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Toronto Guy
Regular Member
Joined : Jul 2011
Posts : 35
Posted 8/31/2012 12:15 PM (GMT -8)
Hi Everyone,

Just got my PSA results...10.24. It was 8.10 in July and 7.97 in June. I'm being scheduled for another biopsy. Had one in October 2011. Came back negative, but with high grade PIN. Prior to that my PSA was 4.89 in August and 4.68 in June 2011. 1.15 in July 2008.
A jump of 2.14 in one month is concerning. I think I'm at the point that I'm convinced I have cancer, but I'm just hoping it's not very aggressive and hasn't spread. I'll be 49 in less than a month. I hope I don't get a nasty surprise for my birthday, but it's not looking too good from where I'm sitting. Uro says he's never seen anything like it, and he looks as though he treated Methuselah.
Crap, I was doing so well not thinking about it the past couple of months. And now...wham...like a punch in the stomach.

Hope you and your loved ones are doing well and getting better.

John
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Infohound
Regular Member
Joined : May 2012
Posts : 232
Posted 8/31/2012 12:55 PM (GMT -8)
OK I can't disagree with your "crap" word choice, but don't jump to bad conclusions. I'm all for jumping to good conclusions, but cancer, eh, try to be hard to convince on that. For what it's worth when we were first worrying about PSAs, a urologist I consulted told me very speedy increases were more likely to be caused by infection than by cancer. You might be thinking it can't just be an infection because this has been going on for such a long time -- again, that uro told me it's really hard to shake a prostate infection, sometimes taking months or years and multiple rounds of heavy duty antibiotics.

It might be cancer but it very well may not -- consider all those false positives that cause people to question PSA testing (I'm not one of them, but I understand the math behind the objections). Go be one of those stories.
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Willie B
Regular Member
Joined : Jul 2010
Posts : 155
Posted 8/31/2012 1:19 PM (GMT -8)
Must admit, between your age and the rapid psa increase, I'd think of an infection first, cancer when proven by biopsy.

Who's the really old doc? Just curious, don't know if you can say in posts.

Which cancer treatment centre? There's an older looking guy at PMH but he must be under retirement age.

My fingers are crossed for you needing some great antibiotics.

Mary
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Jazzman1
Veteran Member
Joined : Sep 2010
Posts : 1196
Posted 8/31/2012 10:25 PM (GMT -8)
I'd be concerned too, but I agree that it's best to take it one step at a time and not jump to conclusions. Sounds like infection is a real possibility.

It also sounds like you don't have much confidence in your uro. You don't say when you're biopsy is scheduled, but if you don't get some definitive answers soon, you might consider getting a second opinion. This stuff can wrack your nerves, and you need a physician you trust.

Good luck and hang in there. You're finding out that the anxiety is often the worst of this whole business. Don't let it eat you up. One step at a time...

Jonathan
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Toronto Guy
Regular Member
Joined : Jul 2011
Posts : 35
Posted 9/1/2012 5:49 AM (GMT -8)
Regarding the possibility of infection, my uro put me on Norfloxacin for (now I forget...) 10-12 days? This was the same antibiotic he put me on last year. When I questioned why he'd put me on the same medication when it didn't work previously, he said just because it didn't work last time, doesn't mean it won't work this time. My pharmacist told me there are other newer medications that he could have put me on.
I'm sure my uro  knows his stuff, but he doesn't appear to be open to answering questions. Not sure how honest he is with me either. Maybe he doesn't want me to worry until the results are in. When I asked him what type of treatment he`d be thinking about if the biopsy showed PCa, he said he didn`t want to discuss it. He softened a bit and then said it really depends on what they find. Could be watch and wait, could be surgery.....fair enough.
I just received my latest PSA results yesterday. They were scheduling a biopsy for me at Princess Margaret Hospital in Toronto. he just refers me, but haven`t called me back with the date and time. My uro doesn`t do the actually biopsy, he just refers me. Not even sure if he`s the one who will do the surgery if needed.
Thanks for the encouragement. I hope you guys are kicking PCa's ass.

(Doctor's name removed - we can refer by name with positive comments, but negative comments about facilities or providers have to be kept to private email. This is to avoid issues for the site owner. - 142)

Post Edited By Moderator (142) : 9/1/2012 9:57:12 AM (GMT-6)

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Jazzman1
Veteran Member
Joined : Sep 2010
Posts : 1196
Posted 9/1/2012 7:13 AM (GMT -8)
John,

My only follow-up comment is that if are diagnosed with prostate cancer, you might want to consider who you want to treat you. If this guy's communication style grates on you now, it'll only get worse later.

Communication style is a very personal thing. Some patients just want to be told what to do, while others have lots of questions they want answers to. Some physicians can be paternalistic to the point of deciding for you what you need to know. That works for some patients, but not for all.

Good luck with your biopsy. I hope it turns out to be nothing serious, and it sounds like that's a pretty good possibility. However, if you get the news you don't want to hear, you'll be entering into a relationship with some doctor that will last many years. Make sure it's someone you can work with for the long term.

Best,

Jonathan
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Worried Guy
Veteran Member
Joined : Jul 2009
Posts : 3790
Posted 9/1/2012 7:38 AM (GMT -8)
Hey Toronto Guy,

I looked at some of your earlier posts to get your history. Are you sure you want a doc who has treated Methuselah? On one hand, the guy lived to be 969 years old. On the other hand he didn't have any kids. Or maybe he lived to 70 but with no sex the last year of his life felt like 900?
I was given Cipro as the antibiotic to see if I had prostatitis. It is a 20th century antibiotic.
Are you aware that ejaculating before your PSA test raises the number? I read a paper that showed "stimulation" in that region raised a patient's PSA from 2 (normal state) to 7, at 12 hours after "rough" sex. Did the uro ask you about your activities? The latest recommendation I have seen says you should abstain from sex for 48 hours before your PSA test. (June 2012, H.B Carter M.D., John Hopkins)

Your doc might have a good reputation but personally, I'd be looking around for someone who cared about me.
Dude, you're 49 and you have a rapidly rising PSA. You're entitled to be a little overly enthusiastic about your situation.

If you get a chance look up "The Whole Life Prostate Book" by the doc I mentioned above. It has treatments, options, trade-offs and data from this century.

Good luck
Jeff

Post Edited (Worried Guy) : 9/1/2012 7:41:27 PM (GMT-6)

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Jazzman1
Veteran Member
Joined : Sep 2010
Posts : 1196
Posted 9/1/2012 7:47 AM (GMT -8)
Once again, our man Jeff said what I should have said. Well said, Jeff.
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Toronto Guy
Regular Member
Joined : Jul 2011
Posts : 35
Posted 9/1/2012 1:05 PM (GMT -8)
Thanks Jeff and Jonathan.
Yes I'm aware that I shouldn't have sex at least 48 hours before the PSA test or ride a bike etc...It was at least 48 hrs between sex and the PSA test each time. And yes, he asked each time.
I just placed a hold on "The Whole Life Prostate Book" at my library. Thanks, I'll check it out.
As far as looking for another uro, I'll think I'll take it one step at a time. I'll wait until I have my biopsy and receive the results.
Thanks Guys.
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Willie B
Regular Member
Joined : Jul 2010
Posts : 155
Posted 9/3/2012 8:00 AM (GMT -8)
Mary here.

I missed his name but am certain, from your descriptions, that he was Willie's second opinion guy.
His attitude was less than one would expect, we never returned.

Might I suggest you get another opinion from either Dr. Klotz or Dr. Nam at Sunnybrook? They are both excellent physicians who do know what they're doing and do it well, IMO.

The fact that your pharmacist says there are newer drugs he could have used, would have me checking around.

Still hoping you only need some great antibiotics.

Stay well everyone.

Love, Mary
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JustJulie
Regular Member
Joined : Mar 2006
Posts : 355
Posted 9/4/2012 8:52 AM (GMT -8)
We used Princess Margaret for Brachytherapy several years ago.  My husband was only 44 when diagnosed and his PSA was 3.74 so there is no magic number as to yes or no.

Hoping you find some kind of answer soon - the up and down of uncertainty can be sheer agony.

 

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CAMRAman
Regular Member
Joined : Sep 2011
Posts : 27
Posted 9/4/2012 11:43 AM (GMT -8)

Toronto Guy said...
Thanks Jeff and Jonathan.
Yes I'm aware that I shouldn't have sex at least 48 hours before the PSA test or ride a bike etc...It was at least 48 hrs between sex and the PSA test each time. And yes, he asked each time.

Next time he asks, tell him you had sex and rode a bike at the same time - that should get him communicating ! smhair
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Todd1963
Veteran Member
Joined : Oct 2008
Posts : 3566
Posted 9/5/2012 6:41 AM (GMT -8)
I think I would opt for a new doc amd a second opinion
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