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Herindoors
New Member


Date Joined Jun 2011
Total Posts : 12
   Posted 6/14/2011 12:06 PM (GMT -6)   
Hello all :-)
I have been reading this forum with great interest and I now feel able to post a few questions if I may.

My husband is 51 and I am 41 and we have two girls 10 and 12.
He has some problems in the peeing dept with urgency and once even wet himself. he is at his GP quite reguarly as he had part of his colon removed last October for bowel cancer. Last month he got the all clear from that disease and we thought that perhaps the weeing problems were due to his surgery etc.........anyway, his GP did a PSA test and it came back at 27, so he has been sent off on the 2 week you might have cancer appointments.
He has seen the consultant who said his prostate felt normal (as did his GP) and he is due a biopsy this Thursday and we get the results on 28th.

Having just had a ride on the cancer bus, I am quite prepared for any outcome and I would appreciate your thoughts if you wouldn't mind :-)

At 51, would a PSA of 27 indicate cancer and is it true that in younger patients it is more likely to be aggressive?

He is also a diabetic and on statins and methotrexate....how much would these drugs lower the PSA level by?

I can handle the bad news so please dont hold back !!


Oh and the next person who tells me about their grandfather who was 104 and had it with no problems and talks to me as if I have just told them my husband has stubbed his toe....I may swear !!!

many thanks in advance.

Tikvah
New Member


Date Joined Jun 2011
Total Posts : 10
   Posted 6/14/2011 12:24 PM (GMT -6)   
I'm a 'newbie' here too - and have been busily learning all I can about the topic.

Everything I've read suggests that you should diligently pursue the doc's recommendations for diagnosis and don't wait!

Also start reading some books on the subject - a very good one to get you started is:

"Prostate Book" by Dr. Peter Scardino it's been recently revised and expanded (late 2010) so try to get the 2nd edition.
http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=scardino+prostate&x=0&y=0

Just bear in mind that it was written by a surgeon - with a bias towards surgical 'cures' - but it appears to cover all the bases.
Scardino does cover just about everything you may need to know right now...and can help a lot with the decision process
for possible treatments made by you and any docs involved.


If you find yourself confused and angry about getting firm answers about prostate matters - you're not alone.

Hang in there and be as positive as you possibly can...and best of luck to you and your husband.

Post Edited (Tikvah) : 6/14/2011 12:30:31 PM (GMT-6)


Herindoors
New Member


Date Joined Jun 2011
Total Posts : 12
   Posted 6/14/2011 12:29 PM (GMT -6)   
Thank you for your reply Tikvah.

My husband is quite angry about having a possible second diagnosis within a year, which I think is quite understandable and i have become quite numb I think.

I will have a look for the book you have suggested.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/14/2011 12:32 PM (GMT -6)   
Welcome to HW, sorry you have to be here, after such a hard road you've been on. If you have read here much, you will know that high PSA can be the result of several things, BPH, Prostatitis, Prostate Cancer, and just even a chemical quirk in the body. That's why the biopsy is done, to get a definite answer to that question. So, although none of us can tell you that he has or doesn't have it, it's a possibility it is. At this point, all you can do is prepare yourself for the worse, and hope/pray for the best. Do stay in touch and keep us informed as to the changes in his journey. If you have any questions, please ask them, we're here to help.
James C, 64, East TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Prob. microscopic inv.-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

Post Edited (James C.) : 6/14/2011 12:55:10 PM (GMT-6)


Tikvah
New Member


Date Joined Jun 2011
Total Posts : 10
   Posted 6/14/2011 12:34 PM (GMT -6)   
My wife had a half dozen major procedures two years ago in dealing with DCIS breast cancer & related matters...so we've been there, done that.

We went through the anger, numbness, etc. It wasn't easy.

You can get through this.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6946
   Posted 6/14/2011 12:35 PM (GMT -6)   
Herindoors,
 
Welcome to our corner of the web, as much as we hate to see you here.
 
I was 56 at diagnosis, with a marginal first PSA, but a really nasty biopsy result. I'm not sure what the statistics may be on age vs. agressiveness. Mine was without symptoms at all, and post-op came out a Gleason 4+5.
 
Not being on anything other that high blood pressure meds, I can't speak to impact.
 
A PSA of 27 by itself is just that. Dr. Walsh tells us that you can have a high PSA but not have cancer, as it is just an indicator. Did they discuss the possibility of infections? Many here seem to have had a preliminary trial of antibiotics to see if that brought the numbers down. (I did not, they felt abnormalities in the DRE).
 
Also, my GP did a second type of PSA test called a "Free PSA", which backed up the diagnosis. Did yours by chance do that?
 
I would also be tempted to follow the rules for pre-PSA tests - no sex for 48 hours before, no bike riding, no DRE, and get a second PSA and Free PSA test before doing the biopsy, but if they come back the same, I would do it.
 
And yes, after both the DaVinci Surgery & Radiation, and a year later still on pads, I give little space to the "it's the best cancer to get" crew. You wouldn't want to say that to me.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Herindoors
New Member


Date Joined Jun 2011
Total Posts : 12
   Posted 6/14/2011 12:40 PM (GMT -6)   
Thank you James for your reply.
I very much suspect PC as his prostate feels small on examination and he has no urine infection so the only thing left is cancer which is hiding where the DR cant feel?

I have been reading of peoples PSAs going up what seem to me, small amounts over the course of a year....how on earth can my husbands have got to 27?
Has it happened over the years slowly or has it gone BOOM over the last year or so?

rcroller
Regular Member


Date Joined May 2011
Total Posts : 326
   Posted 6/14/2011 12:42 PM (GMT -6)   
Herindoors, sorry you have to be here but welcome to the group. There are some very experienced folks here who will no doubt be able to share their experience and knowledge with you. I'm relatively new here too and have been reading up on PCa quite a bit lately. In addition to Tikvah's recommendation of Scardino's 2010 book, I would also recommend Walsh's "Surviving Prostate Cancer"(2007), Chodak's "Winning the Battle Against Prostate Cancer"(2011) and Meyers "Beating Prostate Cancer"(2007). All are good reads and each offers a little something different. Best of luck to you and your husband.
-Bob R.
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.

Herindoors
New Member


Date Joined Jun 2011
Total Posts : 12
   Posted 6/14/2011 12:46 PM (GMT -6)   
142, would you mind explaining what a 'free PSA' test is?
I have read about it, but I dont understand it and i need to know what I am talking about when I ask his GP tomorrow !!

Please excuse me if i dont reply for a while, I need to pick my daughter up from dancing....


As much as I don't want to be here, I feel very welcome, thank you, you lot are a nice bunch :)

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/14/2011 12:53 PM (GMT -6)   
After reading my answer, I see that I may have been playing doctor by saying it is most likely what he has. Let me withdraw that statemnt, It could be many things, and the biposy should give you definite proof.
James C, 64, East TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Prob. microscopic inv.-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

Tikvah
New Member


Date Joined Jun 2011
Total Posts : 10
   Posted 6/14/2011 1:00 PM (GMT -6)   
Herindoors -

Forgot to mention that you probably should not make any decisions based on ONE book - or one Doc's reco's for that matter. It's a good idea to read as much as you can from different sources, books and get more than one opinion from the Doc's, too.

free PSA is another PSA test that's usually done on those with "grey area" PSA stats - i.e. from about 4 to 10 (like mine). Unlike the usual PSA test (sometimes called the total PSA) you want the free PSA # and percent to be as high as possible. It may or may not be useful for your husbands PSA number - but that may be because the studies haven't yet been done for that range of PSA numbers(?).

free PSA is just the portion of the total PSA that's not 'bound' i.e. 'free' of attachment to carrier proteins...it's the part of the total PSA that's considered to be produced by NON-cancerous processes in the body. Kinda like the good vs. bad cholesterol, I suppose.

Here's one site's description of the differences between PSA and free PSA:

http://www.psa-rising.com/prostatecancer/fpsa-flowchart.htm

Post Edited (Tikvah) : 6/14/2011 1:03:47 PM (GMT-6)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6946
   Posted 6/14/2011 1:07 PM (GMT -6)   
Herindoors,
 
A "Free PSA" test is a variation that looks at the PSA which is not "bound" to other components. I don't know the chemical details, but my doctor was quite concerned whan I had a PSA of 7.4 / 7.6 (done twice from the sample) and a Free PSA of 7.2%, I think it was.
 
The "Free PSA" test cost me about the same as the screening PSA.
 
 
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 6/14/2011 1:48 PM (GMT -6)   
Tell your doc (demand) a copy of the actual pathology report, you can learn to decipher it later, alot of guys herein can help spell it out as to what is says and then you can look at nomograms, partin tables and generalizations made of such things. But each scenario in PCa can be unique, two guys could have same stats and different repsonses, because of all the genetics issues, and stuff that technically is seldom checked into (like molecular pathology). It is more complex than you would ever imagine.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/14/2011 1:51 PM (GMT -6)   
Welcome,Herindoors

Unfortunately, the biopsy is the best way to find out what is going on with your husband. I had 3 of them before my prostate cancer was detected. They aren't a lot of fun, but most of us get through them fine. There are other non-cancerous answers to why his PSA is so high. We can all for the best for him, and for your family.

Prostate cancer is my 4th time with cancer. I was diagnosed at age 56, after finally reaching the 10 year "all clear" from my previous cancers, so I can understand both the apprehension and the frustration he must be feeling.

Please keep us well posted, and ask away on your questions. We are here to help and to support you and your husband.

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, 6/11 5.8
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

Herindoors
New Member


Date Joined Jun 2011
Total Posts : 12
   Posted 6/14/2011 3:05 PM (GMT -6)   
Thank you very much, all of you for your responses, you have all been very helpful.

I will question our GP over the free PSA test as luckily, he is very nice and understanding, unlike the consultant who was very rude and abrupt and not the sort of chap you can ask questions !!!

I will keep you all posted on our journey and wish you all the very best on yours :)

Startech
Veteran Member


Date Joined Jun 2011
Total Posts : 1104
   Posted 6/15/2011 12:28 PM (GMT -6)   
Welcome and hoping the best for you and your family. Good for you for getting the biopsy scheduled, it really will help let you know whats going on or not. It was not that bad for me and I dont even like needles, LOL. As my sig shows, I am 51 also with a very high psa. I have no idea if it crept up or just shot up recently, because I stopped testing for to many years. My bad, so the good news for you is that you are now on top of any problems that MAY arise. Best wishes and let us know if we can help.
1985-age 25 diagnosed with enlarged prostate
March 2000 psa=.08
April 2002 psa = 1.4
April 2011 psa = 47.6 age 51
May 17, 2011-Prostate Biopsy
Prostate volume 97--(whoa, that is big!)
PSAD:0.49
3 of 12 cores Positive
Right Medial Base: G7 (3+4) 6 mm of 15 mm
Right Medial Mid G6 (3+3) <1.0 mm of 15 mm
Right Lateral Mid G7 (3+4) 1.0 mm of 4+7 mm (2 pieces)
Bone=neg;ct=50/50 chance within capsule
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