When to do second biopsy- general questions free psa complexed psa

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sportsfan2000
New Member


Date Joined Mar 2006
Total Posts : 13
   Posted 12/2/2006 3:11 AM (GMT -7)   
I've gotten a lot of help from this group in the past, and I appreciate it.
I'm 59. .  Last year I had a rise in PSA to 5.4 (history below) , and eventually after
Levaquin and waiting, ended up with a biopsy at the end of March. 
 
Biopsy was part of a clinical trial testing new contrast enhancer for ultrasound directed biopsy.
I went with the trial because it seemed a win-win.
Whatever happened, I got a standard  biopsy, with directed biopsies in suspicious areas.
End result of biopsy (with 14 samples, some directed) was "no CA, but in "right
upper transition zone... mild chronic inflamamation consistent  with focal
chronic prostatitis.  No tumor identified."

Last PSA, a few weeks ago, was 3.9.
Internist's recommendation is 2 weeks Levaquin, wait a few weeks, repeat PSA, and .. hope for
the best.
I'm also going to try to get free PSA and complexed PSA, though our lab doesn't do free PSA if PSA is less than 4.0
I believe I read that Dr. Catalona recommend waiting a year between biopsies, but I'm not sure I want to do that.

If the PSA doesn't come down I'll go to a urologist, I"m just trying to prepare myself for next steps.
I"m in the PA area, so, if surgery becomes necessary am thinking of Dr. Tewari in NY, Lee in Philadelphia.  Though I personally like  Jefferson University Hospital in Philadelphia,  I don't know of any prominent specialists there.
 
Thoughts, comments are appreciated.

Thanks Ed

PSA history
11/10/2006 3.9
3/20/2006  2.8
1/11/2006 2.5
11/2005 1.9
9/2005 5.4
1/2004 1.6
2/2002 1.5
6/2001 1.2
10/2000 1.1
9/1999 1.0

jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 12/2/2006 6:56 AM (GMT -7)   

Hi Ed,  I think you have more knowledge of this than I, but I'd get a free PSA done and if it was less than 25% I'd go to a urologist.  Actually, I'd go to a urologist anyway.  My two cents worth.

Regards,

Bill


Gleason 3+3=6, T1c, one core in twelve, another pre-cancerous.
62 years old and good health.  Married 37 years.  To same woman!


sportsfan2000
New Member


Date Joined Mar 2006
Total Posts : 13
   Posted 12/2/2006 8:42 AM (GMT -7)   
Bill,
 Thanks .  I forgot to add that I did see a urologist last year.  His recommendation triggered the first biopsy when the PSA hit 2.8.
I agree, unless my PSA drops significantly , I'll see another urologist.

Thanks again,
Ed
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