HealingWell
Search Close Search
☰

Should I have biopsy?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 4/28/2012 6:31 AM (GMT 0)
Should I have biopsy?

Psa has jumped around for years off and on antibiotics.
Psa 09/09 1.78 has been as high as 4.4back to 2005
Up to 2.46 10/10
New Doc in 3/11 psa 4.2 drops to 2.7 after 14 antibiotic Free Psa 28%
Psa 9/9 4.1 drops only to 3.7 after 14 days antibiotic Free Psa 28
New doc says biopsy or watch 3 months
1/12 psa 4.1 new doc says with free so high continue to watch
Went back to old doc said get biopsy 14 day cipro back to 3.2
3/12 back to 3.8 still 26 % free
Don't know which end is up at this point

(Thread title added)

Post Edited By Moderator (Steve n Dallas) : 4/28/2012 1:49:45 AM (GMT-6)

Posted 4/28/2012 8:52 AM (GMT 0)
I would go ahead and get the biopsy. Might as well find out if anything is going on. My psa jumped around like yours for several years until it reached and stayed at the 4+ level. Had biopsy and the rest is history.

I'd get it done even though some see the biopsy as an unpleasant experience. I was one of them so I had my uro do the biopsy with me knocked out. Only pain was when he told me the results!
Posted 4/28/2012 9:47 AM (GMT 0)
I would offer an additional option with your free PSA so high. You might consider a color ultrasound first. I had two negative biopsys and the second was a disaster. It bled for months and caused spasms. I went to Dr Lee in Detroit for the ultrasound and he discovered that the bleeding had caused such a large area of calcification that he could not "see" much of my prostate. Still he did not recommend another biopsy even though my free PSA was under 15.
Posted 4/28/2012 1:59 PM (GMT 0)
With your free PSA staying so high, wouldn't be thinking PC as a high risk possibility. Even a single biopsy, if you choose, doesn't always tell the whole story. Took 3 biopsies spread over 18 months to find and verify a lot of cancer in my prostate. The old story is, that a prostate biopsy is like sticking needles radnomly into a loaf of raisin bread and not pulling any raisins out. It wouldn't prove that it was raisin bread, it would only meant the needles didn't happen to hit a raisin or too, lol.

If it were me, think I would hold off on the biopsy and keep an eye on things a bit longer (6 months to a year), unless you see a sudden spike upward in your PSA number.

david in sc
Posted 4/28/2012 2:58 PM (GMT 0)

The Moose said...
Should I have biopsy?

Psa has jumped around for years off and on antibiotics.
Psa 09/09 1.78 has been as high as 4.4back to 2005
Up to 2.46 10/10
New Doc in 3/11 psa 4.2 drops to 2.7 after 14 antibiotic Free Psa 28%
Psa 9/9 4.1 drops only to 3.7 after 14 days antibiotic Free Psa 28
New doc says biopsy or watch 3 months
1/12 psa 4.1 new doc says with free so high continue to watch
Went back to old doc said get biopsy 14 day cipro back to 3.2
3/12 back to 3.8 still 26 % free
Don't know which end is up at this point

(Thread title added)

How old are you?
Posted 4/28/2012 3:27 PM (GMT 0)
I'd go for the biopsy. 12 samples from an area the size of a walnut isn't guaranteed to hit a tumor, but the chances are farily good. My cancer was found by just 1 of the 12 samples.
Posted 4/28/2012 3:59 PM (GMT 0)
Forgot to say that I'm 53 years old
I also have had flow issues as well frequency issues for a few years.
Have gone through periods with an tender felling in the region.
One doc said you can have chronic prostatitus as well as PC
The other doc said if my symtoms were related to PC my numbers would be much higher. Had a Biopsy set up on 4/26 and now movers it to June.

I think I will go through with in June

Going to pull a Psa next Week though unless it was to spike up or my free were to drop a bunch my mind would still being going up and back.

Is it worthwhile to just get an ultrasound ?

Moose
Posted 4/28/2012 4:04 PM (GMT 0)
Moose:

Look into getting a PCA-3 test. That is an easy test (pee into a cupafter a DRE) and VERY specific for PC. It is designed for those folks who are in the grey area.

Your PSA is not "acting like" PC. Usually there would be a steady rise in the PSA, but of course one can never be too sure.

Look into getting that test

Mel

Posted 4/28/2012 6:09 PM (GMT 0)
Clear as mud?

This just goes to show you that your situation is in the gray area. Some in your situation want a means to get a fairly definitive answer - and will get the biopsy sooner than later. Others would rather take a "wait and see" attitude. Sorry the advice you are getting is all over the place, but ultimately you will need to decide your course of treatment that satisfies your own sensibilities.

My wife, when she was a kid, snuck into her parents room and unwrapped (and re-wrapped) all of her Christmas presents. She also wouldn't even have thought about not finding out ASAP what sex our kids were in the womb. She would obviously represent one end of the spectrum.

I wish you all the best, and that this ends up to be prostatitis or other non-cancerous condition.
Jeff
Posted 4/30/2012 1:11 AM (GMT 0)
I agree with Mel - get the PCA3 test. It is a rather unpleasant couple minutes, but you can handle it. Beats a biopsy, and if the PCA3 < 35% you might dodge the biopsy bullet for at least a while. At the very least, it is good information to have.  (self promotion of a book removed -142) I treated my prostate cancer a year ago with proton beam therapy and spent most of the past year writing about it. I have been surprised how few people know about the PCA3, but not surprised urologists fail to use it, as they fail to mention that proton radiation is worth considering along with other options. You will have to be proactive about your situation, and your doctors are merely one of many resources. The world has changed, and with our access to information, we no longer have to blindly do what the experts tell us. You might (or might not) be surprised at how biased they are. And I don't even mean this to be critical - understandably, there is bias everywhere, including in my book. I just mean that as we research and chart our own course, we must take all information from the Internet, forums, books, doctors, studies, etc. - with at least a small grain of salt. It sounds like you are doing that, and I suspect you'll make good decisions. Best of luck to you, and good health! Sincere regards ... Ron Nelson

Post Edited By Moderator (142) : 4/29/2012 7:36:17 PM (GMT-6)

Posted 4/30/2012 4:14 AM (GMT 0)
Thanks Guys as I'm going to start asking about PCA3 and try to get it done soon.
I have a June Biopsy planned and this would be some great extra info .
I have all these strange pains in my ribs and my hip which sort of freak me out.
My Doc says the chances with my PSA that any if this stuff is related is remote.
That being said I do worry about this stuff way to much and need to find out if anything is going on.

Thanks

Moose
Posted 4/30/2012 11:33 AM (GMT 0)
Moose,

I am not a doctor or an expert, but your journey of rising PSA and then dropping after a round of antibiotics does sound like chronic prostatitis. Usually a PSA rise due to PCa doesn't go back down after antibiotics. My PSA actually rose almost 2 points after a round of antibiotics to rule out  prostatitis. A biopsy might alleviate your fears of PC but it is not a piece of cake. Mine put me in the hospital for 2 days with a antibiotic resistant blood infection, but that happening is rare, about 2% of all prostate biopsies.

The Water Guy

Posted 4/30/2012 11:38 AM (GMT 0)
if your urologist says to wait 3 months, I would do just that.
Posted 4/30/2012 4:47 PM (GMT 0)
A PCA3 test is highly recommended before a biopsy. Also has your doctor calculated your psa density? psa divided by your prostate size in cc. If below 1.5 your psa is coming from BPH and not PC.
PC is indiatated by a slow steady rise in psa.
Posted 4/30/2012 7:55 PM (GMT 0)
John:

But isn't the prostate size fairly indeterminate before surgery?

Mel

Posted 4/30/2012 9:06 PM (GMT 0)
Mel,
An experienced doctor can estimate the size by feeling it, but this is also inaccurrate. When you get a biopsy the doctor will take measurements of your prostate with the ultrasound and this should be noted on your biopsy report. This is very accurrate. The doc estimated mine to be 50cc to 55 cc by feel and it was 60cc as measured by a couple of ultrasounds.
Not as accurrate, but close.
Posted 5/27/2012 6:29 AM (GMT 0)
Thanks for all the advice on what to do. And I Got a pca3 which came back at 38.6 which was not was I was hoping for
Which means that I need that biopsy and it looks like 6/5 is the date.
I getting really scared because I have all these symtoms which has me convinced of a bad outcome. From peeing all the time ,weird pain in my back and legs I'm not good. I also have bubbles and a bad smell in my pee.
Not in a good place
Posted 5/27/2012 1:02 PM (GMT 0)
You've asked all the right questions.  Even with that PCA-3 result, statistical percentages say you may not have PCa.    I know it's easy to say and hard to do, but try not to worry at this point.  It is what it is, the worrying won't alter that.  I felt in my guy I knew I had PCa even before the biopsy given all my results, but still just kept it in my head it was Prostatitus.  That at least kept it out of my head.

Your symptoms are funky.  I had a few funky pain symptoms that the Uro told me were not related, one never knows.  You can't link them at this point. 

Relax, take a deep breath (and even a deep beer if you like it) and await the results.  If it is PCa, it can be treated.  We are all here as examples.

Posted 5/27/2012 2:12 PM (GMT 0)
Moose, while I am well beyond that stage of dealing with the preliminary diagnostic tests for PCa, I like many others here continue to research PCa.

There have been many discussions about the PCA3 test and quite honestly I never really looked into. But while doing some research in the last few days I discovered some testing that is relatively new at Bostwick Labs. One of them is the PCA3Plus test.

Here is the link:/www.bostwicklaboratories.com/GLOBAL/services/laboratory-services/urologic-pathology/pca3plus.aspx

Also I found this procure at the PCA3.org (who new the test had it's own website) website. Thought you might find this interesting. If I read the numbers correctly, they would indicate that you have a relatively low risk of having PCa.

www.pca3.org/public/sites/pca3.org.public/files/content_media/pca3-patientbrochure_english.pdf

Now to each his own and that is for sure, but possibly you might think about trying the PCA3Plus test with Bostiwick before you went ahead with the biopsy. Just a thought and you can still go through with the biopsy at a later date. Seems like you would have the results in about 2 weeks. That would not be much of a delay.

Good luck to you brother in your search for the truth,

Sonny
Posted 5/27/2012 2:55 PM (GMT 0)
Moose, Hang in there buddy. Yes you're in a scary place right now and you need more information. Hopefully the biopsy will give you that. Even if it turns out not to be PC maybe the biopsy can point the doctors to what is really the problem.

Please let use know how it goes. We'll be here.

Andrew
Posted 5/27/2012 3:43 PM (GMT 0)
Moose,

The only thing I can add to all of the above is that after the biopsy you will have some missing information which will help you decide next steps. That alone will be worthwhile for you. Best wishes,

Joe
Posted 6/9/2012 1:30 AM (GMT 0)
Well I got it it's not so good
7 of 10 cores positive from 10 to 80 %
All the Gleasons are 3+3 but as I have read this is not that accurate
Doc is sending me for a MRI and a Bone Pet Scan
At first it was a bone scan but then they called me back to change it
Makes me a little more scared
I had all these symtoms for a long time and now want to kick my own ass
Pca3 turned out way better than free psa

Scared as hell
Posted 6/9/2012 2:12 AM (GMT 0)
Moose,

Sorry in one way, but glad you got a definitive answer via your biopsy. You are officially in the Brotherhood of the PC, for better or worse.

The bone scan is a typical thing at this point, no reason to be scared. Many feel they are not even needed at this point, especially with a Gleason of 6, which would be considered a minimal cancer. The concern I see, is that you have 7 of 10 cores positive, ranging up to 80%. The bone scan, if nothing else, will serve as a base line for future use if needed.

The pains you describe in all probability, have nothing to do with the fact that you are now verified with cancer. Even with these results, do not feel rushed or pressured to make any kind of immediate treatment decision. This is the time now, to spend the time to educate yoursel in all your options. You want to study much, and choose wisely when the time comes.

Good luck, hold your nerves steady, and keep firing away all the questions you need to ask. There are people here experienced with every possible treatment method first hand, so keep your options open. All of them come with "x" of amount of risk and side effects to consider.

Please keep us well posted.

David in SC

P.S.

Your last words - "I am scared as hell" - the best way to diminish the fear and the scare, is with educating yourself. Being here is a good first step. Also, if you have time, get a copy of Walsh's book "Surviving Prostate Cancer", 2nd edition. It's a great primer on all things PC.

And as a final word, my personal mantra: Never, ever give up hope.
Posted 6/9/2012 2:53 AM (GMT 0)
The bottom line is that there is absolutely no blood test or any doctor that can tell you if you have prostate cancer or not unless you have your prostate removed and examined.  We have all seen on this forum that PSA is by no means an accurate predictor of PCa and aggressiveness.  People here have had low PSA and aggressive prostate cancer and they have had high PSA and non-agrressive cancer.  It is my personal opinion that you could pull people at random off the street and biopsy them and find prostate cancer in people you would not expect to and not find it in people you would expect to find it in, regardless of any kind of blood test you give them first.  PSA or PCA3 provide you absolutely no additional information that could possibly make your decision any clearer.   

Everyone who is giving you adivce on what to do, including doctors are just expressing their opinions based on their past experience with PCa not on science. 

Given your age I would wager based on past studies of men who have died of other causes and then had their prostates examined their is a an estimate that 50% men your age have PCa. 

I would not be surprised if you had a positive biopsy purely just because of your age.

Posted 6/9/2012 4:12 AM (GMT 0)
Chris,

You said:

"can tell you if you have prostate cancer or not unless you have your prostate removed and examined"

Did you really mean to say "unless you have a prostate biopsy" instead? Because, obviously, you can tell for certain that you have prostate cancer from a prostate biopsy, it's not needed to have your entire prostate removed to ascertain the prescence of cancer.

david in sc
✚ New Topic ✚ Reply
12