HealingWell
Search Close Search
☰

exponential rise in psa

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
1 2
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 5/27/2011 8:59 PM (GMT 0)
Hi Freepsa,

I'm well known on this site for my lack of specific medical information --- except on a few matters when I'm truly amazing, and modest about it. With that caveat, I'd like to comment on your statement:

"Facts just the facts. Show me them, otherwise these are just words."

You got it! Right now conjecture on whether or not you have PCa and what the % chances may or may not be, is not fact. The only fact that matters we don't yet know: the results of your biospy. Shelock Holmes might tell Watson, "the game's a foot," but without the biopsy we're all peering in warped fun house mirrors, not dealing with clear picture reality.

I'm looking forward to learning your biopsy results.

Sheldon AKA Sleepless
Posted 5/27/2011 9:03 PM (GMT 0)
your right Purgatory!!!!! I hope I didn't also take a Dr's tone by saying "get a color doppler if possible" LOL!!! My motives are pure whenever I post,I make sure I research a little before I say something......but like you say the majority are just trying to help!

By the way I've been keeping up on your posts and again wish you the best...........Cooper
Posted 5/28/2011 1:10 AM (GMT 0)
Hey FreePSA

Maybe I was not clear when I gave odds. I'm betting you have it. (Even without peeking up your butt.) My surgeon told me the biopsy results were required before the insurance company would approve surgery. We both knew I had PCa- the writing was on the prostate.

That said, your odds of a successful treatment are still pretty good. Check out this search on the YANANOW site: YANANOW, PSA >20 . Sadly, I am a member of that club.
You can see the treatments and survivability of the guys kind enough to enter their data.
As the saying goes: "You are not alone now." (Darn it.)

Jeff
(If the link does not work, just go to their site and sign up.)
Posted 5/28/2011 4:48 AM (GMT 0)
Hormone Treatment, HT, can and usually does stop PC dead in it's tracts, PSA levels dropping to very low levels very quickly.. Many surgeons do NOT recommend doing this to contain the cancer until surgery can be safely performed because they claim it makes the prostate gland "sticky" and more difficult to remove.

Other surgeons it seems have no qualms about it and may even recommend it in cases like yours where the gland is enlarged or they feel there is danger of the cancer spreading before surgery can be performed..It all depends on who you talk to...

But I certainly would not be buying a pre-paid funeral plan until you review the results of your biopsy with your urologist...When it comes to deciding on a treatment plan, the Gleason score is more important than the PSA numbers..Until you KNOW your Gleason and other important pathology details, trying to see into the future is pointless and probably counter-productive...
Posted 5/28/2011 6:28 AM (GMT 0)
FreePSA:

I've been reading this thread with interest. You've gotten good advice. Remember, although the ODDS don't look good regarding PC, the only DEFINITIVE dx. would be a positive biopsy.

So, good luck with that and let us know what happens.

When do you expect the results?

Mel

Posted 5/30/2011 9:41 AM (GMT 0)

Sorry. confused

I just got back my biopsy results 1.5 hours ago 12/12 benign!

I am happily embarrassed. So now I get a MRI and repeat PSA in 5 weeks., Still planning to consult with MSKCC since I do not believe there is a reported case such as this in the literature

Posted 5/30/2011 11:23 AM (GMT 0)
Isn't PCa interesting, now the possibilities of missed biopsied areas, the likely hood of a less than totally definitive scanning method(s) and likely future biopsies are coming.  You might even have PCa, missed in the transition zone and such things, happened to John T and a few different uro-docs never did figure it out...so you might wish to listen to his advice on such.   Good luck may be on your side, who knows.

 

Posted 5/30/2011 12:01 PM (GMT 0)
there is a case @mskcc of 12 biopsies before they caught it
Posted 5/30/2011 12:13 PM (GMT 0)

I should add that the pathology reported only benign tissue, nothing to suggest prostatitis. And also that the surgeon said that my prostate was unusually large. Although prostate volume is correlated with PSA levels it would far-fetched to use that as an explanation of 34 ng/ml. I still can't explain a rise of 9 in 6 days or a free PSA of under 10% on two different samples

BX is only 70-75% accurate incatching the tumor, so I am hoping for an MRI guided biopsy in 5 weeks

Posted 5/30/2011 4:51 PM (GMT 0)
Freepsa,
Your options at this time are a Color Doppler guided biopsy, an MRI guided biopsy or a 3D mapping biopsy.
Possible causes of high psa:
1. Prostititis
2. PSA leak( very rare at your high numbers)
3. Transition zone tumor (hard to identify on a biopsy, creates high psa and is usually non agressive and contained). MRIs are not very good at identifying transition zone tumors.
4. Skip matastistis, tumor in prostate has regressed, but has dumped cells into the blood stream that are growing elsewhere (extremely rare).

If all others options fail I would go to Dr Bahn in Ventura Ca, as he is the best in finding hard to DX PC.
I had a psa of 40 and had 13 negative biopsies and a negative MRIS before Dr Bahn found a large transition zone tumor. After 10 years of going through what your are going through I found out that there are only a handful of doctors that are capable of a DX in a very unusual case such as yours. Dr Stephen Strum, Dr Mark Scholtz and Dr Duke Bahn and Dr Fred Lee are in this catagory.
Good luck,
JohnT
Posted 5/30/2011 5:04 PM (GMT 0)

Thanks for the information. I am trying to arrange a MRI guided biopsy in 5 weeks.

I was told Dr. Jonathan Epstein at Johns Hopkins is the top prostate pathologist. Does it make any sense to send him the slides? My feeling is that if they found only normal cells, this is unlikely to be of any benefit and that I should await the second biopsy before sending him any samples.

What do you suggest?

Posted 5/30/2011 7:52 PM (GMT 0)
He would be considered among the best of the best for a second opinion of your slides. If it were me, only my feeling, I would wait to get the next biopsy, and then get the 2nd opinion. Your call, of course.

David in SC
Posted 5/30/2011 8:12 PM (GMT 0)
Freepsa,
Epstein or David Bostwick (mine were re-checked by Epstein) are excellent choices but i don't think it's going to do you much good at least yet. I don't think anyone misread a 12 core biospy that was unable to identify any differentiated sample. Your PSA is still a major concern and you need to consider a better biopsy. Let me give you an example:

If you have a golf ball and a sewing needle you can count the dimples on the ball and poke twelve dimples. Now count the dimples you didn't poke. That's basically what the doctor did here. He poked your prostate twelve times and possibly missed a cancerous sample. A 25 to 40 core biopsy may have proven to have different results. You need to consider asking "what's next?" If the urologist is out of ideas then what John T suggests may be a good option, or even a different urologist doing a saturation biopsy as I described.

Tony
Posted 5/30/2011 8:22 PM (GMT 0)
thanx!
Posted 6/22/2011 4:22 PM (GMT 0)
I repeated the PSA and Free PSA this AM and got back the following results:

Total PSA 23.44 Essentially the same as March 2011
Free PSA 2.66 11% slightly improved from the two others which were 9% and 8%

This is without antibiotic treatment and with taking 25 grams a day of soy for 3 weeks. I guess the question is whether the soy can artificially reduce the PSA?

In any case I have cancelled my short term burial plan
and am enrolling myself in a double blind study.

I plan to add floxin for 3-6 weeks and blindfold myself when I swallow the pills
Posted 6/22/2011 4:58 PM (GMT 0)
Freepsa, I agree with David of SC (Purg) that your comment seemed to be on the rude side but I also understand your frustration and concern at this point and know that you are looking for answers and help since I am a Gleason 9.  I recommend you take a deep breath, step back and start  developing a plan on how to deal with the worst case scenario that you probably have PCa.  I'm betting you still have a lot of years ahead of you.  The Old Sailor
✚ New Topic ✚ Reply
12