45 years old and scared to death now! (Update 16th July 2011)

Hi Steeler
welcome, you have found the right place for help
Don't panic, although your PSA at the higher end of the age based median, it certainly doesn't mean you have cancer. Take it one step at a time and don't get ahead of yourself, there a few things that can cause an elevated PSA and that what the uro is for, to find out.
You have come to the right place for support advice and expirience, as the information from members here is the absolute best, I'm sure some with more knowledge than me will chime in soon. Best thing you can do is get all the info you can so that your decisions are made easier, if that is possible. There are numerous books and another website called YANA which lists the stories of men from all over the world who have been right where you are now, first up don't panic, knowledge is power in this game.
Proper term for "the finger" is DRE digital rectal examination. The biopsy is usually standard for elevated PSA it's no big deal really, most Uro's head straight for that, what it will do is rule cancer in but unfortunately it will not rule it out.
Hang in there more advice will be on the way I'm sure.
Bets of luck

Have the docs give you a round of antibiotics before submitting to a biopsy.....if prostatitis is an issue a biopsy will make it worse......the antibiotics are the usual first step......Cooper 

Blood in your urine is a sign of infection that would also affect your psa. Prostate cancer rarely has symptoms at the early stage and I would guess that the symptoms you are experiencing are due to other issues. Have your doctors eliminate all other issues such as infection or prostititis before you get a biopsy.

DO NOT allow your doctor to give you a biopsy right after having a rectal exam (DRE).  It stirs things up and can artificially increase your PSA numbers.  Check for an infection.

For my treatment they first put me on antibiotics first to rule out infection before biopsy....

Don't you think his doctor would know the right squence of events here? What is missing in this picture?

David,
Many urologist and perhaps most are too quick to pull the biopsy trigger. The most medical mal practice suits against urologists are for failure to DX pc early. It is far eaiser for a uro to just give a biopsy and play it safe. It's pretty easy to give a free psa and a PCA3 test; I would venture that most patients have not had both of these tests before their first biopsy. It's also pretty easy to calculate a psa density based on a DRE estimate and I would venture that few patients know their psa density. It is also easy to calculate the amount of benign psa produced by the prostate tissue. Not one of my uros ever did this. I think a safer assumption is to recognize that the average urologist has only a basic knowledge of pc diagnosis. I recall going for a 2nd opinion to UCLA and the urologist told me to go to the Hopkins site and calculate my psa velocity and doubling time. I asked him to do it while I was in his office. He said the results were very high probability of PC, but in my case he was sure it was BPH and not PC because of my negative biopsies. I got the same opinion from 4 other urologists. A simple calculation would have shown that at most only 6 points of psa could be attributed to BPH leaving 30 points of psa unexplained. After reading Strum and talking to Scholz; it was readily apparent that I had all the signs of PC and that was the ONLY explaination for the steady and consistant rise in psa and consistant low free psa readings. It's not rocket science, just knowledge and taking the time to think beyond the standard protocol.
JT
JT

So should I phone the hospital and ask for the biopsy to be rescheduled (it's down as tomorrow morning) and ask to be put on antibiotics first to see what happens to my psa level?

Or is it best just to get the biopsy out of the way asap?

Dr didn't mention a CT scan or MRI, just booked me straight in for a biopsy tomorrow and a check on my urine flow.

I would postpone......the doctor told my husband if biopsy was done it could make symptoms of prostatitis way worse....not saying thats what you have but a trial of antibiotics won't hurt & will buy some time to see exactly what your dealing with......don't ever be afraid to question a doctor.................Cooper     ps......pay close attention to JohnTs posts [a wealth of knowledge]

Post Edited (cooper360) : 7/14/2011 6:57:25 AM (GMT-6)

My only suggestion is to make sure you are comfortable that your doctor is a real expert, so you are getting high quality medical advice. Unlike with many other professions, a great doctor usually costs the patient the same amount as a lousy doctor. So get a really good doctor if you don't already have one. (That does not mean he has to be a "famous" doctor who does a lot of marketing -- eg some of the names we see repeatedly on this and other boards -- but you should have someone who is well trained and very experienced with the issues you are facing). Best wishes.

UPDATE

I went to the hospital yesterday and talked to a different specialist.

My PSA in June was 4 and my PSA from the blood test done on 12th July was 5.3 (the latest one was done just 10 minutes after a dre, and the first one was about 30 minutes after a dre...though the specialist insisted that makes no difference at all to the reading!?)
He took another urine sample and found traces of blood in it...as did my previous urine sample.

I'm booked in for another blood test on 25th August and a biopsy on 29th August....though if my PSA has gone down from 5.3, will this still be deemed necessary?

He has also put me on the waiting list for a cystocopy to have a look at my bladder.


I am still experiencing an uncomfortable feeling in my belly and constantly feel bloated and full of wind (plus a bad taste in my mouth)....wondering what other things may have caused my PSA to rise over the last month given these symptoms. Surely this isn't a symptom of PCa??????

Post Edited (MrSteeler) : 7/16/2011 2:10:55 AM (GMT-6)