local lab.

HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 414
   Posted 5/12/2011 2:07 PM (GMT -6)   
During an annual physical in 2007, my family doc did a regular PSA test that later came back at 3.7.  He said, "We'll have to keep an eye on that."  Back then I didn't even know what a PSA test was and what it meant.  I made the mistake of thinking, "The doctor knows what he's doing; if there's something to worry about, I'm sure he'll let me know" so I never even gave it a second thought.  In my education over the past few weeks, I've read where some doctors are thinking a PSA threshold well below 4.0 warrants further attention, especially in younger patients.  I wonder if my doctor back then chose to do a free PSA if I could have had a head start on my treatment.
John (HD_Rider) - Wichita, KS
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 3 cores at 3+3=6 and one core at 3+4=7 (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/12/2011 5:04 PM (GMT -6)   
Would have been, could have been, should have been is a cruel game to play in your mind. What you know now, is more important than what you didn't know then.

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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 5/12/2011 6:06 PM (GMT -6)   
Not the point, my PCM's get a failing grade for PCa.
The urologist said you should have had a biopsy five years ago.
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/12/2011 7:18 PM (GMT -6)   
Let's be fair here, most GP and PCM's only have a slight brushing in Medical School about PC at best, combined with learning about hundreds of other maladies. The old standard of "4.0" and getting referred to a urologist has been the standard for so many years, and most doctors dutifully wait till that threshold has been passed. We know now, that standard can miss a lot of lower PSA cases. That's also why pre-dx PSA velocity is so important to pay attention to.

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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

Concerned in Flroida
New Member


Date Joined Jun 2011
Total Posts : 4
   Posted 6/14/2011 2:25 PM (GMT -6)   
My husband went for his annual physical a few weeks ago, his PSA was
4.7
Two years ago it was 1.2
His free PSA this past week was 6%
His DRE was non conclusive.....which is a good sign
He is 52 years old, excellent health, now we are headed to Sarasota to do an MRI-s next week.....we are both frightened as to what may come of all this.....And sometime information overload makes it worse, but we are praying for good news and I will post here with the results and how we plan to handle it if the news is not good....good luck to all of you as well.... confused

rcroller
Regular Member


Date Joined May 2011
Total Posts : 326
   Posted 6/14/2011 4:18 PM (GMT -6)   
Same here. A year ago my GP ordered bloodwork and my PSA had risen from 1.1 to 3.0 in one year. That should have been the clue to send me straight to the Uro. He said we won't worry about it until it gets to a 4 so I requested that we re-test in 6 months. Well, six months later it was a 3.5 so off to the Uro I went. Now I just wonder if we had done things six months earlier if I could have avoided the EPE, PNI, etc. But as was stated above, I could "what if" this forever. It is what it is.
Age 53- PSA 2/11 3.5
4/21/11 BX Path Report: 3 of 12 Left PCa , 3+3, 3+4, 4+4
4/29/11 Received PCa DX, G-8
5/18/11 open RP Performed, Right nerve bundle spared
5/24/11 Post Op Path Report: G-7(4+3) 7%, pT3a N0MX, EPE, PNI+, SVI-, Left margin <0.1mm from inked margin
6/1/11 Cath removed, Incontinence-No, ED-Yes.

Concerned in Flroida
New Member


Date Joined Jun 2011
Total Posts : 4
   Posted 6/23/2011 5:45 AM (GMT -6)   
This is wife posting.....went to Dr. Wheelers in Sarasota, FL yesterday.....remember we have had no biopsy, opted for MRI-s we will not have the results until next week, however they performed a sonogram, there was one area of concern, very small located in the front right side......the MRI procedure according to my husband was a bit painful for a few minutes then subsided and was just uncomfortable.....the doctor said from his opinion according to sonogram that there was a 33% chance it was cancer and that it was not aggressive. The thing that baffles us is that 3 other doctors prior too Dr Wheeler said my husbands prostate was very enlarged, but Dr Wheeler measured it on the sonogram and it is actually very small......since this all began my husband began drinking POM wonderful in large quantities, could that be the reason????? Its all so confusing and the internet is all over the charts with this disease.....at this point in our minds we are going to do diet modification, vitamin and herbal supplements with watchful waiting no matter what the MRI results are and monitor is PSA levels every 3 months.....Then in the future if needed we are considering the HIFU procedure, which if the cancer is only on one side they only target that area leaving most of the internals of the gland still there......I will post the MRI results when we receive them, hoping for the best.....
Age:52
May 2011
PSA: 4.7%
Free PSA: 6%

Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 6/23/2011 11:09 AM (GMT -6)   
How odd I find it to be that several here are the same age, PSA & FPSA.
I am familiar with MRI-S, and understand the PCa needle tracking and blood thing.
Was not conerned with the tracking , if I was hot, I was going to quickly have
it removed.  The blood issue will always be a thought/concern.  I was not thrilled
by going with a biopsy, but a microscopic examination was preferred, with risks
accepted.  Will be very intrested on his testing outcome.
Glenn-AGE-53,NJ, PSA-4.2, FPSA-7%
4/09/2011 - Biopsy, 8 NEG, 4 POS (left), 2(3+3), 2(3+4)
5/23/2011 - Da-Vinci Surgery, Right Nerves Spared, Partial Left
5/25/2011 - PATH, pT2c, 4+3, 25% cancer,Confined, Margin-Lymph-Seminal NEG
5/31/2011 - Catheter Removed
6/01/2011 - UTI, CIPRO 500mg 2 a day for 10 Days
6/10/2011 - No ED, Stress Incontinence
7/12/2011 - First Post Surg-PSA test

Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 6/23/2011 1:42 PM (GMT -6)   
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