New guy with questions

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Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 9/7/2017 10:18 PM (GMT -6)   
Hello to this great forum, I have been reading so much on here that is helping me with understanding of PC. I am wondering what you think I should do with my information in my signature? Do I need to worry, get a biopsy, wait for 6 months, or just learn all I can? I would appreciate any help that anyone could give.
53 years old with long history of Prostatitis, BPH, spermatocele removed in 2016, left kidney cyst, long history of trace of blood in samples. PSA 11/2013 2.71-3/2015 2.69-8/2016 3.59-8/2017 4.12 and was referred to urologist and ran FreePSA 10.5% 8/30/17 tPSA 3.65 no DRE done due history of BPH.

Post Edited (Ron3107) : 9/7/2017 9:30:12 PM (GMT-6)


Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 9/7/2017 10:48 PM (GMT -6)   
Hi Ron-

You are always going to have a hard time using PSA as a yardstick. A bit more specific than % free PSA is a test called Prostate Health Index (PHI). But even PHI (and the similar but more expensive test called 4KScore) are affected by PSA from other causes. PHI is covered by insurance and is fairly cheap.

SelectMDx and ExoDx®Prostate(IntelliScore) are new urine tests that get around the PSA problem. SelectMDx costs about $400 - it may or may not be covered by insurance - get pre-authorization!

You might want to have a DRE anyway. Certainly you have enlargement from the BPH, and you might have hardness from the prostatitis, but a DRE might reveal lumpiness that may be due to benign cysts or tumors.

It's also good to know your prostate size (from an ultrasound). PSA/prostate size is ideally less than 0.15.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

Subdenis
Veteran Member


Date Joined Aug 2017
Total Posts : 580
   Posted 9/8/2017 6:45 AM (GMT -6)   
Sorry you are here and having difficulty. I get "worry" and it is a wasted emotion! I find times of thinking worst case and then I get hope, etc. I like to ask myself two questions: what do and know and what do I think? It is the thinking that jams me up. Just the facts Ma'am! Hang in there! Denis
65 YO healthy man, PSA 4.1/2 for couple years PSA 5/1/17 4.6, Multiparametric MRI, 5/15/17 showed lesion. 13 core biopsy 3 positive 3+3 and one positive in lesion, may be overlap All cores less than 30% 8/22/17 - second opinion Yale pathology shows small amount of (3+4) in one core, < 5%, ordered decipher to inform next steps Leaning towards Active Surveillance. Thanks, Denis

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 9/8/2017 8:35 AM (GMT -6)   
Thanks for the replies, and "Worry" does not help and I know that but when symptoms are daily now even with PSA down some its hard not to be concerned. I know its best to do AS with my information and I guess that's what is planned but Urologist has not talked to me about PC so I guess I will continue taking 2 Flomax a day and see how it goes.
53 years old with long history of Prostatitis, BPH, spermatocele removed in 2016, left kidney cyst, long history of trace of blood in samples. PSA 11/2013 2.71-3/2015 2.69-8/2016 3.59-8/2017 4.12 and was referred to urologist and ran FreePSA 10.5% 8/30/17 tPSA 3.65 no DRE done due history of BPH.

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/7/2018 8:36 PM (GMT -6)   
I am back again looking for some answers for those in the know. Recent checkup with GP in Feb and PSA was up to 4.96 and she sent me back to urologist again. Urologist did another PSA test with PSA 4.79 and Free 9.3 %. He said that if PSA came back high again he wanted me to do a a biopsy as he is confident that something is going on and wants to rule out cancer. I have scheduled the biopsy but not sure it needs to be done this quick? He has been my urologist for over 10 years so he knows my history as well as my father before he passed. I would appreciate any help for a confused man.
53 years old with long history of Prostatitis, BPH, spermatocele removed in 2016, left kidney cyst, long history of trace of blood in samples. PSA 11/2013 2.71-3/2015 2.69-8/2016 3.59-8/2017 4.12 and was referred to urologist and ran FreePSA 10.5% 8/30/17 tPSA 3.65 no DRE done due history of BPH.

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 3/7/2018 8:59 PM (GMT -6)   
Did you ask for PHI or any other test I mentioned?
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/7/2018 10:31 PM (GMT -6)   
Tall I am sorry I forgot about it in all my confusion with him pushing for biopsy. All I have done since last posting on here was I got a copy of Patrick Walsh's book and read it cover to cover. Trying to educate myself on the subject. Although symptoms do not seem to be prostatitis now, just frequent trips to rest room and some mild pain going into left hip from groin. Small stream and dribbling main issues. If understand correctly he could tell me my prostate size from the biopsy which would also help as I no idea how large it is. Just not sure the 2 flomax pills a day is doing the job anymore. I think the jump from the 3.65 and free 10.4 going to 4.79 and free going down to 9.3 is why he wants it done now since it was 6 months apart with the tests.
53 years old with long history of Prostatitis, BPH, spermatocele removed in 2016, left kidney cyst, long history of trace of blood in samples. PSA 11/2013 2.71-3/2015 2.69-8/2016 3.59-8/2017 4.12 and was referred to urologist and ran FreePSA 10.5% 8/30/17 tPSA 3.65 no DRE done due history of BPH.

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 3/8/2018 12:57 AM (GMT -6)   
Always go into doctor meetings with questions in writing - and bring someone with you to catch what you miss. It's a high stress situation and its easy to forget or miss important stuff.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

island time
Veteran Member


Date Joined Dec 2014
Total Posts : 1597
   Posted 3/8/2018 8:40 AM (GMT -6)   
Ron.....welcome to HW.....buddy, you gotta have the biopsy man. I'm sorry. I don't like tellin' people stuff they wanna hear. You've been carrying this around and studying this stuff for over 6 mos.....and if you've read Walsh's book.....you know more than 90 percent of the men who'll ever get prostate cancer.

Worrying about this...and getting different opinions....taking urine tests to figure out if you should take more blood tests to find out if you should have more tests...is gonna keep you in this...and...will tell you nothing...and.is just going to keep you where you are....in the dark. You don't wanna live in the dark. Lived there most of my life....and alot here have...and me more than most...it's not where you wanna be.

Follow you doctor's advice. FWIW.....it sounds to me as if you have a good one. He's gone further than most.....to keep from having to stick ya.

Hang in there buddy. You probably don't even have cancer. And if you do...as you've learned....it's probably slow growing and a relatively benign cancer....as cancer's go.

Take care Ron....and definitely let us know how things turn out.

Peace...and Peace to everyone..
PSA 2010 thru 2014...4.0 +/- .7
Dx 12/14 @ 56 yo...2 cores G6 <5%, 1 core G6 20%, 1 core HGPIN.
RALP 11/25/15...3+4. 3 to 5 mm surgical margin 15% involvement pT2+
PSA's....2/16-.01...4/16-.00...7/16-.00...10/16-.01...1/17-.01...4/17-.02...7/17-.02
10/17-.02...01/18-.05

Post Edited (island time) : 3/8/2018 8:03:04 AM (GMT-7)


Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/8/2018 6:10 PM (GMT -6)   
island time said...
Ron.....welcome to HW.....buddy, you gotta have the biopsy man. I'm sorry. I don't like tellin' people stuff they wanna hear. You've been carrying this around and studying this stuff for over 6 mos.....and if you've read Walsh's book.....you know more than 90 percent of the men who'll ever get prostate cancer.

Worrying about this...and getting different opinions....taking urine tests to figure out if you should take more blood tests to find out if you should have more tests...is gonna keep you in this...and...will tell you nothing...and.is just going to keep you where you are....in the dark. You don't wanna live in the dark. Lived there most of my life....and alot here have...and me more than most...it's not where you wanna be.

Follow you doctor's advice. FWIW.....it sounds to me as if you have a good one. He's gone further than most.....to keep from having to stick ya.

Hang in there buddy. You probably don't even have cancer. And if you do...as you've learned....it's probably slow growing and a relatively benign cancer....as cancer's go.

Take care Ron....and definitely let us know how things turn out.

Peace...and Peace to everyone..


Well I cannot say how much this post has opened my eyes to my situation idea Its ironic that you mentioned hes gone further than most to keep from having to stick ya as his nurse who set up the biopsy with me said she knew him well and that he had waited as long as he could to not request a biopsy but he had to do it now.

I understand completely where you're coming from about being in the dark, and I agree its not a good place to be. I am going to do the biopsy and see what happens. I will continue to monitor the forum and try to help others as much as you helped me.

I appreciate it buddy and I wish the best for you and Thanks

Ocean Geek
New Member


Date Joined Mar 2018
Total Posts : 9
   Posted 3/11/2018 8:10 PM (GMT -6)   
I agree with island time, you should get the biopsy. I had 4 of them in 3 years, and honestly they were no big deal. I was very happy to be put to sleep for the procedure and woken when it was done. Never had any real pain or complications, and it does provide some good info...
Hope all goes well for you.
03/15 PSA 18 at age 52, biopsy 3+3, prostate 90g, AS
By 11/17, PSA 25, biopsy 4+3, high-risk, Decipher 63, time to act
02/20/18 RARP, removed 126g prostate, which had 20% involved
Spared one set of nerves, pathology says we got it all.
First post-surgery PSA coming in April

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/12/2018 5:21 PM (GMT -6)   
I just have trouble believing it is cancer with my PSA so low. To be on the safe side I agree that the biopsy is the best bet and its scheduled for first week in April.
Thanks

garyi
Veteran Member


Date Joined Jun 2017
Total Posts : 964
   Posted 3/12/2018 5:39 PM (GMT -6)   
Ron...the hightest my PSA ever got was in the low 3 range and my biopsy results proved Gleason 3+3's and a 3+4 in 5 of 14 cores.

Getting a biopsy is a good idea, and if you can get a mp3T-MRI to fusion guide it, even better.

Good luck.

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/12/2018 7:23 PM (GMT -6)   
Well Thank You for your replies, and I understand that PSA's can be all over the place. I guess I learn something every time I come on here. Folks helping each other understand this crazy thing we all are going through or have gone through. Support is a great thing and it helps to hear from others. The nurse asked me if I wanted the Polaris test after the biopsy? I had no idea what it was, but she said I could wait to see what the biopsy looked like and send it in then if we had any doubts about was found. I said I would wait and see what the Dr. said after the biopsy. I have read up on the test now, and feel like its the best thing to wait and see what the Dr. says before sending it in.

samster
Veteran Member


Date Joined Oct 2011
Total Posts : 560
   Posted 3/13/2018 9:32 AM (GMT -6)   
My PSA went from 2.54 to 3.04. Biopsy indicated 6 and 7.
Low PSA does not mean cancer is not present...
Get the biopsy. You will either be left with peace of mind or know you have something to deal with.
Either way, it's better to know.
Family history of PC
Father died on 2/16/2006 about 16 years after being diagnosed. Courageous man.
My PSA 3.04
Diagnosed at 54 October 2010
3/12 biopsies 5% 10% 15%
Gleason 3+4
open Surgery February 14th, 2011 Cleveland Clinic
Dr. Eric Klein
Negative margins/lymph nodes/seminal vessels/etc.
Continent
No ED issues
Non-detectable

Lcitti3
New Member


Date Joined Feb 2018
Total Posts : 11
   Posted 3/13/2018 10:36 AM (GMT -6)   
Don't wait early detection is the key. I waited and nothing good has come from it. I'm now being treated for advanced PC and prognosis is fair at best.
1/31/18 PSA 12.9 Started hormone shots and Zytiga down to 11 in less than three weeks.
2/27/18 got first Xgena shots for bone met.
G/S 4+3=7 4+4=8 4/5=9 bone and lymph node No Pain Since Shot.
Monday 3/5/18 will receive my 2nd hormone injections=6 month until my next.

ejc61
Regular Member


Date Joined Dec 2016
Total Posts : 91
   Posted 3/13/2018 11:24 AM (GMT -6)   
Hello Ron. I thing your Uro is being pretty diligent. The biopsy process isn't bad. I was just numbed. And I know first hand PSA's can be all over the place.
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 positive; all 3+3=6;5%,5%,20%
PSA density 0.16; vol 28.8cc; T1c; non-palp DRE
bx confirmed by Johns Hopkins
OncotypeDX-GPS-19-Very Low Risk
mpMRI: 7/17 Emory/Atlanta;(2) lesions(PI-RADS 3, PI-RADS 2),otherwise none or normal results.
PSA:7/17-1.9; 10/17-2.08; 1/18-2.81
AS Program-Emory/Atlanta

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/13/2018 6:35 PM (GMT -6)   
Guys I appreciate the comments, and it is good to hear from some who have been down this road. Dr. is just doing the numbing with my procedure as well, and said he was doing 12 cores or samples. I sure hope I have not waited too long to do the biopsy but I guess it is what is if I have, I will deal with what ever the outcome is. I am reading and learning as much as I can, but my job is going to be tough for the next few weeks. Going to be out of town for several weeks and living out of hotel rooms which is not going to be fun. Hopefully we can get to the bottom of this and clear my mind with the biopsy. I do appreciate all the help and encouragement.

IsItSerious
New Member


Date Joined Oct 2015
Total Posts : 17
   Posted 3/19/2018 1:29 PM (GMT -6)   
Ron-- I'm pretty much in the same boat. The comments here helped push me to take the plunge and get the biopsy. (04/03) Better to know than keep one's head in the sand. I'll watch for your results. My email is in my profile if you want to PM.

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/19/2018 7:32 PM (GMT -6)   
IsItSerious Yes its not something I wanted but got to get it done. Mine is scheduled for 4/5 so we both got the same week. My Uro said 2 weeks for results, sounds like that will be a long 2 weeks. Good luck on yours.
53 years old with long history of Prostatitis, BPH, spermatocele removed in 2016, left kidney cyst, long history of trace of blood in samples. PSA 11/2013 2.71-3/2015 2.69-8/2016 3.59-8/2017 4.12 and was referred to urologist and ran FreePSA 10.5% 8/30/17 tPSA 3.65 no DRE done due history of BPH.

Paxton
Veteran Member


Date Joined Aug 2016
Total Posts : 1103
   Posted 3/20/2018 7:23 AM (GMT -6)   
Ron - I've been watching your journey lately. It is not that different than my own - my uro and I watched PSA and DRE's for years until my PSA went over 5. Then we went to biopsy and the rest is down there in my signature.

One point to cover with your uro. You said that he would "numb you" for the biopsy. There are different meanings for "numbing." Some just use a topical lidocaine to numb the surface. Just a bit better than nothing. I had that for my marker placement prior to radiation, and the procedure was not fun. My biopsy, on the other hand, was really a big non-issue. My uro used a peri-prostatic nerve block, which consists of a couple of scientifically-placed injections of lidocaine, into the nerves of the prostate. With this procedure, I felt literally nothing! So, ask your uro if he is using a nerve block, and if not, ask if he can. It makes all the difference in the world.
Age 68 at Dx
PSA history: 2000-2012 0.9-1.2; 06/2012 started T replacement
2013-2015 3.0-3.3 (new normal); 11/2015 4.6; 05/2016 5.7
Biopsy: 12-core biopsy 07/2016; 3 cores G3+3, 5% or less; 1 core 3+4, 15%; 1 core HGPIN; 2% of gland involved. Summary G3+4.
CyberKnife SBRT with Dr. Hirsch; start 11/15/16, finish 11/23

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 3/20/2018 11:51 AM (GMT -6)   
Paxton the nurse said they would numb my prostate with basically same shot the dentist uses. Do I need to ask specifics on the shot? Thanks for the reply

ejc61
Regular Member


Date Joined Dec 2016
Total Posts : 91
   Posted 3/20/2018 3:13 PM (GMT -6)   
I reread my procedure notes. I was given 10 ml of 1% lidocaine injected around the prostate for a prostate block. I was fine with this.
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 positive; all 3+3=6;5%,5%,20%
PSA density 0.16; vol 28.8cc; T1c; non-palp DRE
bx confirmed by Johns Hopkins
OncotypeDX-GPS-19-Very Low Risk
mpMRI: 7/17 Emory/Atlanta;(2) lesions(PI-RADS 3, PI-RADS 2),otherwise none or normal results.
PSA:7/17-1.9; 10/17-2.08; 1/18-2.81
AS Program-Emory/Atlanta

Saipan Paradise
Veteran Member


Date Joined Sep 2017
Total Posts : 789
   Posted 3/20/2018 3:35 PM (GMT -6)   
Be sure you’re getting a periprostatic nerve block (PNB), not just local anesthetic. The fact you’re getting lidocaine doesn’t tell you whether they’re doing PNB or local.
“Compared with local anesthesia, ultrasound-guided PNB has superior analgesic effect and equal safety...”
/www.ncbi.nlm.nih.gov/pmc/articles/PMC4956809/#!po=44.1176
Age 60 at dx 7/2017 biopsy G8 (4+4), 5/13 cores
RARP 8/2017 (Patel)
Post-RP path.: pT3a N0 M0, 30% tumor; EPE+, SV-
PSA 1/2016, 2.9; 4/2017, 7.2; 9/2017 (post-RARP), 0.13; 10/2017, <0.05, 1/9/2018, 0.09, 1/31/2018, 0.10, 2/9/2018, <0.05(!?), 2/23/2018, 0.08.
Eligard started 3/2/2018. SRT started 3/12/2018, 72Gy

Ron3107
Regular Member


Date Joined Sep 2017
Total Posts : 22
   Posted 4/6/2018 6:19 AM (GMT -6)   
Hello again, just a short update as to let everyone know whats going on. Had the dreaded biopsy yesterday and to my surprise if was not near as bad as I was thinking. Nurse showed me the device to take the samples and let me hear the noise it made so I would not be surprised and that helped as I would probably jumped if she had not. All is well right now, waiting on the results and going back to work out of town again Sunday afternoon. I heard her tell the Dr. my prostate size was 53 so I assume that is a little large for my age of 54. Thanks for all the help and I will update again once I get a biopsy report in 2 weeks.
Thanks
Ron
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