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Just plain BPH?

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Posted 5/28/2013 2:05 PM (GMT 0)
Hello! I am so happy to have found this forum. And, I am grateful to all of you who share your journey here. My husband and I might just be at the beginning of our own journey. He is 62 years old and scheduled for a biopsy in 2 weeks. His DRE was negative except that it was enlarged. It has always been assumed that he has BPH. For the last year, his trips to the bathroom have increased noticeably to an average of 5x nightly. His PSA's are as follows:
2007: 0.8
2009: 1.3
2010: 1.9
2011: 1.9
2012: 2.4
2013: 5.4
My question is... does this look like BPH? I am familiar with doubling time and do not like the +3 rise in 12 months. But I wonder if anyone has had a similar experience. I know, ultimately, the biopsy will provide some answers. Since we have to wait a bit before then... and then an additional 2 weeks for the follow-up appointment... I am hoping for any insight you might have. Thank you!
Posted 5/28/2013 2:57 PM (GMT 0)
Hard to tell if it's BPH without the prostate size. Normal prostate tissue with BHP will produce between .066 and .1 psa for every cc of prostate tissue. Also PCA3 and free psa can indicated BPH vs prostate cancer. His prostate size would have to be over 54cc for BPH to cause his high PSA.
The consistent rise in his PSA rather than spikes and drops is more indicative of prostate cancer.
Only a biopsy can tell for sure at this point.
JohnT
Posted 5/28/2013 2:57 PM (GMT 0)
Something is up. Have they tried antibiotics for an infection? With the quick rise a biopsy doesn't seem out of line. Good luck and keep us informed.

Tom
Posted 5/28/2013 2:59 PM (GMT 0)
Welcome to our corner of the world. Sorry you need to be talking to us but it's a great place to ask questions.

BPH? Well, it's possible but just looking at the raw PSA numbers it is so hard to know for sure. We could speculate but I don't think that is productive. It could also be an infection, bad day at the lab, etc. You could ask for a second PSA to confirm the last number.

The biopsy will tell the tale. The doubling time is worrying but until they get a sample to the pathology lab it would be very hard to know.

And that is the problem with the place you're in - no one being able to tell you for sure. I'll be that even your URO isn't willing to offer much of an opinion.

Keep us updated. Hang in there.
Andrew
Posted 5/28/2013 3:00 PM (GMT 0)
Catti,

Welcome to the forum. Sorry your worries have brought you here but glad you found us.

It could easily be BPH. His PSA history up to last year would be pretty much what you would expect. This year's bump is worrisome but there are a number of things that can elevate a single PSA reading -- sex 24 hours before blood is drawn, bicycling, nasal decongestants, a mild prostate infection, etc., etc.. But you probably already knew all that. The biopsy seems sensible and will give you more info.

Is he taking anything for his enlarged prostate? If, for instance, he were to be on Avodart (to shrink his prostate) then that would tend to lower his PSA and would make the 5.4 a bit more troubling.
Posted 5/28/2013 3:07 PM (GMT 0)
Catti: It could be BPH. I think that your doctor is correct to order a biopsy; just to be sure. We understand that this is a difficult time for you and your husband. Sometime the waiting is the toughest part.

If you want, talk to your doctor and see if he could give you the results over the phone as soon as they come back to his office, rather than waiting the full 2 weeks until the follow up appointment. The doctor had my results back in 3 days (after the biopsy), but I stressed thru 16 days of waiting until my follow-up appointment.

The doctor may give you more information as soon as the the biopsy is done regarding the size and if anything is seen during the ultrasound guiding when the biopsy cores are taken. Perhaps you will get some good news to take the edge off of the waiting for the full biopsy results. Good luck.

Bill K. from NJ
Posted 5/28/2013 6:02 PM (GMT 0)
JohnT: Wish we did, but we don't know the prostate size.
Tom: No, he wasn't given antibiotics. So I guess we can't rule out an infection yet.
Andrew: You are right on... the URO would not commit to an opinion, which is understandable.
PeterDisAbleard: No, he is not taking anything for an enlarged prostate.
BillK: Wonderful suggestion!

Thank you all for taking the time to answer and for your thoughtful, informative replies! We will continue to educate ourselves in the meantime, so that we are prepared... should life throw us one of those unexpected curveballs. I promise to update you once we have the biopsy results. ~ Kindest Regards, Catti
Posted 5/28/2013 6:40 PM (GMT 0)
Hi, catti...my husband and I are in basically the same place as you. He does have an enlarged prostate, but the uro didn't find anything other than that with the DRE. He had a biopsy last Friday. They let us know over the phone when it comes back, which should be anytime between tomorrow and Friday. They don't even schedule a follow-up appointment until the results are back: one with the uro if they find anything of concern, and one for a psa lab test in 6 months if they don't.

Yes, the waiting has been the hardest!!! The not knowing, too. The only thing that has helped it talking to friends and the support of this wonderful forum and the supportive, friendly people here. I am trying to stay busy so my mind isn't wandering in fear.

Good luck and let us know what you find out!

Donna
Posted 5/28/2013 7:05 PM (GMT 0)
Hi Donna,
Thanks so much for your nice words! I think the only thing we can do is stay busy and learn everything we can... just in case. I've already read Dr. Walsh's book. (I am an RN... inactive for the last several years. But, I still love reading all things medical. :) And, I am happy to learn from the experienced members of this forum, as you are.

Oh, my goodness... anytime between today and Friday... I hope your answer comes quickly! And, I hope it is the best of news. I can only imagine how nerve-wracking it must be to wait for that call.

Good luck to you and your husband, also!
~ Catti
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