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bobbaily
Regular Member


Date Joined Feb 2007
Total Posts : 32
   Posted 2/3/2007 6:37 AM (GMT -7)   
age 57, in excellent health
have symptoms including: weak urinary stream, not emptying bladder, up 2 times a night to pee, painful ejaculation, burning sensation when uriniating

had a psa 2 weeks ago = 13.8
all urinalysis came back clear
saw urologist yesterday and he did dre- found nothing abnormal
he was pretty casual about the whole thing. I have no other prostate history and unfortunately I have not had tests done prior to this one

he didn't want me to do anything right now but I asked to have psa re-tested in 4 weeks and if high or higher said that I wanted a biopsy done.

does this seem reasonable? anything else I should be thinking about?
bob

naimnut
Regular Member


Date Joined Jan 2007
Total Posts : 93
   Posted 2/3/2007 7:02 AM (GMT -7)   

I do not understand why he would be casual.  It almost sounds like your dr. lacks experience with PCa. Are you in a small town in the middle of nowhere?  You are 57 with a PSA of 13.8 and your other symptoms and he "didn't want to do anything right now".  This is insane.  What does he want to do? Wait until it progresses?  !!!! What does urinalysis have to do with anything? (really, that is an honest question.)

Rather than blab on and on, like I tend to do, I'll cut to the chase. Get a second opinion. And get a new urologist.  Just my .02.

Markus



Age, 53
PSA 3.76, Gleason 6, T1c, scans negative
psa doubling time 35 months
Still researching and deciding treatment options.  Leaning towards da vinci robotic.

Post Edited (naimnut) : 2/3/2007 7:04:55 AM (GMT-7)


naimnut
Regular Member


Date Joined Jan 2007
Total Posts : 93
   Posted 2/3/2007 7:26 AM (GMT -7)   

Bob,

I apologize for my previous post which must have come across as rather alarmist. To put my response in perspective, please understand that my own diagnosis 2 1/2 months ago was completely unexpected, and life changing. My prostate cancer has been practically the only thing I have been able to think about lately. I think about it all the time. I think many of us on this board do.

So, to put your Dr.'s response in better perspective, let me suggest some "what ifs".  For example, IF you have been having your PSA tested regularly for several years and it has always been well within a normal range for your age, along with a rate of change that is within normal bounds, and IF your DRE's have all been normal (sounds like they have been) and IF a urinary tract infection can cause the PSA to spike to a level like yours, THEN perhaps his casual response is appropriate.  I guess it would make sense. I suppose the urinalysis would have  been to detect a bladder infection, right?

So, I apologize for flying off the handle like I did. Take my reaction with a grain of salt. And perhaps others can provide a more balanced perspective here...

Markus


Age, 53
PSA 3.76, Gleason 6, T1c, scans negative
psa doubling time 35 months
Still researching and deciding treatment options.  Leaning towards da vinci robotic.


SJC
Regular Member


Date Joined Jul 2006
Total Posts : 113
   Posted 2/3/2007 7:32 AM (GMT -7)   
If you have a 13.8 PSA, you are at risk for PCa.  At age 57, and in good health with an otherwise long life expectancy, I suggest you tell your urologist to schedule you for a prostate biopsy, not another PSA.  I doubt he will refuse your request.  With a 13.8 PSA at any age, you need to rule out PCa with a biopsy. 

lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 2/3/2007 7:41 AM (GMT -7)   
We totally agree with Markus and SJC - you don't want to waste time here PCa has to be ruled out! Ask for that biopsy now. In our case the PSA was relatively low (only slightly high for Bob's age at 60 and his PSA was just 3.9 at that point) A biopsy showed cancer. We did end up having laproscopic surgery 4 months following diagnosis and were told that waiting even longer would be "safe".

However, pathology report showed the first slow growing prostate cancer followed by an undetected aggressive cancer both of which were completely confined to the prostate. However, waiting any length of time longer than we did may have had a different outcome.

Please ask for that biopsy now and make your decision based on that. Keep us all posted as to your progress and good luck! You've come to the right place for support!

;o) Linda & Bob
Bob (60) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results received Nov 14th are NO MORE CANCER!  Gleason changed to a 3 + 4; cancer completely confined to prostate; (even a second more agressive, previously undetected cancer)      PSA UNDETECTABLE.   Next PSA check Feb 27, 2007.
 
Bob also takes Hydroxyurea to control Polycythemia (elevated red & white cells & platelets) has secondary condition . . Myelofibrosis) -- If anyone has experience or knowledge of these, please post us.


56pontiac
Regular Member


Date Joined Sep 2006
Total Posts : 230
   Posted 2/3/2007 8:22 AM (GMT -7)   

You are the same age I am and sound like my health excellent except for that darn elevated PSA showing up in a blood test for life insurance. Your PSA is really really high. It can be caused by an infection do a search on "prostatitis" it is very common. Did the doctor put you on any antibiotics? Before I got prostate cancer, my real good friend had a PSA of over 17 he is 55 and a truck driver so he sits on his prostate a lot. The doc put him on antibiotics and it went back down. He still has an enlarged prostate that causes problems with urinating etc. I wasn't so lucky my PSA was 4.3 and did not go down after antibiotics. I had pain when ejaculating which can be cause by an infection in my case it wasn't an infection. I have no pain when having intercourse and an orgasm now after surgery. If you aren't on any antibiotics ask the doctor why or maybe ask another doctor? If your PSA does not go down the only way to know for sure if there is cancer is a biopsy. I was scared to death about the biopsy. It is mildly uncomfortable feels like the finger in your rear for about 15 minutes and like someone snaps you lightly with a rubber band, it was no big deal and I would do it again in a heartbeat. This is not a fun deal and I know you are concerned and worried. If it turns out you do have prostate cancer it is not the end of life as you know it. Stay tuned to this forum you will find a wealth of information and encouragement. Your doctors attitude concerns me, and if he didn't prescribe any antibiotics for at least two weeks I am going to say he is incompetent or senile or both. The urine test doesn't really mean anything about your prostate gland. If he didn't mention infection in the prostate you should consider seeing a different urologist. Let us know we do care.

I am 57 years old Diagnosed with PC 8/10/2006 PSA 4.3  5 of 12 cores cancer DaVinci  Surgery 10/12/2006 cancer confined to the prostate doing wonderful with recovery almost normal in every area first PSA after surgery 0.01


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 2/3/2007 9:13 AM (GMT -7)   
Hi Bob,

I can only echo what everyone here has said. Get some more testing and be sure! My PSA went from 5.1 to 7.1 in a year and the biopsy caught the PCa. There may be other reasons for such a high reading but rule PCa out first.

Good luck and please stay with us....

Jim
Age 72. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2B. Gleason 3+4. Cancer confined to prostate.
PSA on 1/3/07 - 0.04.  Next PSA on 4/4/07.
 
 "Patience is a virtue - especially when dealing with the effects of PCa."


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 2/3/2007 9:17 AM (GMT -7)   
Relax Bob,

It is absolutely reasonable to take some time and remeasure. I assume you were given an antibiotic for what sounds like a prostate infection? If not, would you please call him and ASK him? It takes a miimum of 2 weeks, usually 4 weeks on meds to get rid a prostate infection. The Doc isn't being casual...he's being smart! If you have an infection it may be casusing the whole PSA issue. Being a good Physician, he wants to know how much of the increase will go away when you're feeling better.

bobbaily
Regular Member


Date Joined Feb 2007
Total Posts : 32
   Posted 2/3/2007 9:23 AM (GMT -7)   
he did not mention a prostate infection and did not put me on antibiotics.
bob

spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 2/3/2007 9:24 AM (GMT -7)   
Hello bob,

I agree with all the other members, and suggest a second opinion. I would have thought at the very least your urologist could have suggested a coarse of antibiotics to see if that would lower your PSA score. A PSA of 13.8 needs to be more thoroughly investigated, and it should be done promtly. Please keep us posted, and keep asking questions. We'll be here to support you.

Glen


Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. boundaries
DaVinci surgery on 02/23/06
 


56pontiac
Regular Member


Date Joined Sep 2006
Total Posts : 230
   Posted 2/3/2007 9:30 AM (GMT -7)   
Robin would say "Great Buckets of Boiling Bat Poop Batman", Get another doctor!

bobbaily
Regular Member


Date Joined Feb 2007
Total Posts : 32
   Posted 2/3/2007 9:36 AM (GMT -7)   
I studied up before going to the urologist and I got it pretty clearly that psa 13.8 wsa not good. the dre showed only a slightly enlarged prostate which the dr said was not significant. I asked about a free psa and he boohood that and said they don't work for diagnosis. I kept asking questions but he had quick answers and then flippantly said are you worried about prostate cancer and of course I said yes. he said it is highly unlikely and in his opinion a biopsy is unnecessary.
 
that's why I came here.
and yes, I am scared
bob

Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 2/3/2007 9:54 AM (GMT -7)   
bob,

If you are uncomfortable with this urologist then you should seek out another opinion. The one thing all of us that have dealt with PC agree on is that you have to have confidence in your urologist. If you already do not have it then find one that will give you that confidence. There is no need to panic but there also is no need to be going around worried and stressed out because you do not feel comfortable with your urologist's reaction to you symptons. You have to take control.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/3/2007 1:02 PM (GMT -7)   

Hi ~ Bob  *Bobbaily

 

     Thank you for reaching out to us!!!

 

                                 Sending a “Warm Welcome” …to You!

Guess What???  You came to the right place!!!  You are among friends here…

 

Being scared is normal and we can help guide you along your path ~ no matter what the final outcome is.  Just know that when and if you hear the word cancer….  We will be right here because you will feel it even more than you are right now just thinking about it!!!

 

                                                KNOWLEDGE IS POWER... and POWER conquers FEAR!!!!!

 

1st things first….  We are surprised your GP didn’t prescribe antibiotics…. and we would definitely be checking out another urologist!!  Especially since no antibiotics were prescribed for the burning sensation to rule out infections!!!  If there is still any doubt after the antibiotics ….We would then expect our urologist to order a biopsy.

 

 

Hopefully ~ we will be sending you on your way with no diagnosis of prostate cancer…. 

David’s Wife signed on and we followed her through tests that determined an infection.  Truly a happy moment for all of us!!!!  Because ~ we become a family of friends on this forum. 

 

So ~ there’s always hope ~ and something you need to remember….

”You” are important to us and we would like to follow you and

lend a Helping Hand on your search for answers.

 

Stay with us and know we care!!

Keeping you close in thoughts and prayers…

In Friendship ~ Lee & Buddy  


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

June 29th ~ PSA Less than 0.1 Non-detectable


BenEcho10
Regular Member


Date Joined Jan 2007
Total Posts : 133
   Posted 2/3/2007 2:09 PM (GMT -7)   
Hi Bob,

A PSA free test might help since it can help determine if the PSA is coming from cancer or from a benign problem such as BPH or prostatis.

Below is a quote from the website http://psa-rising.com/prostatecancer/fpsa-flowchart.htm


The free PSA test measures the proportion of free PSA to bound PSA in the total PSA in your blood sample. It's called this because PSA-f circulates in the bloodstream "unbound," without a carrier protein.

Combined with prostate volume, percent free PSA calculation helps reduce the number of biopsies based on "false positive" PSA test results. This may spare you an unnecessary biopsy.

High free PSA -- above 25% -- usually indicates BPH (benign prostate hyperplasia).

Low free PSA likely signals prostate cancer. Most men with prostate cancer have a free PSA below 15%.

If free PSA is below 7%, prostrate cancer is most likely. According to American Cancer Society and National Cancer Institute, men with free PSA at 7% or lower should undergo biopsy. If biopsy is negative but free PSA remains low, repeat biopsy is in order.


You might want to request a PSA free to help determine the source of your rising PSA score.

Ben


DIAGNOSIS: 09/25/06. Age 49. PSA 4.6. PSA free 2%. Clinical pathology: Gleason 10. Stage T2a.           
 
SURGERY: 11/08/06. RP at Johns Hopkins. Surgical pathology Gleason 10. Stage T3a (positive margins.) Negative seminal vesicles, lymph nodes, and bone scan.
 
POST OP: 12/15/06: First post op PSA was 0.00.

Post Edited (BenEcho10) : 2/3/2007 2:19:38 PM (GMT-7)


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 2/3/2007 3:05 PM (GMT -7)   
You should always start with he least invasive procedures first - in this case antibiotics. My initial PSA was 26.5 and urologist put me on large dose of Cipro for 30 days to rule out infection. The other thing to consider is that one should not engage in sex, bike riding or anything else that would stimulate the prostate for at least 2 days before blood draw for PSA. Ther'e plenty of time for a biopsy if really needed.

You should take everything you read here, including my posts, with a large grain of salt.

-Gordy

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/3/2007 3:24 PM (GMT -7)   
With that kind of attitude toward your health......I'd be looking for another Urologist. If he did finally test and found somehting. I would not want to be treated by someone that would act that way considering this is a curable cancer if you act upon it.

Good luck... KW
    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
    Gleason 7
    Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate
    RRP on Oct. 17, 2006 - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 3 weeks due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Scheduled Feb.20th Cystoscope with possible Cottigen injection into bladder neck to help control leaking.
   


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/3/2007 3:34 PM (GMT -7)   
PCa is very curable When caught early. My husband's PSA was 4.1 biopsy found cancer. My father was 49 years old when after years of being diagnosised with bladder infections and kidney infections a surgeon found his cancer by accident. He was allready in the final stages with the cancer being spread throughout his body. Don't ignore symptoms, or let your doctor. My dad's doctor is now overly cautious when anything is wrong with my family. Good Luck. Elevated PSA does not guarantee PCa, it just serves as a warning sign. Courtney
Kurt & Courtney
47 year old male
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 2/3/2007 6:17 PM (GMT -7)   
Wow Bob,

When people ask around here...whew! What service eh?

I understand you must be concerned with the symptoms you have coupled with an elevated PSA. The Doc did cover a UTI (urinary infection) with a urine test, which is good. He realizes you are concerned..because he said so! It really is a good idea to play your own advocate now by asking for a trial of antibiotics then retest your PSA. What's the harm since he wants to wait a month to retest anyway? If there is nothing going on UTI-wise, there certainly is something with the prostate. Keep in mind that most elevated PSA's turn out NOT to be cancer!! It's one of those can't hurt might help situations. All antibiotics can do is nothing, right?

Good Luck, Swim

bobbaily
Regular Member


Date Joined Feb 2007
Total Posts : 32
   Posted 2/3/2007 9:26 PM (GMT -7)   
thank you to all of you for your encouragement and information. I have decided to call the urologist on Monday and request a course of antibiotics followed by a psa in 4 weeks. If he isn't co-operative, I will go back to my GP and get a referall to another urologist.
 
I am happy with this decision, and will wait see what happens and go forward once I know if the antibiotics did the trick.
thanks again
bob

ed from pa
Regular Member


Date Joined Dec 2006
Total Posts : 42
   Posted 2/8/2007 6:06 PM (GMT -7)   

Holy Cats bobaily!!!!!!!!! Forget the antibiotics! That is one more month the killer has to live in your body. My urologist told me the same thing, and my psa was a 6, he said he is going to put me on antibiotics for a month and go from there. I said no way doc,  we are getting a biopsy done ASAP! He  agreed, and we came up with a gleason of 7. Bobaily, you have to be your own health advocate. You are just a number in the medical business. Naimnut, forget the apology, you are one hundred percent correct. You don't baby cancer, you are not dealing with the flu. Remember, cancer is a killer, and it wants to kill you. Do not underestimate your enemy. And I have had a very good day today no apologies needed. Bobaily deal with it unrelentlesly. Once you get a biopsy done at least you will know where you stand. Maybe it is not cancer, and maybe it is. Everyone on this forum has been where you are right now. No one intends to be mean spirited, everyone on this forum hates cancer!!!!!! We all react differently but with the same intention. Get cancer out of your body ASAP! Your worries will be over, get it done.

I will be praying for you,

ed from pa

Jesus Christ Big C

cancer small c

 

bobbaily
Regular Member


Date Joined Feb 2007
Total Posts : 32
   Posted 2/8/2007 6:42 PM (GMT -7)   

I am seeing a new urologist tomorrow. have planned what  I want to say and just have to see what he says.

report back here tomorrow night

it is so good to have place to come and share and be informed and be understood

cheers

Bob


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 2/8/2007 7:28 PM (GMT -7)   

Bobdaily:

Glad you are trying a new urologist! Do you have any previous tracking of your PSA to indicate how quickly it got to 13.8?  From now on keep copies of every test you have done.  If a new PSA is done, I too think a "free" PSA would be good and remember that 72 hour rule for sex, bike riding, heavy exercise and NO DRE until after blood is drawn.

Good luck on your journey and hope it's just an infection.

Dutch


bobbaily
Regular Member


Date Joined Feb 2007
Total Posts : 32
   Posted 2/9/2007 3:04 PM (GMT -7)   

I saw the new urologist this morning. He did another DRE and felt a bumpy area, he booked me right away for a biopsy which is happening next Wednesday at 5pm. He was so different from the last one, he listened to my questions, he took the PSA reading of 13.8 seriously and is proactive. This is the guy for me.

Dutch I have had no previous PSA tests, so no history and no way to see how fast it got to that, my own fault, I procrastinated. Won't do that again.

thanks to all of you who responded to my thread

will check back with you guys next week.

bob

 

 


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 2/9/2007 4:34 PM (GMT -7)   

Bobdaily:

Hip, Hip, Hooray for the new urologist!!!!  Keep us posted.

Dutch

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