Rapid rise in PSA

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newbie2007
New Member


Date Joined Mar 2007
Total Posts : 3
   Posted 3/29/2007 7:00 AM (GMT -7)   
First, all of you on this board have hearts of gold. As a newbie to this world I really appreciate this board being here. Thank you.

I am here becuase at a routine annual my PSA result went from a 1.4 in Nov 2004 to a 1.2 in Nov 2005 to a 10.1 in early March 2007 back to a 6.0 this week. DRW negative. No history of PC in either side of my family. My uro wants me in for a biopsy right away. I am quite concerned as this whole development has hit me llike a freight train. I have had a few symptoms develop like increasing frequency/urge to urniate during the day, persistent lower left back pain (although I had this back pain since 2003 after a car wreck when my PSA was pretty low). Uro has me on Levoquin(sp?) for 6 weeks. Anyone who has any insight into this wild fluctuation in PSA and whether a rush to biopsy is warranted would be greatly appreciated.

hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 3/29/2007 8:09 AM (GMT -7)   
There are other factors besides cancer that can cause a rise in PSA - such as sexual activity prior to the test.  However, in my mind, getting a biopsy is certainly the right thing to do.  It is not a painful or difficult procedure, and can let you know if you have something down there that will require treatment.  While I know it's difficult, don't let your emotions get you down.  If there is something, it's much better to find out early when it's treatable, rather than much later, when it is advanced.  Keep reading and posting once you get your results.

PSA 4.7 (up from 3.2 one year ago)
Biopsy November 8, 2006
1 of 10 cores positive 5% LEFT Side
2 others questionable (small gland proliferation)
Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology
     Stage T3a, Gleason 3+4, positive margins and
     capsular penetration RIGHT Side
Post Surgery PSA:  March 5:  0.01


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 3/29/2007 8:35 AM (GMT -7)   
Welcome to the forum newbie. Glad you decided to post.

A biopsy is really the only way to know if you have cancer or not. Hopefully not, and your rise in PSA is just prostatitis or something like that. My opinion is better to find out as soon as possible with a biopsy. At least you will know instead of having to keep wondering.

Best wishes and keep us updated!

Tanya (and Ken)
Significant other diagnosed: 10/30/06
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Da Vinci Scheduled: 4/10/07


newbie2007
New Member


Date Joined Mar 2007
Total Posts : 3
   Posted 3/29/2007 9:52 AM (GMT -7)   
Thanks hawkfan and IzzyBlizzy for the quick response. I think I will proceed with the biopsy. Although you bring up a good point. My uro suggested that a yo-yo in PSA without treatment over a short period of two weeks is usually more indiciative of prostatitis. He said he does see it in PC prior to diagnosis but nowhere near as often as in inflammation or prostatitis. I have no idea though. Has anyone heard that before?

I'll let you all know how the results turn out and what they find. I am having a 12 core sample biopsy on 4/10.

____________________________
Age 53
PSA 11/04 1.4 DRE neg
PSA 11/05 1.2 DRE neg
PSA 3/07/07 10.1 DRE neg
PSA 3/24/07 6.0 DRE neg
Bioposy scheduled for 4/10/07

Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 3/29/2007 11:01 AM (GMT -7)   
yes, and there have been "lucky" ones who have posted on here where the diagnosis ended up being prostatitis rather than cancer.  One thing to know about a biopsy is that your PSA can't be accurately tested again for 6-8 weeks (cause PSA isn't accurate after you have had a biopsy until the prostate is healed up from it).  Just curious, did you get a "free psa" test too?  Sometimes that can give the docs a bit more info. 
 
Ken has had three biopsies, over the last three years from yo-yo PSA numbers (although not as dramatic as yours) and it wasn't until the third where any cancer showed up. 
 
The other alternative would be to wait to see if the levoquin brings your PSA way down. I personally believe the biopsy is the way to go and just find out :)  But as everything with prostate cancer, it is a personal decision with lots of paths off of every step  along the way to diagnosis, treatment, etc.
 
We are having our surgery on the 10th of April, so hope your biopsy and our surgery BOTH go well :)
 
Tanya
Significant other diagnosed: 10/30/06
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Da Vinci Scheduled: 4/10/07


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 3/29/2007 11:11 AM (GMT -7)   

Newbie:

With the flucuating PSA a "free' PSA would be worthwhile if you are questioning the biopsy - if it is under 19% the biopsy would be a good idea.

When you have a PSA test remember for 72 hr prior do not have sex, ride bike, do heavy exercise and always have DRE  AFTER the blood is drawn.

Good luck.

Dutch


Diagnosed Feb 2001  (Age 65)  Currently 71
PSA 4.8
Gleason 3 + 3 = 6
T2b
Completed Proton therapy @ Loma Linda - Aug 2001
5yr PSA   0.17
Have had no side effects.


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 4/1/2007 8:42 AM (GMT -7)   

Hi ~   newbie2007   &  Loved Ones,

  

                         A   “Special”  Warm Welcome  to  You!   yeah  

 

We know ~ we can “all” make “Your Journey” smoother just by being here for you! 

This is truly a great forum!!! ~ You have joined!  You are now part our forum family ~ a group of wonderful individuals who are so willing to share...  It helps “all of us” ~ to help you ~ if we know where you are on your path. So ~ Please stay with us and take our hand when you need it!  Keep posting.... OKAY!!

  

KNOWLEDGE    IS    POWER  ...  and  POWER conquers  fear

 

YOU MAKE THE DECISIONS… YOU HAVE OPTIONS…

~ and ~

Your decision will be the right decision for you!!!

 

We invite you to visit our personal thread “Our Journey” in the signature line below.

Our thoughts and prayers will be with you as you continue to move forward with your decision. 

In Friendship ~ Lee & Buddy

 

“God Bless You”

It's a little prayer  ~  "God Bless You" ...but it means so much each day,

It means may angels guard you and guide you on your  way.

 

(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there)

Helpful Hints ~ & ~ Direct Links to Important Topic Threads ~ Hope this helps you!! :)


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

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


peeweeaz
Regular Member


Date Joined Apr 2007
Total Posts : 27
   Posted 4/1/2007 11:00 AM (GMT -7)   
I, too, am a newbie to this forum and just wanted to let everyone know how great it is to know there are folks out there willing to share their experience(s) with the dread PC word. HealingWell web site is like the Consumer Reports of health care. My PC stats of two weeks ago:
 
age - 63
PSA 4.50 (up from 3.25 in 2005 and 2.0 in 2002)
Urologist took ten biopsy samples that came back with 3 core positives in the left Apex.
Pathologist report - Gleason 3+3=6; Grade T1c.
Urologist was open-minded enough to suggest the radical or the lap dance (robotic laporoscopy), or Brachytherapy. Of course urologists will suggest surgery first because that's their specialty. Unfortunately, I have a history of Deep Vein Thromboses (yes plural) in my right calf, so surgery is risky. He said because of my normal size prostate - 25cms, I was a good candidate for Brachytherapy. Anyone had any experience with Brachytherapy?? 

biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 4/1/2007 11:16 AM (GMT -7)   
Hey peeweeaz,

Sorry you have to be here but this is the right place for support and hope.

I bumped the "Helpful Hints Page" to the top for you to use to find various topics.

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.
 
 "Cancer feeds on fear - starve it to death."


peeweeaz
Regular Member


Date Joined Apr 2007
Total Posts : 27
   Posted 4/1/2007 6:13 PM (GMT -7)   

biker90,

     Many thanks for your quick response. After roaming around the net like the Greek God, Diogenes with a lantern looking for an honest man, I'm fully aware of all the options, procedures and side effects associated with each. I was really looking for someone who has had the Brachytherapy procedure and how they made out with it. I'm in the greater Phoenix area and am now faced with evaluating the "seed-man" (radiation oncologist) to make sure he aims the seeds in the right spot. Thanks again for your support.

 

Bob

 


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 4/1/2007 6:42 PM (GMT -7)   
peeweeaz - check out Julie's Brachytherapy Journey - I've bumped it to the top for you - she and her husband tell their complete journey and it's pretty interesting and probably just what you are looking for for information.
;o) Linda & Bob
Good luck!
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 aggressive, previously undetected cancer)      PSA UNDETECTABLE November 2006 AND February 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.


djhouston
Regular Member


Date Joined Jan 2007
Total Posts : 68
   Posted 4/3/2007 1:27 PM (GMT -7)   
Hi peeweeaz and newbie,
Sorry this is happening to you, too.
Newbie, Dutch's words are sage about a free PSA. For some reason, PSA can be bound up in prostate cancer cells, and so there is less circulating. I posted a blurb from the American Journal of Family Practice that came out in 1998 or 99, that said that free PSA percent might avoid biopsies, if the percent comes out above 20 or 25 %. Mine, unfortunately was 8, and so I thought, I am toast. But my doc said no, it doesn't mean spread cancer, it just means more likely that it is cancer than infection or BPH. Try to get a free percent before the biopsy, although the biopsy wasn't as bad as I thought it was going to be.

peeweeaz, I am not a surgeon, but as anyone who has read any of my posts can tell you, I am VERY OPINIONATED about surgery vs. any kind of radiation therapy. Granted that both these doctors to be mentioned are surgeons, but you owe it to yourself to have a look at both Dr. Patrick Walsh's book on surviving prostate cancer, and Dr. Peter Scardino's Prostate Book. My doctor, again who is a surgeon, gave me the long-term statistics: 91% chance of no recurrence with surgery vs. 75% chance of no recurrence with radiation, cryosurgery, or HIFU. I worry a lot, so the extra 16% was a comfort to me.

Surgeons will tell you have surgery (if they think surgery will cure you), and radiation guys will tell you to have seeds, beam radiation, proton etc. They are all good docs, who are also trying to make a living. My standpoint is related to Hawfan's. Look up some of his posts after his surgery. Our preference is to have the darn thing out of our bodies and in a jar of formaldehyde somewhere, where we know exactly how far the cancer cells got to in the gland: in my case, contained in the capsule, and in his, unfortunately, with some penetration. Biopsy can often be an inaccurate estimate. Mine said cancer on only one side, the right and only in the base. When the post-op pathology report of examination of the whole gland (which you give up when you have radiation, as contrasted to surgery) came, I had cancer, albeit scattered small collections of cells, all over the gland. Hawkfan was likewise, except that a close examination showed the capsule had been breached.

To me, seeds and radiation are like shooting fish in a barrel, and hoping you got 'em all, without being able to see if you did. Surgery is like diving into the barrel with a net and getting everything out, while being able to look around to see that everything is out, but still worrying that there are some fish eggs that still may be left to grow up some day. One can shoot them then, if they grow up--radiation after surgery is preferable to most doctors, rather than surgery after radiation when there is radiation fibrosis (scar tissue all over the area). Seeds and beam radiation are not without their side effects, and I didn't want to deal with complications to the colon and rectum.

peeweeaz, are your DVTs gone, or are you on continuous Coumadin? I learned all about DVTs and Lovenox and Coumadin after my surgery. Prior to my surgery, my doctor's staff hounded my about wearing my TED hose and keeping my feet up and exercising after surgery, and I followed their instructions faithfully. However, they didn't ask me to wear TED gloves or walk on my hands or keep my hands up, and I got a DVT in my right ARM(!), elbow to armpit, I believe, because the nursing staff at the hospital didn't flush my IV enough after they stopped the IV fluids and antibiotics before I left the hospital. So, two days after discharge from the surgery, I was back in getting anticoagulated for the arm DVT (the first arm one my urologist had in over 2500 open and robotic prostatectomies). DVTs are a risk, I know, but maybe you can work with your internist or hematologist and a urologist to get the (IMO) less-long-term risky prostatectomy. If you get a robotic laparoscopic procedure, the blood loss is minimal- they usually don't ask you to donate your own to put it away for this kind of surgery.

Just my "high horse" thoughts, but keep us posted, guys.
dj
dj's stats:
PSA (10/04): 2.9; PSA (2/06):4.4, on Androgel (serum T about 450) at age 56; negative DRE, no symptoms.
PSA (5/06):5.7 with a free PSA% of 8, OFF Androgel (serum T 163). 
Biopsy (5/06): 4/12 samples positive; postitive samples only on right side; max Gleason 4+3=7 (in 2 of the 4 -from area nearest bladder. One was 40% of sample, the others less than a mm. thick.
DaVinci robotic-assisted laparoscopic radical prostatectomy + bladder lift + Right nerve plastic surgery (8/23/06).
Catheter out 4 weeks postop, due to internal pinhole leak at bladder-urethra junction.
Pads-Not needed after about 2 weeks post-cath, but gotta go a lot more often.
Final pathology report:T2c-both sides,but in capsule; neg. margins, neg. lymph nodes, neg. seminal vesicles; final max Gleason still 4+3=7.
1st Follow-up PSA (11/7/06): <0.008 !!!; serum T: 195 - still OFF Androgel (at present). Low T may delay return of erectile function (in presence of one damaged nerve).
2nd Follow-up PSA (3/19/07): <0.003 !!!; serum T: pending
Testosterone Level (3/19/07): 163, down from November 2006!
Uro-Endocrinology Consult (3/28/07): Prescribed Testim gel 1% once a day, and recheck PSA and T-level in a month.
 


newbie2007
New Member


Date Joined Mar 2007
Total Posts : 3
   Posted 4/3/2007 1:46 PM (GMT -7)   
Thanks all for the great input. I often feel I get better explanations from these forums than I do from doctors.

I did not ask for a free PSA test because I did not know. None was offered. But makes sense to me.

My Uro gave me the choice of a 45 day course in antibiotics then retest or biopsy now. I opted to schedule a 12 core biopsy. For those interested I have been on antibiotics about 8 days. I actually believe I am experiencing an improvement in symptoms. But it could all be in my head.

Question: is a PSA test right before biopsy always indicated? My Uro offers a 20 minute response time to a PSA test in his office. He said it is up to me and if by chance my PSA dips down below 2.5 (from a 10.1) he would suggest aborting the biopsy -- at least for the time being. Anyone ever heard of this strategy?

Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 4/3/2007 3:24 PM (GMT -7)   

Newbie:

Never heard of a turn around time on a PSA test that fast.  If it is that fast why not the "free" PSA test now which might give you the answer you are looking for.

Dutch


Diagnosed Feb 2001  (Age 65)  Currently 71
PSA 4.8
Gleason 3 + 3 = 6
T2b
Completed Proton therapy @ Loma Linda - Aug 2001
5yr PSA   0.17
Have had no side effects.


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 4/3/2007 3:26 PM (GMT -7)   
peeweeaz:
 
Since surgery would possibly be a problem you might want to research proton.  There are several proton threads here (check Bluebird's post above) and you can check out www.protonbob.com.
 
Best of luck
 
Dutch


Diagnosed Feb 2001  (Age 65)  Currently 71
PSA 4.8
Gleason 3 + 3 = 6
T2b
Completed Proton therapy @ Loma Linda - Aug 2001
5yr PSA   0.17
Have had no side effects.


peeweeaz
Regular Member


Date Joined Apr 2007
Total Posts : 27
   Posted 4/3/2007 4:37 PM (GMT -7)   

DJ, Dutch, lawink,

You guys and the rest of the posters are great sharing your venture into world of prostate cancer. DJ, you should have gone into medicine. I've never seen such extensive research that you apparently have done. I'm in awe.  I've done a little research into Proton Thearpy and, although it looks promising, I understand it's done only in about nine centers throughout the country and is still considered experimental. The closest one to me would be California. Not having unimited funds to travel around the country looking for the perfect cure, I'm going to have a consult with a radiation oncologist next week to ask (to put into DJ's words) how good he is at "shooting fish in a barrel".  Re my past DVT problems, my urologist said he wouldn't do the surgery without the consul of a hematologist. However, even if the blood man were to give his ok, if you have a pulmonary embolism on the operating table, you're toast. This way if the "seed guy" misses I may have to wear Depends or a colostomy bag (God forbid), but I'm still above the ground.  I'll keep everyone posted and thanks again.

Bob


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 4/3/2007 5:07 PM (GMT -7)   

Dear Peeweeaz,

Do all the research that you can manage.  Be very aware that survival statistics that you read (surgery v. radiation) are very unreliable.  IMRT has had limited availablity for about 10 years.  IGRT has had limited availability for much less time.  When you read numbers for long term survival rates for radiation, they are simply not meaningful.

Please read JustJulie's thread.  It's most informative and well written. 

Best of Luck to You,

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!
Began IGRT January 23, 2007. 

Post Edited (jetguy) : 4/3/2007 6:11:22 PM (GMT-6)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 4/8/2007 7:22 PM (GMT -7)   

Hi ~ Newbie,

         Biopsy on Tuesday…..

                  Thinking of you and wanted you to know!!! 

 

In Friendship ~ Lee & Buddy

 

Post edited to delete signature line only

Post Edited (bluebird) : 6/26/2007 8:24:41 PM (GMT-6)


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 4/9/2007 5:54 PM (GMT -7)   

Bob:

Just to correct your statement in your 4-3-07 post - proton IS NOT experimental.  Loma Linda has been doing proton for Pca since 1990 - there is a 15 yr study - Medicare (as well as most major insurance companies) covers proton and Medicare will not cover an experimental procedure.

 

Dutch

 



Diagnosed Feb 2001  (Age 65)  Currently 71
PSA 4.8
Gleason 3 + 3 = 6
T2b
Completed Proton therapy @ Loma Linda - Aug 2001
5yr PSA   0.17
Have had no side effects.


peeweeaz
Regular Member


Date Joined Apr 2007
Total Posts : 27
   Posted 4/9/2007 7:13 PM (GMT -7)   

Dutch:

I stand corrected. I think most of us who have extensively researched various treatment options for our condition would agree that, rather than experimental, proton therapy is probably the wave of the future. I guess what I was trying to say was until more treatment centers are established and up and running, it is probably out of reach for those of limited financial means. I notice many of the testimonials from those who have had proton therapy are doctors who, most of would agree, are not of limited financial means. I'm happy that you were able to receive the therapy and apparently are doing quite well as of this time.

Bob


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 4/9/2007 7:46 PM (GMT -7)   

    I think I would have the biopsy just to be sure.  It really isn't that uncomfortable or painful.

    Good Luck with your Journey.

    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.
    Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)
    Dr. said everything looks fine.  Continue to work Kegeal's. Leaking appears to have improved  after Cystoscope?!?!?!  Down to 3-4 pads per day!
    March 1st  Leaking has crept back up to 6 - 8 pads a day ??????? 
    March 8th Started Detrol LA to see if it helps with the leaking?
    March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking.
    Return office visit May 2nd unless leaking starts agian.
    May 22nd Follow up and 3rd Post Op PSA
   


M. Kat
Veteran Member


Date Joined Jul 2006
Total Posts : 715
   Posted 4/10/2007 4:41 AM (GMT -7)   
Newbie - best wishes today as you have the biopsy. don't be surprised to see blood in your urine and semen for a while after this. take care and we'll all be anxiously waiting along with you for your results. kat
Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test <0.1, 2nd post-surgery PSA test <0.1, 3rd PSA <0.1
no more pads Oct 12, 2006
first "real" erection with use of pump 12/16/06
3/07 - occasional dribbles and erections with Cialis and pump


myman
Veteran Member


Date Joined Feb 2007
Total Posts : 1219
   Posted 4/10/2007 4:50 AM (GMT -7)   
Newbie - Good luck today, we'll be awaiting your news.

All the best,
Susan
Husband Diagnosed 11/17/05 Age: 63 No Symptoms
PSA: 7.96, Positive DRE
Biopsy Right: 6 of 6 Cores Positive Biopsy Left: 1 of 6 Cores Positive
Gleason: 4+3 = 7 Stage: T2B N0 MX
2/09/06: LRP Restage: T3A NX MX
3 mo. PSA Post Surgery: 11.8, 12.9, 13.9 Bone scan, CT scan, Endorectal MRI, Chest XR - neg.
9/06/06: 6 mo. PSA: 18.8 CT shows lymph node involvement Start HT Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07 - PSA 0.3


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 6/26/2007 7:23 PM (GMT -7)   

Hi ~ Newbie,

Thinking of you!

Just a little note to let you know we are right where you left us!!!  Holding your hand.

You reached out once ~ please let us know how you are doing.  Hope to hear from you soon….

We continue to keep you in our thoughts and prayers. In Friendship ~ Lee & Buddy


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 6/30/2007 4:49 PM (GMT -7)   
  smurf   Newbie,

                                                  chirp~chirp~chirping….. 

      Where are you!!!!!????? 

            We need you … So ~ please  touch base soon…. yeah  

                 You reached out and we all took your hand... we haven't let go!!!!

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