Comments or opinions please

Hello, I just found this forum - got here through a Google search after spending days researching prostate issues. Here's my story.

I'm 53 and in fairly good health. I went in for a yearly checkup and the PSA came back 4.2. It had been 1.4 15 months earlier. I was referred to a Urologist who I saw 3 weeks after the first test, who did the DRE and another PSA test after the DRE - came back 3.8 (different lab).

The Dr.said the prostate was 'smooth' upon DRE but enlarged. He was more concerned about the 300% PSA increase from 15 months ago. But, I have since learned that several things were not told me before either PSA. Such as:

Exercise, Sex, no DRE in the prior 72 hours before the PSA. I exercised, had sex, and drank lots of coffee within 24 hours of each test,  and the DRE 30 minutes before the second test.

Also, I understand you should allow 6 weeks before repeating the test. It was only 3 weeks.

Now -- I don't have any of the urination issues, or other symptoms that you might expect. However, I do get frequent twinges, aches in the prostate area and groin, a general weird feeling there and infrequently a very brief knifelike pain up the rectum in that area. Used get them sometimes when younger after having been aroused but not satisfied :) I have had these things off and on for many many years as long as I can remember.  Maybe a little more recently, but then again I'm thinking about it.   The Dr. said riding a bicycle can cause the PSA elevation.  I don't bike but I do some serious rowing at home and the seat is hard like a bike. I have noticed that the aches are a bit more after rowing. Coincidently, I started rowing in the past year.

The Dr. wants to do a biopsy.  He is a local Dr. in Fredericksburg Va.  Do you think I should shop around? I don't know that he has that much experience, he's young and does pediatric work.  Can anyone recommend someone in the DC, Northern Va, Maryland area?

Should I need to go the next step -- does anyone have information comparing results of the Da Vinci vs the Cyberknife? Are they the best?  I just learned about both.  I'm more concerned about continence if it comes to that then ED.  In the same geographical area --- would anyone recommend someone for either of those procedures? I could travel too.   Just trying to research and get my ducks in order.

I have a consult 10/31 and the Dr. wants to schedule the biopsy.

Sorry for the long winded post -- I have a lot to get off my chest and right now my mind is spinning.    Thanks for any help...JR

 

 Hello there Mr. Goat! I'm assuming from your screen name, you drive one? Anyway, sorry you're here but glad you came,  welcome, welcome to the best site on the net for Prostate issues. Many of us who've traveled the road you're on now......research and knowledge is your best offense. Many more of the guys and gals will be along soon. I promise.

  With that being said I'll just share this with you. My PSA too rose from around the 1.5 or so  to 5.0 in fifteen months as well, three months later it had dropped back down to 4.1. I too before the first one, had sex, never stopped my workouts in the gym, and rode my bicycle....so, it is about the velocity of the rise. I had the biopsy, it wasn't bad at all. Of course my doc puts all of his patients in a "twilight state" so I don't remember a thing about the biopsy. Most of the fella's here have a different story. If it were me, I'd go for the biopsy, but then that's just me. I think I'd probably be shopping around for a more experienced Doc too. You'll hear from the gang and many a option you have-

   good luck  

                                                                        

Hi GTO ... Big Welcome to HealingWell

about the biopsy, it had some discomfort for me, although everyone is different. The rise in PSA should be of concern, but the biggest problem I see is...was the second PSA reading elevated abnormally because of activity prior to the blood test? From what I have read only, while those activities will raise the level of PSA, it is questionable as to how much it will alter the results. The drop you reported is a good sign, but it was from a different lab so it is hard to use that as a solid marker for PSA reduction. PSA levels will vary slightly from day to day so while you are left with more confusion than answers right now and the best thing I would recommend is to find an urologist that you are comfortable with and follow his recommendations based on the test results so far. I suspect he will recommend a biopsy given your age to make sure and rule out whether it is cancer or just inflammation or infection. That way he can properly treat your current symptoms. By the way...typically prostate cancer doesn't have symptoms in the early stages..so with your low PSA and having symptoms usually will mean that you don't have cancer...but a biopsy is the only accurate way to know for sure. Any other test will only lead you either in the direction of a biopsy or towards a treatment for infection/inflammation.

Good luck and keep us posted as you learn more and if you have additional questions just ask...that is what this forum is about. Getting answers from cancer survivors and their personal journeys.

Everyone: Thanks a bunch for the information. I have a consult tomorrow morning and now a lot of questions to ask. So we'll see where that leads.

Yes -- the DRE was done just prior to that last PSA test in the office. I am thinking I'll do the biopsy anyway. My only concern with that is that I read that a lot of men have some cancer and live with it their entire lives with it never giving problem, so many biopsies result in unneeded surgery. At least that's what I've read about. I'm looking for someone that I know will do a good job on the biopsy and have a good pathologist look at the results.

Also -- yes -- I do have a GTO, I've had 4 of them. The one I have now I bought when in the Navy back in 76, restored it 10 years ago. thanks again -- I'll post later.

I didn't have as large a percentage increase in the PSA results as you did in such a period, and my exams didn't reveal anything suspicious to my primary care physician or the Urologist he referred me to - but the Urologist was concerned enough about the rise in the PSA test result that he and my primary care physician recommended a biopsy - and that's the advice I followed.  The results of my biopsy revealed the presence of cancer and that led me to have surgery to remove it.  I have no regrets about having the biopsy, and if the results hadn't revealed cancer (because it wasn't present) I would have rested easier knowing that information.  I rely heavily upon my excellent relationship with my primary care physician, his examinations of me, the testing he does and his recommendations of specialists when he thinks I should get additional opinions.  Best wishes for you.