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PSA Level Concerns

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Prostate Cancer
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PSA Level Concerns  
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k9guy
New Member
Joined : Nov 2013
Posts : 18
Posted 1/18/2019 6:04 AM (GMT -7)
I’ve decided to seek out some counseling for my anxiety. I’ve tried different things to manage it but it’s no use, this is all I think about. I’m one of those people that will worry and dwell on things if everything is not as it should be.

I feel stupid honestly for having this high level of anxiety considering my situation, I have not even been diagnosed with anything.

I hope this will help...
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Mumbo
Regular Member
Joined : Nov 2018
Posts : 106
Posted 1/18/2019 6:32 AM (GMT -7)
Do what you have to do to get a handle on your feelings. My best talks were with a work friend who went through this at age 49 and still plays hockey. It is a personal issue that is hard to talk about except with others that have been there. There are support groups in most cities if you want to find others to chat with.

I still have trouble getting to sleep sometimes as my thoughts return to my PCa and the future. The situation never converges on a solution in my mind and the gears keep whirring. It sucks but gets better with time. It is a shame that the doctors cannot have have you come in and do everything possible in one day and then give you all the results. As it is, there are many steps in the process so it always seems like you are waiting on something thus some anxiety is always there.

Good luck
66yo at DX, PSA 4.1->5.1, 7/18
MRI Guided TRUS Biopsy 8/18 - (4+3 and 3+4)
CAT and Bone Scan clear 9/18
RALP 11/6/18 @ St. Johns Hosp, MN
Post surgical G7 (4+3), pT3a pN0
Pos. Surg. Margin (SM+), EPE, L=0.1mm?
All other pathology negative
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k9guy
New Member
Joined : Nov 2013
Posts : 18
Posted 1/23/2019 4:32 PM (GMT -7)
Well I had my initial visit with Dr. Pavlovich at Johns Hopkins today. He gave me a general exam along with a DRE which he said was completely normal. Even though my PSA was a 3.00 which is a little for my age of 48 he was not that concerned.

I’ve been having my PSA checked ever since I turned 40 and it started out then at a 1.1 and now has gotten to a 3.00 almost 9 years later. He said he does not want to rush right into a biopsy when he believes currently I do not need one. He has scheduled me for a MRI of my prostate both with and without contrast in 3D. He states in the order that if the MRI is abnormal (PIRADS 3,4,5) lesion is seen then he would order a biopsy. If all clear then he states to continue to get my PSA read each year along with a DRE.

Thoughts???
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InTheShop
Elite Member
Joined : Jan 2012
Posts : 10362
Posted 1/23/2019 4:58 PM (GMT -7)
Sounds like you're in good hands and he's given you a smart plan.

Andrew
I'll be in the shop.
Age 58, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17 .3 4/18, .4 11/18
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
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Pratoman
Forum Moderator
Joined : Nov 2012
Posts : 6629
Posted 1/23/2019 5:14 PM (GMT -7)
K9, this is good, you are, as Andrew said, in good hands, with a Dr who is careful, but not an alarmist.

I truly hope this helps calm you. Don’t be concerned unless the Dr is concerned.
I am not a doctor, just another guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP with Dr Ash Tewari Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV (+ frozen section apex converted to negative)
PSA @ 6 weeks 2/15, .<02, remained <0.02 until January 2017, .02, repeat Feb 2017, still .02. May 2017-.033, August 2017- .033 November .046, March 2018 .060. June 2018 .068, July 2018 - .082, August 2018, .078, August 2018 - .08 Start ADT. Sept 2018 Start SRT
Sept 2018 thru November 2018 – T = 4, PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/qgyu3xq
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Mumbo
Regular Member
Joined : Nov 2018
Posts : 106
Posted 1/23/2019 5:19 PM (GMT -7)
Nice, I am sure your JH doctor has seen a lots of PSA’s and done lots of DRE’s so if he is feeling good about everything, you should also. Hopefully the fancy 3D MRI does not turn up anything significant and you can skip the biopsy for a year as he recommended. That would be really good news so hope for the best.

The problem with this journey is that there will always be a next test, next appointment, etc so many things to get anxious about. You have pretty good news so far so enjoy it and play a video game.
66yo at DX, PSA 4.1->5.1, 7/18
MRI Guided TRUS Biopsy 8/18 - (4+3 and 3+4)
CAT and Bone Scan clear 9/18
RALP 11/6/18 @ St. Johns Hosp, MN
Post surgical G7 (4+3), pT3a pN0
Pos. Surg. Margin (SM+), EPE, L=0.1mm?
All other pathology negative
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three 5's and a jack
Veteran Member
Joined : Jul 2017
Posts : 642
Posted 1/23/2019 7:56 PM (GMT -7)
Listen to the Doc......................you be good

Roger
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WeightLoss
Regular Member
Joined : Feb 2017
Posts : 148
Posted 1/24/2019 6:54 AM (GMT -7)
I think its a good treatment plan. My PSA rose from 0.7 to 4.3 over about 8 years before I had a biopsy. The Endocrinologist who ran the PSA test was monitoring me for other issues and never thought to raise the alarm. When I eventually saw the Urologist, he felt that a rise over 8 years from 0.7 to above 3 would have warranted some further investigation and he would not have let it go so far as the Endocrinologist. I had a MP MRI, which showed PIRADS 5 followed by a MRI fusion biopsy. I was fortunate that although the Gleason 3+4 cancer was already causing the prostate capsule to bulge, it had not broken through. I was lucky.
Now 57 Dx Dec '16, PSA 4.313
Jan '17 MP MRI PR 5, Bn Scan -ve; Fusion BX 4 of 12 +ve G7 (3+4)
RALP Feb 2, 2017
Path: G7 (3+4), PT2c No ECE, margins, LN or SV all -ve
uPSA:
2017: 0.029-0.059(Siemens); <0.008(Abbott); <0.03(NCCS); < 0.01(Bck Coulter); <0.006(Labcorp)
2018: 0.019-0.029(Siemens);<0.008(Abbott); <0.03(NCCS); <0.006(Labcorp)
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k9guy
New Member
Joined : Nov 2013
Posts : 18
Posted 2/6/2019 9:27 AM (GMT -7)
Well I went for my Prostate MRI this morning, now waiting on the results. Dr. Pavlovich said based on what he sees will determine if I need a biopsy or not, so we will see.
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ejc61
Regular Member
Joined : Dec 2016
Posts : 107
Posted 2/6/2019 9:37 AM (GMT -7)
From the age of about 40 to 54, my PSA ranged from 0.9 to 1.9. Always under 2. Then at 55, boom 5.2.

You are doing the right things in a good place. Stay calm.
PSA:
2/16-5.2
5/16-2.8,FPSA-13.2%
10/16-4.6,FPSA-11.5%
1/17-4.4
dx:3/17;age 55
bx:3/12+;GS6;5%,5%,20%,28g
neg DRE. bx confirmed byJH
OncoDX-19
mpMRI:7/17-(2) lesions (PI-RADS 3 and 2),
PSA:
7/17-1.9
10/17-2.1
1/18-2.8
4/18-4.3
4/18 bx:4/12+;GS6;5%,5%,20%,30%,32g
JH-20% & 30% to 10% & 20%
PSA:
11/18-5.1
1/19-3.5
mpMRI;1/19; no focal abnormalities consistent with PIRADS 3,4,5.
AS - Emory/Atlanta

Post Edited (ejc61) : 2/6/2019 9:40:39 AM (GMT-7)

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Leah77
New Member
Joined : Jan 2019
Posts : 18
Posted 2/6/2019 12:02 PM (GMT -7)

k9guy said...
Well hello everyone, it’s been awhile since I posted about this. I have been watching my scores and now I’m a little worried and have a consult with a urologist next month. I’m 48 now and my PSA just came back at a 3.00, last year is was 2.4 and the year before that it was 2.2. My father had his prostate removed when he was 57 and is doing fine so I have the family history. I’m just very worried about the whole situation, any words of wisdom and/or encouragement would be much appreciated.


Hey K9 Guy, my hubby is going through diagnostics right now. He is 44 and his PSA levels are similar to yours. 2 different urologists told him he was fine ( he may be) But I pushed for an MRI- It came back with a suspicious mass... Biopsy is tomorrow. The mass is in an area of the prostate that is not typically reached by biopsy or felt by DRE. So having the MRI is crucial for proper diagnostics in my husbands case.
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k9guy
New Member
Joined : Nov 2013
Posts : 18
Posted 2/6/2019 12:26 PM (GMT -7)

Leah77 said...

k9guy said...
Well hello everyone, it’s been awhile since I posted about this. I have been watching my scores and now I’m a little worried and have a consult with a urologist next month. I’m 48 now and my PSA just came back at a 3.00, last year is was 2.4 and the year before that it was 2.2. My father had his prostate removed when he was 57 and is doing fine so I have the family history. I’m just very worried about the whole situation, any words of wisdom and/or encouragement would be much appreciated.


Hey K9 Guy, my hubby is going through diagnostics right now. He is 44 and his PSA levels are similar to yours. 2 different urologists told him he was fine ( he may be) But I pushed for an MRI- It came back with a suspicious mass... Biopsy is tomorrow. The mass is in an area of the prostate that is not typically reached by biopsy or felt by DRE. So having the MRI is crucial for proper diagnostics in my husbands case.

I wish you and your husband the very best. I will update when I have my results back.
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k9guy
New Member
Joined : Nov 2013
Posts : 18
Posted 2/11/2019 4:13 PM (GMT -7)
Well I got my MRI results back but I have not heard from my doctor as to his opinion of the results. While I’m not a doctor I want to say from the way I’m reading it it’s good news, anyone with experience in MRI readings your input would be helpful, here is what it says.

No suspicious abnormalities on MRI imaging

Modules in keeping with benign prostatic hypertrophy

Prostatitis

Small bilateral hydroceles and fluid in the left inguial canal. Enlarged bilateral inguial lymph nodes, probably reactive.

Overall PI-RADS=2

Prostate measures 5.0cm TV x 3.6cm AP x 4.3cm CC, volume 41cc

Linear T2 hypointensity without restricted diffusion or asymmetric perfusion, which can be seen with prostatitis.

Moderate hypertrophy with heterogeneous T-2 signal

No focal areas with suspicious morphology.

Enlarged bilateral inguinal lymph nodes measuring up to 1.2 cm short axis, however maintain fatty hila, probably reactive.
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jmadrid
Regular Member
Joined : Sep 2017
Posts : 240
Posted 2/11/2019 4:31 PM (GMT -7)
I also think it is good news. PIRADS 2 is not bad. Your prostate is enlarged, this may justify your slightly elevated psa. As the final part of the report underlines, the enlarged nodes may mean something. I do not understand exactly what it tries to say, in special if whether "probably reactive" is good or not, but with this level of psa and no signals of extraprostatic breaks, PCa node involvement is not probable, in my non-expert opinion. But maybe it needs to be investigated. Enlarged nodes can be explained by many causes, some worrisome, some trivial. Your doctor will tell you about what it means, if something.

Post Edited (jmadrid) : 2/12/2019 3:28:43 AM (GMT-7)

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