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davidss
New Member


Date Joined May 2011
Total Posts : 4
   Posted 5/16/2011 10:38 PM (GMT -6)   
Iam 57 psa is 1.8 was .9 when I was 51. The urologist says he feels a very small nodule subtle yet present according his notes. He wants to do a biopsy. I have already cancelled two appointments. I dont like the idea of it at all. What are the odds I have cancer? If I do have cancer I dont want to know. I cant see me taking chemo or radiation or surgery either so what is the point? This is really working on me mentally.

North49
Regular Member


Date Joined Feb 2011
Total Posts : 83
   Posted 5/16/2011 10:53 PM (GMT -6)   
I know what you are going through, as do pretty much everyone who has had PCa, it't not something any of us thought we'd get.

However, after doing some research I think you'll come to the conclusion many of us have already, don't wait to get educated about treatments and outcomes. The numbers you stated show a PSA velocity that needs to be investigated with a biopsy. I know someone who had similar numbers as yours and ended up with a positive biopsy and decided on surgery. He has had a great outcome and his life has returned to pretty much pre-op status. There is also a possibility you don't have cancer but at this time, you can't say for sure.

I'm coming up to 6 months post op and wish I had been diagnosed much sooner as outcomes are in the 95-97% range if detected early. So don't put it off, ask as many questions as you have to, talk to others who have been through it, read as much as you can and get opinions. Hang in there, you'll look at this completely differently soon.
PSA 5.6 - 04/2010 - DRE positive
PSA 6.7 - 09/2010
Biopsy - 09/2010 - Age 53
T2b/c Gleason 7, 4+3
PSA 8.2 - 12/2010
RRP - 12/2010
pT3a, Gleason 7, 3+4, 20% PCa
pNO
Negative margins and seminal vesicles
RP 37.3 g
No further treatment recommended.
PSA <0.01 - 03/2011 - 3 month post-op

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 5/17/2011 12:35 AM (GMT -6)   
That's a small PSA reading for your age, BUT if you have the biopsy you will know, if you don't you won't .

Mal.
age 67 PSA 5.8 DRE 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 07 Totally dry
PSA 23rd Oct.0.5
Started SRT on 5th Dec.
Finished 24 Feb 08
PSA from 30th April 08, until now range- 0.5 to 0.7

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 5/17/2011 4:18 AM (GMT -6)   
DavidSS, sorry you are going through such a stressful time. I don't know how much research you have done on prostate cancer but strongly encourage you to spend some time researching it...I think you will find that the majority of prostate cancers are treatable with surgery and/or radiation. No chemo is used for most cases.

My husband was 57 at diagnosis, and his PSA was much higher than yours (6.4). He had two biopsies; the first one found nothing; the second one (4 years later) found 2 out of 12 samples positive for PCa. He went the surgery route and, as a self-confessed baby when it comes to pain, came through with no problems. I've included my signature below so that you can read his history. The surgery was 3 years ago and, for him, the worst part was the darn catheter. Once that puppy was out, he got back to his life and hasn't looked back.

Your fears are natural, and I'm sure there are quite a few guys here who felt as you do (not wanting to know if you have cancer). My question to you is are you ready to live with the uncertainty of not knowing and wondering what is going on in your body? If you are, fine; if you're not, then make that third appointment for a biopsy and keep it.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of posterior extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA 0.0 thru July 2009. August 2009 - 0.1, September 0.3, October 0.0. Last PSA in April 2011: 0.02

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 5/17/2011 4:33 AM (GMT -6)   
Examples: my brother has something felt on DRE and psa was only like 1.0 or 1.1 at the time, after biopsies had 1 out of 12 with < 5% PCa found...doc mentioned surgery, my brother smiled because he was armed with some knowledge and Dr. Strum's book helped him see that in some cases A.S/W.W. is not insane(also Brady Urology definition of 'indolent PCa' fit his parameters, easily). So he is at year 7 now and psa remains about the same exact range and no issues....known...thus far...his choices...I told him to keep vigilant watch and check fPsa and Psa regularly. Same has been done and found in others, not totally insane to do such. Some patients are very good candidates for this, some are on the cusp of it and would be risker, some it is a now way from day one. Based on this you may have PCa, it is actually very common and many men don't even know they already have it.

Example #2: 1996 Rick K. diagnosed with psa of 11.0 and 2 biopsies positive (I don't know the percentages), back then Gleason (2+3) today that is a Gleason's 6. Well he didn't like anything that ruined his prostate for destruction. So, he did Dr. Leibowitz protocol of ADT3 drugs for 13 months, quit and stay on proscar for maintenance. He has been rebiopsied a total of 3 times (last one recently with color doppler used too) and no PCa has been found. He has normalcy as a man (he mentioned) and just bought 15 yrs.
Of course everyone would think this is totally insane, well Rick is pleased!!!

Even if you have it, you could be cured, you could have very long control of it otherwise with many choices of protocols, some you have to seek out in a quest like fashion.
Hopefully your is negative, if so keep watching your psa or fpsa levels.

Post Edited (zufus) : 5/17/2011 4:39:00 AM (GMT-6)


adderboy
Regular Member


Date Joined May 2011
Total Posts : 33
   Posted 5/17/2011 5:28 AM (GMT -6)   
davidss, your story is similar to mine. My PSA was 1.2. Dr. found a small nodule not present the year before. I too did not want to have a biopsy to find out if I had cancer. This drove me crazy. I started reading and reading more. I found out that my age, good health, and low PSA the outcome for a successful conclusion even if I did have cancer were favourable.
I was right!
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!

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 5/17/2011 6:55 AM (GMT -6)   
Hey DavidSS,

You are not the first person in the world to feel that way. When I was told my PSA was 17.8, I was 100% sure it was a mistake and some other poor guy was walking around with no idea he had a rotten walnut.

OK, with that preamble let's talk about your situation for a minute. Life is all about options. Every day you decide to walk left or right or which road to take. Choices make us guys feel like we are in control. If getting a biopsy now when things are small gives you options (including doing nothing ) why not do it? Think of it as a lab test -- like a PSA with a little extra "stimulation".

What are the chances? You can go to the Sloan Kettering site and enter your numbers into their predictor simulation. That will tell you the chances of 5 years and 10 year outcomes. Maybe some other guys here will chime in with better sites.

When you ask a question here you are talking to a bunch of guys who have already had biopsies and treatments and are glad they did. By far, the majority of us choose to fight so our answers might be biased.

Good luck to you. May your nodule be nothing.

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: Glsn 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 Dry

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 5/17/2011 8:15 AM (GMT -6)   
DavidSS. Listen to the Mr. Wizard for healingwell. He speaks the truth. I know that it is a scary time but you will only know if you need to be scared with a biopsy. If is comes back negative you have had all this anxiety for nothing. Lets face if. Your assume that you probably have it. One can never assume anything when it comes to the big C.

Best of luck with your decision process.

Another Jeff but not the Wizard I would the

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

Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 5/17/2011 8:58 AM (GMT -6)   
Biopsy.
DOB = DEC-1957, PSA HISTORY, FPSA = 7%
2002 = 1.83, 2006 = 3.18, 2007 = 3.09, 2008 = 3.20
2009 = 3.50, 2010 = 3.50, 2011 = 4.70, 2011 = 4.20

BIOPSY, 12 Cores, APR 2011, 4 POS, 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

Aggie '97
New Member


Date Joined May 2011
Total Posts : 5
   Posted 5/17/2011 9:00 AM (GMT -6)   
Davidss,
 
Anxiety had been the ruler of my world for quite some time.  I have recently been diagnosed with PCa and actually feel more in control of my situation than I did a year ago.  I'm 36 with a long family history (not sure what your family history might be) and was encouraged by my fathers doctor to get checked at 35.  I did so and the journey began there.
 
The biopsy had to be the hardest thing to handle to date.  It signified so much.  The procedure itself was not as bad as I had made it out to be.  Hints: ask for the Xanax and take it before leaving your house.  I was extremely relaxed.  Next, make sure they give you Lidocaine to numb the prostate.  I've had 2 with the 1st being clean and the 2nd finding cancer.  After research, many hours on this board and the support of my family, I feel more at ease than I have in a year.
 
Don't push it aside or it will eat at you mentally more than cancer would.  My motivation is my faith, family and friends. 
 
Good luck and stay strong.
 
Case
 
Age: 36, dx: 4/28/11, PSA: 4/11  10.8
Biopsy: 4/11 1 of 24 Pos, Gleason 6 (3+3) Bone, CT Neg

p_elliott
Regular Member


Date Joined Nov 2010
Total Posts : 143
   Posted 5/17/2011 10:43 AM (GMT -6)   
If you do nothing not all that good if you take a proactive stance in this your out look is very good. Go to the doctor get a biopsy get this taken care of.

Architect
Regular Member


Date Joined Apr 2011
Total Posts : 43
   Posted 5/17/2011 3:37 PM (GMT -6)   
My doctor found some "nodules" during a DRE, and my PSA raised had raised to 2.5. I had the biopsy, and found that I have PC. I'm glad we caught it early so I can beat it, and move on with my life.

Not knowing was much worse than knowing. Information is power. Research and learn, and then get the biopsy. If you have PC and wait too long it might spread. My father died in March at age 59 from PC that spread into his bones.
DX 4/26/11 (Age 36)

6/15/09 PSA 2.1
3/17/11 Lost my father to Prostate Cancer that had metastasized to his bones (Age 59)
3/30/11 PSA 2.5 & Abnormal DRE (Nodules felt) found during post-op for extracorporeal lithotripsy procedure
4/18/11 Biopsy
4/26/11 Biopsy Results = 3 of 12 Cores Positive (both lobes) with Gleason 6 (3+3)
5/5/11 CT & MRI = Negative for metastatic cancer

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3738
   Posted 5/17/2011 5:52 PM (GMT -6)   
Davidss, there is about a 40% chance your condition is nothing and a biopsy is not necessary..There is a 60% chance you are passing up a chance to be cured should it turn out you have prostate cancer.. If you like, reverse those numbers but that's the ball-park you are in...

Having an impacted wisdom tooth removed is MUCH worse than having a biopsy...

You can get a PSA test every 3 months for the next year, try to maintain the same conditions, and see what develops..PSA Velocity, how fast the number goes up, is a VERY strong predictor of trouble ahead.. If you choose to do nothing, you can accurately calculate your termination date by how fast that number doubles.....
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

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 5/17/2011 6:12 PM (GMT -6)   
We need even better testings and assessments still in PCa...you could have PCa but missed biopsies that could miss detection even more than once, seen this happen in cases over the years on patients. You could combine the overall weight of these types of tests before getting a biopsy:
1) PCA-3 test (urine test method)  blush
2) fpsa test (unbound psa antigens low percentages have high risk for PCa)
3) psa tests (psadt or psav) changes and your history (red flags on velocities)
4) ultrasound findings for size and psa density, what is your non-PCa psa #
5) color doppler ultrasound testings (can detect suspecious blood flow areas) cry
6) DRE (with 2nd opinions added by qualified docs) shocked
7) CTC test (might not be worthy) circulating tumor cells specialized testings (new)
8) PCa sniffying dog (does exist-see inside of on line Newsletter from www.paactusa.org  one of the past two issues had an article on the dog, approx. 90% detection rate) rolleyes
 
9) (for likely advanced PCa in ones system) PAP, pyrilinks-D or similar testings, CGA, NSE, CEA, chemistry panel on kidney-liver-bone and electrolyte status, cbc (blood counts) skull
10) compare family history and risk factors probablities smhair
Any other ideas could be added ..... idea
 
Just throw out some ideas, kind of like talking about Shrimpin' in the Forest Gump movie and how many ways one can serve Shrimp. (humor intended...I live best w/humor). smilewinkgrin
That's all I have to say about that  (lol).  F.G.

Post Edited (zufus) : 5/17/2011 6:19:25 PM (GMT-6)


leeanglo
Regular Member


Date Joined Dec 2010
Total Posts : 191
   Posted 5/18/2011 10:19 AM (GMT -6)   
David, the Biopsy is Scary but by no means painfull urologists do these on a daily basis and anesthetic is given to numb the prostate.If i were you id get one done and then you can be a little more confident of your position.Without a biopsy its really just all maybes
Good luck..
psa on dx 144, gleason 4+3 7 12 biopsie cores cancerous
T3a N2 M1.
psa after 3 months zoladex 20
T levels 0.5 after 3 months zoladex.
now taking 50mg cosadex daily also.
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