About to have biopsy at 43yo with PSA of 5.2

Hi All -

I've been following the discussions here off and on for the past couple of months since my first PSA spike in December. I can only handle little bits at a time before the anxiety gets too high. I keep catching myself scanning here and elsewhere online, looking to find the page that says "YOU do NOT have prostate cancer." Haven't found it yet.

Tomorrow is my biopsy and then I start The Wait for results. It sure would make me feel better if someone could look at my stats and tell me if I have cancer or not. (kidding, kidding).

Seriously, though, can anyone throw me a rope by telling of someone with PSA numbers like mine, no pain (as in prostatitis) who did not have cancer? I'm not seeing what else it could be, and my profile sure looks like a lot of the signatures I see here.

43 years old - four kids ages 2 to 10
Maternal grandfather with BPH starting in early fifties - no other prostate family history.

2008-03 - 2.6 - Just over the limit for a 40yo.
2008-06 - 3.4 - Uh oh. Off to the urologist.
2008-07 - 2.5 - Different lab. Urologist calms me down and talks me out of a biopsy.
2009-11 - 2.9 - A little higher but still in that high-two range.
2010-12 - 6.4 - ***!? Total freak-out. I demand a repeat just one week later.
2010-12 - 4.7 - A week later . . . that's better than 6.4. We hope it's "trending down" and wait 30 days
2011-01 - 5.2 - Sh*#. That's not trending down. Urologist orders a biopsy.

I was on Cipro for three weeks before that final test. No symptoms except a stream that is sometimes reluctant to start. That seems to have improved some. I'm on meds for blood pressure, cholesterol, and two different antidepressants (which we have been messing with since that 6.4).

Any advice for a scared newbie would be appreciated.

Your best bet is to have the biopsy to give you some peace of mind. My only suggestion ONLY based on my own experience is demand them give you something before the procedure. And drink ALOT of water afterwards it helps with the side effects after words. Good Luck and Keep us informed. And hopefully as James says you just need to post all clear and never come back :)

Okay, so compiler says I don't have PC! Thanks!

Seriously, I do appreciate the perspective, and you know I must be eager to know for sure if I'm actually LOOKING FORWARD to the biopsy . . .

MoreData - look at my profile.  I am currnelty 49.  I have had 2 biopsies and 1 MRI between Jan 2010 and Dec 2010.  So far, so good.  I believe that at some point down the road, something will eventually be found.  In the meantime, however, I am not worrying about it until I have to.  I did enough worrying about this last one figuring for sure they were going to find something, particularly in light of the "suspicious" area on the MRI.

The biopsy is the only way you will know.  I understand the anxiety and, if there is a positive result, it seems like it would be found early and you research whatever option to get rid of it is best for you.  That is what my mindset finally was (in between the angst and worry, of course ).  My uro and I are going to watch this closely and take care of whatever eventually comes (if anything).

Good luck.

___________________________________________________________

Mid-2008 PSA 2.4
Nov 2009 PSA 3.9, DRE fine, slightly enlarged
Jan 2010 Biopsy – 12 samples all negative
May 2010 PSA 4.1, DRE again OK
Nov 2010 PSA 4.5, DRE OK - MRI ordered
Dec 2010 MRI – revealed “suspicious” spot
12/22/10 Biopsy – 12 samples from suspicious area
1/5/11       Biopsy negative. Slight enlargement.  PSA is 4 mos.

MoreData,

Welcome to HW, I am sorry you have to be here. I too hope you get good news and no longer have a need to be here. Prostate Cancer is a “strange bird”, no blood test can tell you that you have it; the only sure way to find out is the biopsy. Good luck and I will be praying for you.

Lynn  

If it is something- be glad to catch it early. I'm speaking from experience. I went through all the feeling you have [ look at my name]- we here all have. I'm 2 weeks out of surgery. I got a good report because things were caught early. My life is getting back to normal.
You have a wife and 2 children. Remember the prime directive is too survive to enjoy all 3 of them- and sooner or later you will

Thanks all for the support, information, and perspective everyone. I agree I want to catch any cancer early. I also agree survival to be a parent and husband is my main job. My supportive wife, who obviously has a big stake in the potential side effects of surgery, is ready to take the thing out without a diagnosis and be done with it. She says we'll deal with the side effects if and when they come.

I did have two FreePSA tests. The first one (two years ago) was .24. The one in Dec 2010 was .21. So that's encouraging but doesn't rule anything out, especially since the total PSA on that last one was much lower than a standard PSA test done on the same blood sample. If the total PSA was an underestimate then the Free ratio would have been an overestimate.

I did have the biopsy today.

Bottom line:
The first anesthetic shot was unpleasant but not too bad. After that the whole thing was more annoying than anything. Even the clicking sound wasn't bad.

The doc (Dr. Wei with U of M) was very gentle and communicative throughout. He did 12 cores, 6 on a side. He said he didn't see anything on the ultrasound, which I know doesn't rule out PC but at least it suggests there isn't anything big and ugly going on in there. He will call personally in about a week and then mail me his written report along with the pathology report. He struck me as very experienced yet patient with what must have been his 900th nervous patient.

The longer story:
This office is a part of the University of Michigan Med School which is doing a study on a genetic marker for PC so I started out talking to a researcher, signing consent forms to be a part of the study, and giving a blood sample. If that will make this process easier for my sons then I am happy to help.

My doc gave me a Valium to take before the procedure but I don't think it helped much. I just felt a little drugged. Overall the general anesthesia option would have been a waste for me. I'm glad I didn't go through that extra complication.

By far the worst part of the experience was preparing for the urine sample. The written instructions said I would have to give a sample before and after. So I showed up very well hydrated. Then I waited, legs crossed. Then the research guy came in and talked for a while. I was squirming like one of my kids. As I gave the blood sample my eyeballs were starting to turn yellow. They finally told me I wouldn't give a sample 'till after the procedure, and I said that was going to be a very damp procedure, so they said I could go let a little off the top. A few minutes later another nurse shows up with a sample bottle. She said to give a sample now but save some for later. The story goes on, but suffice to say when I drew up my knees on the table I knew I wasn't going to make it. Fortunately that nurse said I was done giving samples and was patient enough to let me get back up. BIG relief.

The worst of the pain was later in the day when the anesthetic wore off. That's pretty much gone now. And my stream is disappointingly clear. I was looking for some interesting colors!

I'll post an update when I get my results after this longest week of my life!

There is already one approved urine sample test for detecting prostate cancer. Genetically based, it's much more sensitive than a PSA test..Both Abbott labs and Quest labs are licensed to do this test but so far they have not marketed it..So it's not surprising other companies are developing their own genetically based tests...

Data, you can see from my signature that this is a very imperfect science.. No two cases are the same..The first few threads on this board list all kinds of helpful things, including books. Doctors Walsh and Chodac are a good place to start...

This past Tuesday I had my second biopsy in 4 months and am waiting the results . The first biopsy showed positive with 1 core as healthy as I thought I was it was a shock. I feel there is not much or nothing I can do to change this so what ever will be will be .

Hey Moredata, welcome to this forum.  I am new here also.

I can't tell you that you don't have cancer, but can tell you my journey and I do not have cancer.

My PSA jumped 2 points 3 years ago.  Then has gone up 1 point every year.  Had the 12 sample biopsy nothing.  Had 30 day anitiobic twice to make sure I did not have an infection and each time PSA would come down half a point, but last round of antibiotic, PSA did not change.  Just went thru the 40 plus sample biopsy with nothing.  Go back to see Dr. in 6 months. 

Dr. said that some mens PSA will do like mine.

Good luck to you and keep us informed.

 

Re: PSA bouncing up and down. Mine bounced up and down between 2.9 and 4.1, and my urologist told me it probably wasnt PC because if it was, the PSA usually has a steady rise. When it went over 5 I had a biopsy and the rest is history. I assume I had an infection as well as PC, thus the bouncing.

MoreData,
You do not have to take that route. It was the route I took for 10 years with 12 negative biopsies and increasing PSA because most doctors have no idea how to distinguish a rising psa is due to prostate cancer or due to other factors.
A PCA3 urine test can give more information.
The best is a color doppler ultrasound and the next best is an MRIS. These can give a very good idea if you have PC and it's extent.
You could also do a 3D mapping biopsy.
All of these options are much better than continuing with biopsies and getting no definative answers. No one should have to undergo more than 2 negative biopsies without getting some answers and piece of mind.
JohnT

I had the 3D mapping biopsy that John T mentions. As explained to me, it gives a much more comprehensive  result as the entire gland is sampled, and not just the fraction that is accessible to the needle biopsy. And since you are 'out' there is no pain nor humiliation. Also, very few side effects except for bruising in the perineum where the needles were placed, and the gosh awful color of ejaculate which seems to last much longer than one would think it would. When it is all said and done, however, it gives your doc a pretty good idea of what you are or are not up against. Good luck to you.