Biopsy Tuesday - what are my odds???

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gadget
Regular Member


Date Joined May 2011
Total Posts : 55
   Posted 5/13/2011 7:46 AM (GMT -6)   
Hi all - really hoping not to join the group, but I do really appreciate all the information I've been able to glean from reading all the posts - very helpful!

So, here's my deal -

48 years young - fit and very active.
July 08 - 1.5
Oct 09 - 1.9
Nov 10 - 2.4
May 11 - 2.9 fPsa 3.4%

In Nov 10, my primary noticed the rising numbers and said I should have another PSA in 6 months, so I did and that one came in at 2.9. They suggest I see a Uro and once I started reading more, had a free PSA run and that came in at 3.4% - which from what I can tell is very low - but my overall PSA isn't exactly high and every thing I read about free PSA talks about people with PSA over 4 - so I'm not sure if the free PSA being low is overly significant. One more piece of info, I've been taking Propecia (hair loss too!) for over 10 years. According to my Uro, not a huge deal - he said at the strength for Propecia, it's not a doubling of numbers. Also, DRE was negative, but I sort of expected that.

So, having a biopsy on Tuesday - he says they'll use the ultrasound, numb the prostate and take 12 samples. I know with the low fPSA, I have about a 56% of being positive, but there's also a 44% it won't be - so, thoughts from you experts? I do think (hope) that if it is PCa, that I've got it really early and should have some options.

Thanks in advance!

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 5/13/2011 7:54 AM (GMT -6)   
Sounds like your Doctors are on top of your situation. Your Uro has told you a lot more than mine told me before my biopsy. He did exactly the same thing. Used untrasound,, numbed it and took 12 samples. It was not a bad experience. Not a fun time either but fairly quick and then just wait for the results.

Do keep us posted.

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

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 487
   Posted 5/13/2011 7:59 AM (GMT -6)   
Hello gadget, and welcome to our forum. I do have a couple of comments.
Your positive indicators are; low psa, and neg DRE. The troubling indicators are psa doubling time, and the low free psa, and your age. PCa in younger guys statistically tend to be more aggressive, but not always.

My only suggestion,since you had a neg DRE, would be to ask for a higher density of cores. Personally, I am a little uncomfortable with only 12. But that's just my opinion. I would ask for a minimum of 18.

Please keep us informed of your progress.

K
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
Biopsy, 7 of 18+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg, Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed
10/20/10 OD'd .5cc trimix, after 3hrs, neo synephrine shot
tried .15 & .17 cc neg, next .2

gadget
Regular Member


Date Joined May 2011
Total Posts : 55
   Posted 5/13/2011 8:11 AM (GMT -6)   
Thanks guys for the fast replies!

kbota - question about the PSADT, I agree it's increasing but I didn't take it as all that fast actually, or maybe that's just my wishful thinking :-)

That's really my nagging fear which is why I'm glad the biopsy is soon! If it's aggressive, I want to move fast and that probably means getting it out. I'm thinking even if it is aggressive, it's still early - wouldn't it be rare or at least odd for it to have escaped with these numbers?

My Uro did tell me that even if the biopsy is neg, we're not out of the woods and they would still keep a close eye on me.

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 487
   Posted 5/13/2011 8:23 AM (GMT -6)   
You are being prudent to be aggressive with this. I don't mean to alarm you because most PCa is slow growing, but not all. I suggest that you google "psa velocity". It truly is a meaningful factor.

Keep asking those questions friend. Wen I was at your stage, I drove these guys nuts with questions.

K
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
Biopsy, 7 of 18+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg, Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed
10/20/10 OD'd .5cc trimix, after 3hrs, neo synephrine shot
tried .15 & .17 cc neg, next .2

adderboy
Regular Member


Date Joined May 2011
Total Posts : 33
   Posted 5/13/2011 9:43 AM (GMT -6)   
Welcome - I agree with kbota, important to be on top of things as not all PCa is slow growing.

In my case they found a lump on the prostate not there the previous year. My urologist didn't think it was significant, and didn't want to do a biopsy until I insisted. After cancer found, he said it was insignificant and I should opt for watchful waiting. Needless to say I did not agree. After reading as much as I could on the subject and creeping on PCa forums... I asked for a referral.

Education is key to a decision you and your family can live with. I have no regrets, and look forward to a long and happy life.

I wish you well on your journey and am praying you have a good results with your biopsy - take care
Age: 55 Ontario, Canada
PSA: 1.2
Dec 2010: Family Dr. found lump on routine physical (not there 1 year prior)
Feb. 6 2011 biopsy: 3 of 11 cores, T2a, Gleason 6 (3,3)
Urologist recommended "watchful waiting" ...back to my family doctor he recommended surgery.
Back to Urologist asked him to refer for third opinion (he did so reluctantly)
3rd opinion: Urologist recommends surgery
April 15: open radical prostatectomy
April 27: catheter removed...absolutely no ED issues and a little incontinence.
May 6 2011: Pathology report excellent, cancer confined to prostate, Gleason score remained at 6!

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6048
   Posted 5/13/2011 10:57 AM (GMT -6)   
These local urologist and Gp's never cease to amaze me. I would find some one who will do a saturation biopsy. BTW welcome aboard, Either way, your odds for a long life, not without seasons, are very high, from a Pca perspective.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

gadget
Regular Member


Date Joined May 2011
Total Posts : 55
   Posted 5/13/2011 11:11 AM (GMT -6)   
Thanks again guys - so what I'm seeing as the recurring theme is that I should ask for more than 12 cores.  My Uro seemed pretty on top of this and said they would be using the ultrasound to really pinpoint any areas that looked suspicious. 
 
He was also pretty up front about the fact that even if this is negative, it doesn't mean we're clear - which I appreciated - it wasn't like once that was done he was going to just say it's clear, he said it just means they may not have found it.
 
I'm certainly going forward with the biopsy - those numbers tell me something's up - but you also have to wonder what about the 40 some percent with low fPSA that don't have PCa?  Are we thinking they all fall in to the "haven't found it yet" group?
 
I think I'll let him that while he's there - please take as many as he wants, I'm more for overkill - make sense? 

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 5/13/2011 11:22 AM (GMT -6)   
The low dose Finasteride you have been taking WILL have some effect on artificially lowering your PSA...A biopsy is a good idea, 18 cores is an even better idea and yes, your chances are about 50-50..

The biopsy itself is not that big a deal..It's the aftermath that's the rough part...Best of luck to you...
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

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 5/13/2011 1:30 PM (GMT -6)   
Gadget:
 
You have a good doctor. Mine went by the 4.0 threshhold and I didn't know any better.
 
Mel

Going for brachy
Regular Member


Date Joined Apr 2011
Total Posts : 201
   Posted 5/13/2011 4:19 PM (GMT -6)   
I had a 12 sample biopsy on February 17 without numbing the prostate. Wasn't bad. Like being hit by 12 rubber band snaps.
__________________________________________________________________________
Age 70
PSA 3.4 January 2011
Biopsy Feb 2011 Gleason 3 + 3 T1C 2 out of 12 one 5% other 10%
Treatment option: Brachytherapy in the next 5 or 6 weeks
Volume study 5/3/11 49 cc
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