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Posted 8/3/2012 10:41 PM (GMT 0)
Hi Everyone,

Went to Dr. Cornfield today with hubby. Explained about seeing the RO and him wanting to do a STRB saturation biopsy out of the gate. He slowed down and said, yes with history and any abnormal DRE biopsy would be indicated, but not saturation. He did want to do another PSA with free this time. Took urinalysis, which was normal and ultrasound to check bladder, to see if emptying. and he then did another DRE. I asked about PCA3, but for whatever reason he did not believe in the validity of it and probably not covered (unusual, not sure I agree). Glad about the free though. The doc did DRE and he said that it is enlarged and it is asymmetrical, with the right side bigger than the left, but smooth through out. He wanted to also check through his lab total PSA and see if it is same or different as well. He put him on Rapaflo? Just for a few weeks to see if prostate changes. Most likely if his PSA stays a five and free is low, biopsy will be scheduled. What is Rapaflo? Is it an antibiotic? Should I be worried about having him wait another month? I honestly thought we would be scheduling a biopsy today, but a 12 core. What if PC is in there and aggressive and waited? By the way, this doctor had a great bedside manner and explained the route he was going, I just forgot half of it. Will bring recorder next time for
sure. Thanks for letting me vent. Still worried.

Crazy question. I read somewhere that bike riding can cause an enlarged prostate? Doc said no and it was ok for him to ride. Anyone know if this is a myth and if not are there any studies? He wants to ride, and now got the ok, but I just don't want him to make matters worse.
Posted 8/3/2012 11:03 PM (GMT 0)
In my opinion, the doc is playing it safe. I just googled "Rapaflo prostate" and it is used to treat BPH (enlarged prostate). A larger prostate will have a larger PSA output.

To be safe, the doc could also check for prostatitis if the PSA has not gotten lower and have your husband take a specific antibiotic for 10 days.

Only have a biopsy done by someone who is not shooting in the 'dark' trying to get a sample. Make sure he/she has a nurse to do the biopsy sample marking/paperwork while he/she is doing the biopsy to reduce the overall time - not an experience I'd want to repeat. Painkiller and antibiotics would be nice, too, but that is another extensive topic.

Talking to various doctors, it seems that they consider a PSA around 10 in the critical zone to have to do something. If your husband can handle going on watchful waiting/active surveillance down the road, that will give you time to learn more.

Good luck and will keep my fingers crossed things will work out.

CowboySailor
---------------------------
PSA 6.9 - Gleason 4 + 3 = 7
Trying to find the right treatment...
Posted 8/3/2012 11:10 PM (GMT 0)
With my husbands experience being so aggressive with just PSA of 5 and only one core positive, Gleason 9, there is NO WAY I would wait until PSA reached a 10......but thats us. Nothing felt on DRE. He might be a one in a million...but I could have told them that after 42 years of marriage. Every time something different,unusal shows up we hear ...this is very rare this happens ....hello...it's happening to us and quickly ....
Posted 8/4/2012 12:24 AM (GMT 0)
I don't think he will even wait that long, I think if the free PSA is low we will be getting a phone call possibly.

Jitters: Because of what you went through, that is why I brought it up to the URO. Because I know that a low PSA means nothing. The fact that his prostate was asymmetrical I am sure was not great. He was still very matter in fact that if the free PSA is low and the total is still 5 the biopsy will be scheduled. I think if the PSA shows way different than 2 weeks ago on his labs meaning lower and a high free PSA, he will keep him on the Rapaflo for a short while just to see what happens. He kind of contraindicated himself when he said that any abnormal DRE warrants a biopsy, and then went into the blood work numbers and rapaflo, so I am confused about that? Should my husband call next week and ask him about the results and push for the biopsy if needed? I am more confused

As far as the Rapaflo, I am thinking not just to reduce size but he is having frequent urination with some burning, so maybe for the urinary symptoms as well?

How are you supppsed to find out how he biopsy's in his office as far as nurses and marking etc? Just call over and ask?

Post Edited (nosywife) : 8/3/2012 7:12:15 PM (GMT-6)

Posted 8/4/2012 1:20 AM (GMT 0)
Regardless, I don't feel your husband is in any immediate danger even if he had to wait a month for a biopsy. If one can be ruled out, that's all the better. But if one is justified, by all means have it. In most cases, a low PSA number is a good thing, there are a few cases here of low numbers in conjunction with an agressive cancer, but they are far and few between.

As far as DRE's go, opinions are all over the place. I had at least 10 DRE's done before my PC dx, and they all came back completely normal, but I ended up with an aggressive cancer. That is one of the problems with PC, is that there are often so many inconsistencies, which can make it harder to determine what to do and when to do it.

Good luck with the steps ahead, sounds like the doctor has a good handle on things, at some point, you need to trust your doctor's sense of direction. If you don't, or can't, then I would suggest finding another doctor in whom you can trust completely.

David in S.C>
Posted 8/4/2012 2:01 AM (GMT 0)
Trusting your doctors advice is KEY. That is so important in my opinion. If they can't explain everything or every question I have in terms I can understand I don't leave and I always take a recorder with us. We have even conferenced my daughter in from another state..
Posted 8/4/2012 2:01 AM (GMT 0)
Trusting your doctors advice is KEY. That is so important in my opinion. If they can't explain everything or every question I have in terms I can understand I don't leave and I always take a recorder with us. We have even conferenced my daughter in from another state..
Posted 8/4/2012 2:11 AM (GMT 0)
Nosy:

Assuming your husband just had a rigorous DRE, do NOT do any blood tests for a week as the DRE can falsely raise the PSA.

Try to relax. Easier said than done but you will soon find there are no absolute answers in terms of what tests to take and it gets worse if he is dx. with PC. There are lots of grey areas. Just gather as much information as possible and make a decision.

Mel

Posted 8/4/2012 2:25 AM (GMT 0)
Noseywife,

I'm an avid cyclist and so is my Uro, so there might be some bias. My Uro and his associate (did my surgery) pretty well said that bike riding causing PCa is more of a myth. Bike riding will stress the prostate which can elevate PSA readings, especially after long rides. After a week long ride (500 miles), my initial PSA was high so my GP waited a few months for a retest. It did go down, but still remained on the high side. Once I was diagnosed with PCa, I was told to stay off the bike prior to surgery. I'm now back to biking and the good news is I don't have to worry about the prostate anymore.

I hope you find this helpful. I don't have any studies to back this up but recall various articles stating the same. Good luck with your journey.
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