Hello again. I'm back with more questions -- this time about Color Doppler and where it can be done. Following is what I wrote about my husband back in December (I cut and pasted from my original post the pertinent parts). He did not get his PSA and free PSA checked at the 6 month mark because we had travel plans this summer. However, he did get everthing done at 7 months. I will give you the results after this history so it is consistent.
At age 50 he had his first PSA test for a workman's comp physical. It was fine. 1.9 or somewhere in that range. The next year it was very slightly higher but nothing the doctor worried about. DRE's totally normal.
The third year it jumped to 4.3 and he was sent to a urologist. Normal protocol -- antibiotics and a free PSA was done. Normal DRE. The PSA came down to 3.8 after the antibiotic therapy, but the free PSA was only 17%. To make a long story short, over the course of the last year and a half his PSA went up after the antibiotics were discontinued, his free PSA continued to be very low. He's had a half dozen -- results have been 17%, 12%, 10%, 7% 9%. All tests were run at the Mayo Clinic as that is the lab used by our clinic. His PSA's have fluctuated from 3.8, 5.6, 10.3, 7.9, and the last one was 5.6. All DRE's normal.
His first 12 core biopsy was done this past August and it was completely benign. No cancer, no pre-cancer, no inflammation, no prostatitis. Nothing! It was noted that his prostate was 52cc. The only physical symptoms my husband has noted was a weaker stream and a bit of trouble starting in the morning, but during the day everything is fine. He does not get up at night, and has no urge to go. All other plumbing works just fine.
A cystoscopy was done and everything look fine in the bladder but it was obvious his prostate was a bit large and pushing into the bladder which probably causes some uriniation difficulties he has, although minor. The doctor suggested Avodart but didn't really push it since he wasn't really having that much problem. He also said he could try Saw Palmetto which he ended up doing.
When his PSA came back at 10.3% (a jump from 5.6% in three months) and the free PSA was 7% we decided right then and there to go to the Mayo Clinic. We were fortunate to get in with an excellent urologist who confirmed that he was NOT comfortable with this history. He got my husband in for a biopsy the next day. They also ran a PSA and free PSA during the visit and those values were 5.6 and 9% which were down (and up, depending on which one) from only two weeks prior. DRE at Mayo normal. The biopsy done was an 18 core biopsy with state of the art equipment and something called 'end fire probe'. He was completely sedated which was different from the first biopsy which he tolerated with no problems whatsoever. He was assured he did not want to be awake for this particular biopsy though.
Has anyone heard of these types of values and no cancer? We have been preparing ourselves for months and had even discussed and accepted various treatment options should cancer have been found. Let's just say that we were in a good place had the news been otherwise and were ready to act. Now we are just more confused and although we have been to Mayo still not sure there isn't cancer there that has been missed. Is anyone ever comforted by negative prostate biopsies??
Ok, the results of his latest tests were that interestingly he PSA went DOWN to 4.5% but that dang percent free PSA is at 7%. Last week he had another saturated 24 core biopsy and we are still waiting the results. The ultrasound photo looked perfectly normal, and there are no lumps or ridges on the prostate. We won't be surprised if the biopsies are negative and we won't be surprised if they are positive. (neither gives us comfort, and this is getting to be a real drag).
So, my question is: Where is the closest place to let's say Fargo, North Dakota to get a color doppler ultrasound? Is this something insurance would cover or is it considered experimental (my husband's urologist says it's still experimental), and they don't do it or recommend it at Mayo as far as we can tell. How much would the test run if we pay for it out of pocket? And why in the heck is something that can detect cancer experimental? grrr.
Frustrated, but thankful for all of the help and advice here! 
deb
P.S. is there any other reason in the world, other than cancer that the percent free PSA would be so low?
Post Edited (nodaker) : 9/6/2009 10:04:17 AM (GMT-6)