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High PSA with no cancer

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Posted 4/23/2011 9:06 PM (GMT 0)

I am 45 years old. For the last 7 years my PSA has risen from 2.0 to currently 39.90.  I have had 6 biopsies during this time.  The first biopsy with a 6.6 reading at the age of 39, resulted in a 2mm piece of cancer found on my prostate.   I have had 5 subsequent biopsies that have yielded negative results with  occasional  inflammation.  I haven't seen my doctor in over a year in regards to this.  My doctor continues to give me biopsies without doing anything else.  Antibiotics have never lowered my PSA reading.  Does anybody have any idea of what can be done to lower my PSA? 

Thanks

Posted 4/23/2011 10:29 PM (GMT 0)
If it were me, I would get a 2nd opinion of another urologist who specializes in prostate cancer. If this is something you are considering, if you post your general location, maybe some other members can suggest someone to see in your area.

Although I hope you continue to stay healthy and don't need a treatment, I think it is unusual for a uro to find a 2mm tumor on a 39 year old and not suggest a treatment. Do you remember what the Gleason score of the cancer specimen was? Or the percentage of the sample core that was cancerous?

Good luck!

Dan
Posted 4/23/2011 11:20 PM (GMT 0)
You might try to find a uro that does color doppler exams. By using the color doppler they find the suspect areas and then guide the biopsy to the area in question. THere is a limit, I think, when you have had enough biopsies and I think you are way beyond that. There are not a lot of places doing the doppler color biopsies but it would be past time for a road trip if it were me. Sorry to hear about your problem, by now you must be anxious with that high psa.
Ron
Posted 4/24/2011 12:47 AM (GMT 0)
You really need to get a color doppler or a 3D staruation biopsy. I would go to Duke Bahn in Ventura Ca or the Dattoli Cancer Center in Sarasota. Has your psa risen at a steady rate or has it risen rapidily and then fallen? If it has been a steady rise it is indicative of PC. There are several conditions that would explain your psa. Infection, but you would have seen a lowering of your psa at some time, matastitis to the lymphnodes, a very large transition zone tumor or a world class case of psa leak. In this case you now need a medical detective and not an ordinary doctor to help discover what the problem is. There are only a handful of doctors capable of figuring this out.
I had the same issue, except I had 13 biopsies in 10 years and saw 6 different doctors, before I figured out that I was an unusual case and needed an expert. Urologists just don't have the experience or skill necessary in your situation.
Transition zone tumors are very hard to detect by biopsy and will cause very high psa reading that rise steadily over time. I have heard of only one case of psa leak at your psa levels. A deep infection can also not be ruled out. In any case you need an explaination of what is causing it and it must be done by process of elimination. I would travel to see Dr Bahn as he currently is the best in the world at detecting hard to find PC. His web site is www.pioa.org. I know what you are going through as I have been down the same road. If you are in the Mid west you can see Dr Fred Lee in Rochester MI; but I think that he just retired. Don't keep fooling around with regular urologists at this point as you need an interventional radiologist. A good medical oncologist specializing in PC would be good to have on your team, but he would just send you to Dattoli or Bahn anyway. Feel free to email me with questions, click on my profile for my email.

JohnT
Posted 4/24/2011 1:24 AM (GMT 0)

John,

Just curious wht you didnt have your removed ? It seems ost get theres removed just curious. Sorry to hijack this post

Posted 4/24/2011 4:00 AM (GMT 0)
CVC,
Because of the location of my tumor, Apex and transition zone, surgery woud have had a high probability of a positive margin. Also after some research I discovered that combination seeding and IMRT had a more effective rate of cancer control for intermediated risk cases as well as less side effects than surgery.
JT
Posted 4/24/2011 12:55 PM (GMT 0)
Welcome to the forum Psaprisoner.

You have had several biopsies, but you do not say how many needles were used each time.
If you have had multiple biopsies, but each one has only used a few needles (eg six), then there is distinct possibility that something gets missed, especially if you have large prostate. A saturation biopsy would give a clearer picture because a PSA of almost 40 suggests that all is not well.

Alf
Posted 4/24/2011 1:32 PM (GMT 0)
Play it safe my friend. Go for other opinions..I understand: Biopsing is not fun!

EVen after I was diagnosed, another biopsy found no cancer! It was only after my Urologist decided to 'break the tie' and do a saturated biopsy that they found it again (I wa sput to sleep for that).

On ther other hand, something else could be causing your high PSA (which will be good news no matter what that something is!).

Best wishes as you contunue to investigate.

Posted 4/24/2011 10:11 PM (GMT 0)

psaprisoner said...
I am 45 years old. For the last 7 years my PSA has risen from 2.0 to currently 39.90. I have had 6 biopsies during this time. The first biopsy with a 6.6 reading at the age of 39, resulted in a 2mm piece of cancer found on my prostate.

Thanks

You say "high PSA with no cancer", but in your message mention a 2mm piece of cancer...If you had cancer at the time your PSA was 6.6 and now it is 39.9 what was your Gleason Score at that time?

RalphV
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