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Posted 9/1/2011 6:14 PM (GMT 0)
I am 60. I have not been diagnosed with prostate cancer yet - but my urologist is 90% sure I have it.

My psa had a 1.5 rise in the past year from 2.7 to 4.2 (tested several times)

He suggested that I can go on my overseas trip, return next year and get tested/do a biopsy in March 2011.

Any thoughts? Thank you.


(added a subject)

Post Edited By Moderator (142) : 9/1/2011 12:18:56 PM (GMT-6)

Posted 9/1/2011 6:24 PM (GMT 0)
Welcome Jonathan.

I added a subject to your post, hope you don't mind (you can change it with the edit function if you want).

I hope you are talking about 2012, although many of us, myself included, would like to turn back the clock a bit.

I would be tempted to do the biopsy early, knowing now what I didn't know when I first started my journey. That aside, I wouldn't see any reason not to travel.

Welcome to HW, and although the door is always open, we sure wish folks didn't need to use it.

Posted 9/1/2011 6:35 PM (GMT 0)
Before you decide to delay another 6 months, check into PSA doubling time statistics and determine if you're comfortable waiting till then....PCA is slow moving but you might as well get the biopsy done and begin the research (if, indeed, it is positive) and begin then start evaluating options.  Nothing to stop you from a trip unless the biopsy reveals a Gleason score that requires more immediate attention.  Just my two bits...

Posted 9/1/2011 6:58 PM (GMT 0)
Jonathan,

First welcome to this forum no one wants to join and we all hope you do not have PC and can go away never to return.

Let me tell you some about my journey with PC.

I am 61 now but last year when I was 60 My PSA went from 2.5 to 3.5 in 6 months where my GP referred me to a URO in January this year.  My URO did a DRE exam and he thought I didn't have PC and put me on 3 weeks of Cipro antibiotic for a possible Prostatitis infection. I had another PSA in February which was 5.25 and the URO wanted a biopsy by the middle of April. So in 9 months time my PSA went from 2.5 to 5.25.  I had my biopsy on April 13th and I had 2 of 12 cores positive for Gleason 7 grade and both samples were 15% and 20% cancer cells. My URO thinks I probably had PC when my PSA was 2.5 in June of 2010 with a G6. Your PSA can rise very high in a short time or not it seems to effect all men differently. My case was further complicated as I have family history (Grandfather) of PC which is why at my age my GP used a 3 PSA as the base point to be referred to a URO.

IMO and I am not a doctor, you should go ahead and get the biopsy done now otherwise you may worry about it for the next 6 months needlessly. If the biopsy is positive with a Gleason 6 you could still have the option of waiting until next year for treatment. If it is G7 or higher you may be taking unnecessary risks  for delaying treatments.

Good luck and we hope to not hear from you again, but if you need us we are all here for you with great opinions and advice from our personal PC journeys.

Terry the Water Guy

Posted 9/1/2011 7:15 PM (GMT 0)
From what I understand 4.2 is not that out of the norm for a man your age. The rise is a bit of a concern, so it is a possibility, but PSA can be influenced by many factors. Unless there are other symptoms or factors, I don't think that a 90% probability is a fair assessment.
Posted 9/1/2011 7:21 PM (GMT 0)
Jonathan,

First welcome to HW and I'm sorry you may need to be here. Hopefully your visit is brief and your results are negative for PCa.

Like the others have suggested, I would look to have the biopsy early and still plan to take the trip. As you can see from my signature, my PSA jumped significantly in one year and I had a similar experience as Water Guy by being put on Cipro for three weeks. My PSA increase was noted in August 2010 and it wasn't until May 2011 (9 months later) when I had my biopsy. My biopsy Gleason was 6 but after surgery my Gleason was actually two levels more to the aggressive at 7 (4+3). No way of telling whether the time between PSA increase and biopsy had any impact on the PCa. Every individual is different.

Good luck with your decision and come back to let us know your outcome. There are many individuals here at HW that can share there experiences.
Posted 9/1/2011 7:30 PM (GMT 0)
Hi Jonathan, and welcome. I'm no doctor, but I've learned that a quick rise in PSA like you experienced is very commonly caused by a (benign) prostate infection. It'll take some work on your doctor's part to identify this, but I'll hope that this is the case for you.

That being said, autopsies of men your age who died in accidents (car accidents, for example) show that a majority have at least some very small, often indolent, forms of prostate cancer which form as a part of the aging process...and it turns out that a lot more men die with prostate cancer than die of prostate cancer. A couple dozen strains of PC have been identified, and while it can be hard to precisely tell them apart and it takes an ongoing surveillance of characteristics over time to verify, most show themselves to be slow growing.

So, it's good that you are on top of your PSA changes, and that you are looking into it with your doctor, but it is unlikely that you need to rush anything. In the mean time, and whether you have PC now or not, here's some good reading for you from the Prostate Cancer Institute. This article is called, "I have Prostate Cancer, now what?" The answers are to first find good doctors to care for you, and second, to make immediate lifestyle changes.

Studies show that lifestyle (diet, nutrition, exercise, and even stress reduction) can have a notable impact on many (not all) cases of PC. In fact, so much so that if you make a donation to the Prostate Cancer Foundation, they give you a card with instructions on ways to fight PC: first on the list is "What to Eat", second on the list is "What to Avoid [eating]", and third on the list is "What to Do [exercise]."

Whether you end up finding PC or not, lifestyle changes which have been shown to reduce risk of prostate cancer and prostate cancer progression will also help your overall health in general, and extend your longevity and quality of life.

My thoughts (at your request): while you get organized with your doctor, get started now on the PCI recommendation to make immediate lifestyle changes.

best wishes...
Posted 9/1/2011 7:39 PM (GMT 0)
Hi Jonathan, welcome to HW...sorry you have to be here but hopefully you do not have PCa and you will have only a short stay with us!

I agree with the others and would encourage you to get a biopsy sooner rather than (that much) later, especially if your urologist says he is "90% sure" you have cancer.  It would be interesting to know why he feels that way...did he feel a nodule, just from the PSA rise, or what?  A common approach to your situation might be a course of antibiotics to rule out prostatitis and then move on to a biopsy if the PSA did not drop.  I think an unusual approach (which I don't like) is for the doc to say he is 90% sure and then send you on your merry way for 6 months.  Maybe you should look for a new doc...

Tudpock (Jim)

Posted 9/1/2011 8:39 PM (GMT 0)
I would, at a minimum, get my free PSA and PCa3 checked. If these tests indicate the need for a biopsy, I would do it now.
Posted 9/1/2011 9:03 PM (GMT 0)
Johnathan, hope you don't need to be a member here, but if you do, its a good place to be.

If your doc has ruled out an infection, I would be inclined to the have the initial biopsy done sooner rather than later, my entire PC journey has been tainted by having extreme PSA velocity before I was diagnosed.

I wish you well, and please stay in touch.

David in SC
Posted 9/1/2011 9:30 PM (GMT 0)
Jonathan, Over the course of several years, my PSA, as revealed in the course of my annual physical, went from the 2 range, to the 3 range, to the four range, to the 5 range, and finally to the 6 range. My internal medicine family doctor started urging me to see a urologist when it was in the 4 range, but I felt I was smarter than he was, would never get cancer, and went my merry way. After all, my older brother had a PSA in the 8 range, and in spite of three biopsies, has never been found to have cancer. I felt that all I needed was a drug to shrink the prostate and all would be fine.

Nevertheless, when the PSA rose to 6.2, I agreed (reluctantly) to see a urologist, who felt a "bump" on the prostate during the digital exam, and a biopsy revealed Gleason 7 (3 + 4) prostate cancer. Only through dumb luck and the grace of God did it turn out to be organ contained. I'm darn lucky that my wife and my family doctor finally prevailed and pushed me into seeing the urologist.

Given my personal experience, I would encourage you to have that DRE and, if necessary, a biopsy sooner rather than later. Had I done so two years earlier, I might have avoided that palpable nodule and maybe been Gleason 6 rather than 7, with a much better long term prognosis. I can't understand why your uro would postpone a biopsy until next March. Why not find out now what you're dealing with, then go on vacation if immediate treatment is not required. Knowledge beats ignorance every time in my book, and unfortunately, not everyone ends up as lucky as I did. Just my thoughts. Good luck.
Posted 9/1/2011 9:36 PM (GMT 0)
 

Clock so well stated and I ditto all your wisdom.

Terry twg

Posted 9/1/2011 10:07 PM (GMT 0)
Hello Jonathan, Welcome to HW. As many have already suggested, it is probably a good idea to have a biopsy prior to your travel. The biopsy for me was not a big deal, so it shouldn't stop you from traveling. Also you may ask for a free PSA test. Good luck.
Posted 9/1/2011 10:12 PM (GMT 0)
I should have added in my earlier post that had I acted a couple of years earlier, I would likely also have saved that left nerve bundle and perhaps avoided the ED problem which stubbornly persists a full year after the surgery.  Once there was that palpable nodule, it was bye-bye nerve bundle.

Thanks for the nice words, Water Guy.  Bill

Posted 9/2/2011 3:31 PM (GMT 0)
Thank you all for your concern, support and thoughts. I will digest all comments. I am leaning to 'sooner than later'. And making lifestyle changes.

Your help is valuable to me.

I will post again soon.

I wish you all well in your work related to your own challenges.

Jonathan
Posted 9/2/2011 7:15 PM (GMT 0)
J Z,
Here's another vote for having the biopsy now and plan to take the trip (unless the biopsy results suggest you should not). Regards,

Joe
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