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Posted 6/23/2010 10:34 PM (GMT 0)
Bitte:

 

    Had high 30 PSA in Jan. Went on Cipro. Wenr down to 10. Since then it's gone to 8, then 6, 4.4 in May, and finally 4.18 few days ago. Have no history of PC. Dr requested biopsy, I opted for more Cipro and re-test. Did I make right choice? Dan

Posted 6/25/2010 12:43 AM (GMT 0)
Not being doctors, most of us can't say yes or no.
You didn't give us your age, which can tell if 4.18 is high or normal. But in my opinion, getting one more test before a biopsy, with such a big drop, wouldn't be the worst choice.

If the PSA doesn't drop any further, you would want to add a free PSA test to the standard next test. There are a number of posts here describing the relationships, but I'll leave it to say that my PSA was 7.4. They added a free PSA test, and based on the results had me into the Urologist's office the next morning.

Dr. Walsh's book tells us that you can have cancer with a low PSA, and not have it with a high PSA. It is just one of the screening tools.

If the Urologist feels a biopsy is warranted, ask why (in detail), read up on the subject, and make an informed decision. I would have much preferred to go through the biopsy and have been clean than for it to have come back like mine did - no symptoms at all, but 9 of 12 cores positive 7 of them at Gleason 4+4.

We each must feel comfortable with our choices, but there is no single decision path to point you to.
Posted 6/25/2010 1:09 AM (GMT 0)
Dan

PSA results can be over and under inclusive which is why the PSA tests are attacked from time to time, although nobody yet has better tests,

That being said, your numbers are high enough, the risks of PCa are high enough, and with precautions the biopsy risks are low enough, that you should follow your MD's advice.

Good luck.
Posted 6/25/2010 1:28 AM (GMT 0)
Not being doctors, and not being you, NONE of us can say yes or no! That said, I think the re-test was good move. But if your psa is bouncing around like that, you want to get to the cause at some point, sooner than later. I had 4.0. I mean, it was pretty high in Jan.. Biopsy sounds like the move to me.. but I am me, not you. Best of success.
Posted 6/25/2010 3:46 PM (GMT 0)
Thanks for advice. I do remember reading many times in this forum to take your time (for treatment), as you have time and the type of treatment decision is life long. Maybe I need to seperate the two. Have PSA re-test in 3 weeks. Do you think I should call and ask for additional fPSA to be performed also? Is that something that has to be asked for specifically?
Isn't the fact it's still trending down a good sign (even a little), or are these minor variations to be expected? I know I've ready plenty of posts where one has had 3 or 4 clean biopsy's, only to have anotehr one come back positive. Thanks, Dan
Posted 6/25/2010 9:46 PM (GMT 0)
Dan,

Deciding to get a biopsy is not deciding to do surgery, radiation, or other remedy. You can get even get a biopsy result of CANCER (all caps because it's scary) and if it is a Gleason 3+3 with small % involvement, you can properly still decide that Active Surveillance is the way to go.

There can be inaccuracies in biopsies, but, biopsies are a far more accurate test of whether you have PCa than PSA tests.
Indeed, if you get a 3+3, I suggest that you get a second opinion to make sure the numbers are accurate before you decide on AS. The numbers are too low on first read about 1/3 of the time. They are too high, however, only about 5% of the time, so you should stop grasping that straw.

You are right in being careful, but I sense a bit of denial in not having the biopsy.
Putting your head in the sand does not make the lion go away, it only makes it easier for the lion to bite your ass off.
Posted 6/28/2010 2:10 PM (GMT 0)
larch:

Much appreciated, as I reluctantly came to same conclusion this wk-end. Having a biopsy is a 'no threat' option here, as I came to convince myself of. Your correct in assessment of grabbing at straws and being in denial. I know I am. The Urologist said that I could just have a high PSA as a baseline because of enlargement etc... and that only 50% of biopsy's result in cancer being detected. I can't find anything about these stats and kinda think it was made to put me at ease. The only past PSA results my wife could find put my PSA about 2, some 5+ yrs ago. Been kinda hard as wife doesn't like to talk about (freightened, just like me) it, and no one to discuss with (new job/state/and country after being overseas 25 yrs). This site and advice has been lifeline. Again--thanks for some perspective, dan
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