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Posted 5/8/2008 4:41 PM (GMT 0)
hi, im so glad i found this place. first off, i wish all you pca people nothing but my best wishes.here is my question. my father who does not have pca has been urging me to get a psa test. i turned 45 so to shut him up i made an appt. with my dr.test comes back my first ever psa 4.5.my dr says no big deal im going to refer you to a great urologist just to be sure get it checked out.the uro gives me the dre exam and says everything feels fine but your psa number is to high for your age so i want to do a biopsy. i cant even ask a question and he hustles me out the door and gives me a 6 week from now biopsy appt. i got the impression this dr biopsys everyone who walks thru the door it was a wierd feeling


now i never get to tell him ive had prostatitis on and off since my early 30's. since i got the results from my dr i have been doing a lot of research on this learning that sex should be abstained from for 72hrs prior. i had sex 72 48 24 the morning of the test i didnt know. i wanted to tell the guy based on this info and its my first test is not a biopsy a little harsh. why cant i redo the test a 2nd time doing it right this time. also i do have an enlarged prostate right now this is the time of year i guess lol. my wife thinks i should just get it to find out for sure. im really confused. any help you good people could recommend would be great.

thx again and the best to all of you

rick
Posted 5/8/2008 4:59 PM (GMT 0)
If it were me, I would call about trying a course of antibiotics and retest. However, with that being said, I agree with your wife. Why not rule out cancer? Hopefully it is nothing, which your PSA could be elevated from an infection, but there is always the "what if". I haven't heard the sex thing regarding PSA testing. My dad's PSA was only a 5.5 and he has cancer that has spread outside the prostate. In my opinion, you are better safe than sorry.

PS. The biopsy, which my father was really upset he even had to get done, was not as bad as he expected. No pain in his case.

Good luck!
Posted 5/8/2008 5:18 PM (GMT 0)
Hi seekeroftruth,

Welcome to the best PC site in the world. Sorry that you have to be here.

What have you got to loose by getting the biopsy done? If you decide against it, you'll wonder for ever whether you did the right thing or not. If the biopsy turns out negative you'll have peace of mind and can go on with your life without worry. If they detect any cancer early, it can be treated quite successfully in most cases. 

My biopsy was scary, but uneventful and virtually painless and only slightly uncomfortable. It takes 15 minutes and it's all over - no big deal (we're all a bit different, but that was my experience).

Good luck with your decision and all the best to you in your future.

Magaboo

Posted 5/8/2008 5:22 PM (GMT 0)

How recently have you had prostatitis?

If recently, then that could in fact be the cause of your high PSA (and over 4 for a man as young as you IS high).

If this were me, I would do one of two things:

1. Schedule another appointment with the urologist and talk with him about your medical history....and possibly ask for a few weeks of antibiotics if in fact you believe this is related to prostate infection, or

2. Have the biopsy done.  Your wife's statement is absolutely correct.

Posted 5/8/2008 5:29 PM (GMT 0)
Hi Seekeroftruth,

My husbands PSA was up for a few months. They tried 2 rounds of antibiotics and then on to the biopsy because as you can see from his signature, it didn't go down. He was worried about having the biopsy done but it was painless. It was alittle uncomfortable but he walked out of the doctors office and just rested that day. I for one think its extremely important to get the biopsy. What can it hurt? Its best to know and then you can make your decisions from there.
It does seem sometimes with doctors that you can be one of a million in an assembly line. If you are not happy with your doctor or surgeon, then find someone else. Peace of mind starts with your trust in the person that will be taking care of you. It will help you in making your decisions in the future.
Cindy
Posted 5/8/2008 6:11 PM (GMT 0)
I thought like you did. This is just overkill. I was wrong. You paid your doctor big bucks to give you professional advice. I would take it and if it comes back negative come back and brag about it and we will pat you on the backa nd you can stop worrying about it.
Posted 5/8/2008 6:16 PM (GMT 0)
I was 47. a PSA for you should be .5-1.2 or somewhere around that. a High PSA after sex, should be 1.3-1.9. 4.6 for a guy in his late 50's-60's may be no big deal.
An enlarged prostate, prostatitis, all these things might cause it, sure. But it's not worth the risk.
Why would you not want the peace of mind that that is all it is? If you don't get a biopsy, you are enter the world of not knowing, even denial that it could be something.

Mine was 4.6 and every doc pretended it was no big deal, nothing to worry about, just do the biopsy, they said. With a little research I found out that for our age, it was really high.
A biopsy is not that bad. Just do it, as Nike says. Why wouldn't you? You've got nothing to lose - and everything to lose.
Paul
Posted 5/8/2008 6:21 PM (GMT 0)
Hey Seeker,

Welcome here. You will finds lots of support and information from folks that have "been there, done that".

One thing we all agree on is that we must take control of our journey. Whether it be PSA testing, biopsies or treatment for PCa, we all learned that any one doctor isn't the last word and second opinions are always needed in order to make an informed decision that we are comfortable with.

If your urologist is too busy to talk to you, get an new one. At every appointment, take with you a list of questions you want answered and insist that they get answered then and there. Take someone with you and write down the answers. Two people are needed in order to sort out the information.

You are placing your life in these people's hands and they have a responsibility to do their best to meet your expectations. Besides, you are paying his bills.

Please stay with us...

Jim
Posted 5/8/2008 7:27 PM (GMT 0)
Rick:
You sound just like me. No cancer in my family, history of prostatitis, enlarged prostate, sex before my PSA, ran 5 miles the morning of my physical, even had a negative biopsy performed 5 yrs. ago ... I was just looking for reasons not to go through another biopsy. Now I'm very glad I went through with it.

One thing that changed since the last biopsy - my urologist no longer performs biopsies in his office, but rather does them at a surgical center that specializes in minor outpatient procedures. In my case, because I was experiencing urinary obstruction symptoms, he also wanted to do a cystoscopy to get a look at my bladder. So I asked if I could get the kind of anesthesia (MAC*)that's typically given for colonoscopies instead of a local anesthesia like I had the last time. I liked this method much better - woke up after it was all over.
(By the way, no reflection on this urologist, but I found another to do the surgery when I was exploring options after my diagnosis).

For peace of mind for you and your wife, get the biopsy done. I wish you the best of luck and hope you get good news. (Of course, that would also mean you wouldn't be visiting this forum anymore, but that's our loss, not yours).

John

*Like general anesthesia, MAC uses sedatives and other agents, but the dosage is low enough that patients, remain responsive and breathe without assistance. MAC is often used to supplement local and regional anesthesia, particularly during simple procedures and minor surgery. http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijh/vol1n1/mac.xml :-)
Posted 5/8/2008 7:41 PM (GMT 0)
I agree with all replies. What do you have to lose. The biopsy is not bad, it took about half hour for the whole procedure and I went back to work after the biopsy. Hope you come to the correct decision.

Kris
Posted 5/8/2008 8:14 PM (GMT 0)
hi you people are the kindest most compasionate bunch i have ever met. im sorry i had to meet you under these circumstances. Thx for all the help and advice. i guess im in shock and cant believe it im not thinking straight i will get it done. the one other thing that bugs me is how 2 dr's so far have acted like its no biggie maybe thats where i get the overkill from.


thx again you people are a special group.

god speed to you all
Posted 5/8/2008 9:53 PM (GMT 0)

Good choice and we are hoping your reply back will be a good one - negative biopsy!!!

Dutch

Posted 5/8/2008 10:52 PM (GMT 0)
Hi Seekeroftruth there was enough said about the biopsy I won't repeat but I will say if you have any questions and your Dr. doesn't answer find another there are great ones out there that will be were responsive to you. I changed Dr. cause first one wasn'tt to inforative (not a people person) If you should have Prostate cancer you will be spending alot of time with him or her so make sure you get one you feel comforable with. Good Luck.

Gary
Posted 5/8/2008 11:37 PM (GMT 0)
Ive got to agree with biker90. You have to be confident in your doctor. If you have the feeling your one in a production line then change your doctor. If it were me I would attempt to eliminate other causes of the higher PSA reading (which your's is, given your age). Just last night at my local support group we had a couple of pathologists in explaining prostate cancer and the ins and outs of PSA readings. As they explained readings up to 16 can occur with inflammation of the prostate and ,yes sex and even a DRE (which has the effect of massaging the organ) can cause the PSA to elevate. It was also his suggestion that any initial PSAs should be conducted in conjunction with a urine bacterial test to eliminate any influence due to infection and inflammation. It was actually very interesting as he said that markers contained in urine currently being researched and developed will replace the taking of blood for a PSA based check for prostate cancer over the next 5-10 years.

" PSA is an unsatisfactory diagnostic marker; most patients with a raised PSA do not have prostate cancer. Recent evidence suggests that up to 15% of patients with a normal PSA have cancer (2) and this has led some to question the role of PSA in this setting (3). This in turn has led to increased interest in new markers, of these PCA-3, a urine marker, appears to predict the presence of prostate cancer more accurately than PSA (4),(5)"

Apparently this test is being currently used in the U.K. on younger men whose families have a predisposition to getting PCa.

However if there is the slightest inkling of a doubt following the above tests I would certainly proceed with the biopsy (albeit with a doctor who has your complete confidence) . A biopsy although not a pleasant experience is not as bad as it sounds (like all things in life there are exceptions). My urologist had me sedated to the same level as having a colonoscopy and I was completely unaware during the whole procedure. Like others have said, you can eliminate that niggling doubt.
Posted 5/9/2008 12:54 AM (GMT 0)

Hi Rick, in my case my GP mucked around with my PSA for nearly a year, it ranged from 5.0 to 5.8 over that period, in the end it was ME that said think its time I saw a specialist,of course the Biopsy was positive, and showed stage T2a, which after the op, was upgraded to T3a....can't help wondering that if I had acted sooner, the Pca may not have advanced that bit more...have the biopsy my friend.

Regards Mal.

Posted 5/9/2008 12:57 AM (GMT 0)
Sorry your going thru this time and hope your results all come out on the good side. 

Biopsies are better than having teeth pulled and I have had 3 and one reverse type when they put my markers in last week (it was the worse).  Looking back I wish I had insisted on more.

Richard yeah yeah yeah

Posted 5/9/2008 1:00 AM (GMT 0)
Rick I would encourage you to get that biopsy. I know you are questioning why verses why not, but let me just say I to was 45 and I wish I had gone a year earlier. I am sure you will be fine, however peace of mind is worth tons. Thanks for coming to healing well, this is truly the best support site I have ever found.

stay in touch

peace and love
dale
Posted 5/9/2008 1:10 AM (GMT 0)
Hi Rick,
I think that you should take the advice of most of the replies. It doesn't hurt to check it out. I wish I had paid more attention to my rising PSA several years ago. I was told that the numbers were normal for my age. I became very proactive with my Dr'.s about my PCa since being diagnosed. Good luck and hope your results are negative.
Posted 5/9/2008 4:36 AM (GMT 0)
Hi Seek and i am glad you came to the right place,
I have been monitored for about 1 1/2 years before diagnosed with PCA.
My Psa was elevated from 2.1 to 5.2 then to 8.4 i that period , i had 4 Biopsies done in less than 2 years ,and in between tried antibiotics , and i wish i knew about this forum before hand and maybe even try to help matters with the right diet and exercise, however i was monitored carefully and my first 2 biopsies came negative but the one before last biopsy came back a bit suspicious my Uro suggested to do another one in order to make sure he got an absolute good reading , and thankfully i caught it early on while it was confined to the prostate.
Biopsy is the next step of diagnosis , and not a big deal really..it is a walk in the park compare to everything else and a safety measure to make sure you are clean...as one said before Better safe than sorry ... i would do the biopsy regardless just to be on the safe side and keep monitoring your PSA.
even if it is negative (as mine was ) keep monitoring, eat healthy, and maybe try antibiotics prescribed by your Uro.


Good Luck !!!
keep us posted

GB :-)
Posted 5/9/2008 4:59 AM (GMT 0)
I agree with Biker Jim.  If the urologist is too busy to talk to you and answer your questions, fire him.  It's a good idea to have two people at any conference and, as Jim pointed out, have a list of questions written out to take to the appointment. 

I tape recorded the conversation my wife and I had to discuss treatment options.  I agree with some of the other posters that with an elevated PSA at your age a biopsy is a good idea.

Hope you continue to post hear and keep in touch.

Take care and hang in there...Tim 

Posted 5/9/2008 3:34 PM (GMT 0)

TimG said...
I agree with Biker Jim. If the urologist is too busy to talk to you and answer your questions, fire him. It's a good idea to have two people at any conference and, as Jim pointed out, have a list of questions written out to take to the appointment.


I tape recorded the conversation my wife and I had to discuss treatment options. I agree with some of the other posters that with an elevated PSA at your age a biopsy is a good idea.

Hope you continue to post hear and keep in touch.



Take care and hang in there...Tim

I also agree with TimG you should go for other opinions regardless of Biopsy ....biopsy is a good idea in your position anyway but research and widen your knowledge base about treatments and all the possibilities.

Good Luck !!

PS Tim i had the same open surgery as you, how is recovery is going for you ?? your profile does not have updates ... hope all is well !!

GB
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