New and have questions regarding high psa and low fpsa

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Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/1/2018 1:10 PM (GMT -6)   
Posting for my husband. He had a wellness exam for life insurance thru his employer in Dec. We received a letter last week. He was denied due to his PSA levels. His PSA was 6.6 and his FPSA was 5% He is 48 years old and for the past year and half has had some difficulty with urine flow. He mentioned to his GP over a year ago and was told it was most likely due to him nearing 50 and getting older. He had recently been assigned a new Dr after his had left the clinic. He has had normal dre's performed in past but not since mentioning to this new Dr. He has made an appt with a urologist for next week. We are so scared. I am in the middle of fighting stage 2 breast cancer. Can anyone give us some hope that this may not be as bad as it seems.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4089
   Posted 1/1/2018 1:37 PM (GMT -6)   
Hello Blackcoal and welcome. The flow issues are possibly a result of an enlarged prostate. Rarely does prostate cancer exhibit any symptoms in the early states and with your husband's PSA level. Most likelly the urologist will do another DRE and possibly put your husband on a round of antibiotics in case the PSA level is due to an infection. However don't be surprised if he prescribes a prostate biopsy as the FPSA level would indicated an increased chance of prostate cancer. If the biopsy is suggested please come back here for some advice on that procedure and to learn what to expect.

We are ahead of ourselves to talk about him having cancer and I hope it's not the case. However, if it is, please know that most of us who have this disease are successfully treated with many of us totally cured. It's a slow growing cancer and you guys will have plenty of time to study your options.

Stick with us and we will help you through this.

Jim
Forum Moderator-Prostate Cancer. Age 62 (71 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-9 yr: 1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1

Jack & Diane
Regular Member


Date Joined Sep 2016
Total Posts : 102
   Posted 1/1/2018 2:24 PM (GMT -6)   
Blackcoal,

I'm so sorry that you are going through this at the same time you're fighting breast cancer. You must be an amazingly strong woman.

So much about what you wrote reminds me of our story. We went through the discovery of an elevated PSA (very similar to your husband's PSA) and low FPSA at the age of 48 as well. We were never given any antibiotics, just straight to a biopsy (first one came back negative by the way) and went on to find he did indeed have PCa. I'm very thankful for the PSA test I randomally asked for for him.

Hopefully there is another cause for your husband's PSA, but I want to tell you that if it is PCa just as Jim stated above, many, many men are successfully treated.

Another very important thing Jim said is to make sure you stick with us here on HW. I cannot tell you how valuable this forum has been to me. If I did not find this place, I would have lost my mind and not been able to be there for my husband. You will find support and knowledge here that you will not get from the doctors.

If there is anything at all I can share with you about our journey so far please ask! I am always here!

Please keep us updated!
Wife posting for spouse - 49, age at dx 48
06/2016: PSA 6.48
07/2016: PSA 7.22 FPSA 10% 12 Core Biopsy Negative
10/2016: PSA 6.30 FPSA 13%
12/2016: MRI W/COIL PI-RADS 5 with Probable EPE, Bones/LN Clear
12/2016: Biopsy Two cores 3+4 and Seven cores 3+3
02/2017: RP at University of Chicago Pathology 3+4 Grade 4 component is 5%
Prostate: 32.7 gm Tumor Volume Estimate: 35%
No EPE or lymphovascular invasion 13 lymph nodes, Seminal vesicles, vasa deferentia, no tumor present
High grade prostatic intraepithelial neoplasia, Perineural Invasion: Present
Tumor involves proximal basilar margin of 2.0 mm Gleason at margin is 3 pT2c,N0,MX,R1
04/2017: 6 Week PSA <0.01
05/2017: 3 Month uPSA <0.006
8/2017: 6 Month uPSA <0.006
11/2017: 9 Month uPSA 0.014 12/2017 Re-test 0.012
100% Dry

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/1/2018 3:00 PM (GMT -6)   
I have been strong for the past 9 months as I went thru surgery, chemo and now radiation. Not feeling very strong right now. It just feels like this nightmare will never end. I pray I don't have to tell our children their dad also has this crapty disease. They lost an aunt to pancreatic cancer this year as well.

Post Edited (Blackcoal) : 1/1/2018 2:20:40 PM (GMT-7)


Jack & Diane
Regular Member


Date Joined Sep 2016
Total Posts : 102
   Posted 1/1/2018 3:40 PM (GMT -6)   
Try to take this one step at a time. Right now he has an elevated PSA and the next step is to figure out why. Focus on keeping yourself well and we will help and guide you through whatever comes next. I promise, you are not alone and I understand what you're going through.
Wife posting for spouse - 49, age at dx 48
06/2016: PSA 6.48
07/2016: PSA 7.22 FPSA 10% 12 Core Biopsy Negative
10/2016: PSA 6.30 FPSA 13%
12/2016: MRI W/COIL PI-RADS 5 with Probable EPE, Bones/LN Clear
12/2016: Biopsy Two cores 3+4 and Seven cores 3+3
02/2017: RP at University of Chicago Pathology 3+4 Grade 4 component is 5%
Prostate: 32.7 gm Tumor Volume Estimate: 35%
No EPE or lymphovascular invasion 13 lymph nodes, Seminal vesicles, vasa deferentia, no tumor present
High grade prostatic intraepithelial neoplasia, Perineural Invasion: Present
Tumor involves proximal basilar margin of 2.0 mm Gleason at margin is 3 pT2c,N0,MX,R1
04/2017: 6 Week PSA <0.01
05/2017: 3 Month uPSA <0.006
8/2017: 6 Month uPSA <0.006
11/2017: 9 Month uPSA 0.014 12/2017 Re-test 0.012
100% Dry

TennFarmBoy
New Member


Date Joined Jan 2018
Total Posts : 1
   Posted 1/1/2018 4:37 PM (GMT -6)   
Hello....A newbie here. 56 years old, and dealing with some issues that involve, stop and start urination, forced urination, lower back pain, painful testicles, painful/burning urination. Had a PSA done in Feb 2017, with the result of 1.59, a second PSA in July 2017, result 1.88. In October 2017, I began having most, if not all of the aforementioned symptoms, visited my Nephrologist, for routine visit. With labs and urine culture, it was found I had a UTI, was given two weeks antibiotics, but some of the symptoms continued. On Dec. 29, 2017, I visited my Infectious Disease Specialist (I have been living with HIV since 1991). He did labs, an additional Urine culture, along with a PSA. The culture shows no bacteria found in regards to continued UTI. A DRE was done, with no abnormal findings, even though I felt some tenderness. The PSA is at 4.88. Perhaps this could be due to UTI I had????
Am waiting to see what, if any further evaluation will be done to see if all this is just a "blip" or, should I be concerned that it could possibly be PC. My late Father dealt with prostate issues, and was suspected to have had PC, but due to having Alzheimer's he was not subjected to a biopsy, or further testing to confirm. I also have an older brother is dealing with ongoing elevated PSA levels, nd symptoms similar to mine. He is 61 years old. Just waiting and wondering here.

Bobby Mac
Veteran Member


Date Joined Mar 2016
Total Posts : 691
   Posted 1/1/2018 5:44 PM (GMT -6)   
The 5% fPSA is troubling - further blood tests and biopsy should be considered-

Bobby Mac
Age: 69 at PC dx, PSA 6.7 Biopsy: 2/16 13 of 14 Positive, - RALP 4/16 Path:EPE, 2 + margins, Gleason 4+3=7, 50% of gland, Stage pT3a N1, nodes 2/10,+, 68 Ga PSMA 8/16 left node +, bed +, Lupron 8/16 - 6/17, Firmagon 7/17, uPSA 6/16, 2.41, SRT completed 12/16, PSA 6/2016, 2.6, 7/16, 2.2, 8/16 .6, <0.1. since 10/16, 1/17 T=43 5/17 T=34, 6/17 T=25, 7/17 T=25, 9/17 T=48. 12/17 T=11

Saipan Paradise
Veteran Member


Date Joined Sep 2017
Total Posts : 509
   Posted 1/1/2018 6:11 PM (GMT -6)   
TennFarmBoy said...
Hello....A newbie here. 56 years old, and dealing with some issues that involve, stop and start urination, forced urination, lower back pain, painful testicles, painful/burning urination....

Welcome, TennFarmBoy, and thank you for posting. Because you’re seeking advice for your own medical condition, it should have a separate thread from blackcoal’s, even though the topics — high PSA — are related. That way each of you can get responses tailored to the particular facts you’ve presented. I’ve taken the liberty of starting a new thread for you.
Age 60 at dx
Dx July 2017 after biopsy G8 (4+4), 5/13 cores, bone scan clear
RARP Aug 11, 2017 (Dr Patel)
Post surgery pathology: pT3a, tumor 30% of gland; EPE+, SV- and 3 lymph nodes clear
PSA 1/2016, 2.9; 4/2017, 7.2; 9/25/2017 (first post-RARP), 0.13; 10/10/2017, <0.05

island time
Veteran Member


Date Joined Dec 2014
Total Posts : 1438
   Posted 1/2/2018 1:02 AM (GMT -6)   
got your hands full sounds like black coal! CANCER.. scary word. Sorry to hear of your troubles. FWIW...my sister had stage 2 breast cancer and had a lumpectomy at MDAnderson when they first began doing them. (32 years ago) Then she came home and had radiation at the local hospital. She was 30 at the time. She's 62 now.....and except for a partial knee replacement and being half crazy (you know those "crazy aunts"?.....that's her....but in a fun way smile.....she's healthy as ever. It seems like a lifetime ago.

Well....everybody's been healthy as an ox until 2 years ago.....when her husband was diagnosed with Prostate Cancer. His PSA was 20. No matastisis. It's now completely undetectable and the guy works like a horse. (I think he's thinking of retirement soon....but....that's neither here nor there)

Point being.....you've read about all there is to know about prostate cancer on the web by now. so...you don't have to be told that *if* your husband *is* diagnosed with some sort of prostate cancer.....95% of the time the survival rates are over 5 years. (the vast majority of most...*much* longer.....)

No one likes messing with medical stuff. (what a hassle!) It's inconvenient as all get out. Not to mention the emotional turmoil.....which....with what we''re dealing with here....could be argued that.....for the most of us.....is the most difficult part. And....*that* is where you find yourself. In the emotional turmoil. That's a very different thing from your husband not being diagnosed.....and even if he is.....it's almost a surety he'll be around for years to come....if not probably cured completely.

This is where I come for perspective. Many of us do tend to think worst case scenarios. And that messes with our heads. It rarely is worst case scenario. The people here...and my doctors.....keep reminding me that I'll live to be an old man......unless I get hit by a bus first.

(Why is it that....getting hit by a bus sounds so nice all of the sudden? sad)

Everything's OK. Your husband.....*if* he has prostate cancer.....will deal with that....when....and *if*....the need arises.

You've got another week or two of worrying about this. I hate it for ya....but....heck...I can't take that from ya. If I could...I would.

Take care blackcoal ....

Your husband'll be fine. either way.....

smile
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+
2/16-.01...4/16-.00...7/16-.00...10/16-.01...1/17-.01...4/17-.02...7/17-.02
10/17-.02

Post Edited (island time) : 1/2/2018 12:39:06 AM (GMT-7)


fiddlecanoe
Regular Member


Date Joined Oct 2016
Total Posts : 274
   Posted 1/2/2018 11:10 PM (GMT -6)   
Welcome, Blackcoal. You've been through a lot, so, if for the reason alone, I hope all the news from here on is good. A couple of things to keep in mind. First, a PSA test is NOT a test for cancer. Second, poor urine flow is NOT normally an indicator of prostate cancer. Third, an enlarged prostate causes both poor flow and an elevated PSA. Try to relax and take it one step at a time.
Age: 62
Diagnosed in July 2016 with G7 (4+3) PC & PNI
Bone & CT scans clear
Surgery at Lenox Hill Hospital in NYC, 9/12/2016
Post-surgery pathology showed G7 (3+4), with SVI and PSM
Lymph nodes clear
First post-surgery PSA October, 2016: <.008
Second post-surgery PSA December, 2016: 0.01
Third post-surgery PSA June 2017: 0.05
IMRT begun: July 18, 2017 (35 fractions)
Post-SRT PSA, 11/17: <.008

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/3/2018 9:04 AM (GMT -6)   
Thank you for the replies. They have been reassuring. The hardest past is the stress and anxiety these results have again created for us. It seems like we just finished going thru all of this and now it is happening all over again. Anxious for his appt next week.
I have read that inflammation of the prostate can affect fpsa. Thoughts?

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4089
   Posted 1/3/2018 10:40 AM (GMT -6)   
You are correct...chronic prostatitis can lower FPSA. As I indicated earlier, your urologist may try to treat for infection prior to moving to biopsy -- especially in a relatively young man like hubby.

I understand your anxiety. Hopefully the urologist appointment will help alleviate some of your concerns.

Jim
Forum Moderator-Prostate Cancer. Age 62 (71 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-9 yr: 1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/3/2018 11:13 AM (GMT -6)   
Thank you Jim. Helps so much. He has no family hx of any type of cancer either.

Jack & Diane
Regular Member


Date Joined Sep 2016
Total Posts : 102
   Posted 1/3/2018 9:30 PM (GMT -6)   
BC,

When is his appointment?
Wife posting for spouse - 49, age at dx 48
06/2016: PSA 6.48
07/2016: PSA 7.22 FPSA 10% 12 Core Biopsy Negative
10/2016: PSA 6.30 FPSA 13%
12/2016: MRI W/COIL PI-RADS 5 with Probable EPE, Bones/LN Clear
12/2016: Biopsy Two cores 3+4 and Seven cores 3+3
02/2017: RP at University of Chicago Pathology 3+4 Grade 4 component is 5%
Prostate: 32.7 gm Tumor Volume Estimate: 35%
No EPE or lymphovascular invasion 13 lymph nodes, Seminal vesicles, vasa deferentia, no tumor present
High grade prostatic intraepithelial neoplasia, Perineural Invasion: Present
Tumor involves proximal basilar margin of 2.0 mm Gleason at margin is 3 pT2c,N0,MX,R1
04/2017: 6 Week PSA <0.01
05/2017: 3 Month uPSA <0.006
8/2017: 6 Month uPSA <0.006
11/2017: 9 Month uPSA 0.014 12/2017 Re-test 0.012
100% Dry

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/4/2018 10:05 AM (GMT -6)   
This coming Monday

Jack & Diane
Regular Member


Date Joined Sep 2016
Total Posts : 102
   Posted 1/4/2018 10:55 AM (GMT -6)   
Ok, we will be keeping both of you in our prayers. Let us know the results when you get them.

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/4/2018 10:59 AM (GMT -6)   
Thank you

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/9/2018 2:30 PM (GMT -6)   
Update: psa was now 6.8 Up from 6.6, 1 month ago. Not sure if they tested free psa this time. DRE was normal, smooth with no lumps. Will have a biopsy scheduled.

Jack & Diane
Regular Member


Date Joined Sep 2016
Total Posts : 102
   Posted 1/9/2018 6:35 PM (GMT -6)   
Thank you for the update. Hopefully the biopsy will provide some answers. Our first one was negative even though there was a lot of cancer in there. My husband's PSA went up and then down a bit as well. His FPSA actually improved slightly (from 10% to 13%) right before they found the Pca. He was never given any antibiotics.
Wife posting for spouse - 49, age at dx 48
06/2016: PSA 6.48
07/2016: PSA 7.22 FPSA 10% 12 Core Biopsy Negative
10/2016: PSA 6.30 FPSA 13%
12/2016: MRI W/COIL PI-RADS 5 with Probable EPE, Bones/LN Clear
12/2016: Biopsy Two cores 3+4 and Seven cores 3+3
02/2017: RP at University of Chicago Pathology 3+4 Grade 4 component is 5%
Prostate: 32.7 gm Tumor Volume Estimate: 35%
No EPE or lymphovascular invasion 13 lymph nodes, Seminal vesicles, vasa deferentia, no tumor present
High grade prostatic intraepithelial neoplasia, Perineural Invasion: Present
Tumor involves proximal basilar margin of 2.0 mm Gleason at margin is 3 pT2c,N0,MX,R1
04/2017: 6 Week PSA <0.01
05/2017: 3 Month uPSA <0.006
8/2017: 6 Month uPSA <0.006
11/2017: 9 Month uPSA 0.014 12/2017 Re-test 0.012
100% Dry

Blackcoal
New Member


Date Joined Jan 2018
Total Posts : 8
   Posted 1/24/2018 2:48 PM (GMT -6)   
Just wanted to post an update on husband. He had his biopsy and received results...negative for cancer. His urologist said his prostate is very large for a man his age so that is concerning. wants to see him again in 6 months. Thank you again for your advice and prayers. I finish radiation this week. It truly feels like we can begin to cautiously move forward again.

Post Edited (Blackcoal) : 1/24/2018 2:04:46 PM (GMT-7)

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