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Posted 8/14/2013 3:02 PM (GMT 0)
Hi, new to the forum. 54yrs old with psa of 2.5 2yrs ago with psa of 4.9 2wks ago. Just got tested again with psa of 4.3 and free psa 9%. Ultrasound scheduled this Sunday, with Urologist appt the following Friday. Any insights? I know, it doesn't look good.

Post Edited (Patel) : 8/14/2013 9:09:23 AM (GMT-6)

Posted 8/14/2013 3:13 PM (GMT 0)
Welcome HW. Sorry you need to be talking to us.

PSA is just an indicator that something is up with the prostate - could be infection, BPH, bad day at the lab. All the number means at this point is that you need to be getting more tests by a good URO.

While it could be PC, the drop in PSA from the last test suggests that it could be something else. With PC you'd expect to see a steadily increasing PSA number but you never can tell for sure. The only way to know for sure if you have anything really bad is to do a biopsy. Don't be surprised if your URO recommends that. The URO will also do the fun DRE. That along with the ultrasound should give enough info on whether or not to proceed with a biopsy or try something else.

It is also very possible that 4.something is your normal number and you just need to be monitored for awhile.

It's easy for me to say don't worry but until you have positive evidence of badness, don't worry and take it test by test.

Hang in there and keep us updated on your progress.
Andrew
Posted 8/14/2013 3:21 PM (GMT 0)
Hello Patel,

Welcome to the forum. Sorry you find yourself here but glad you found us.

You are right, your odds that the doctor will find something during Sunday's ultrasound are better than even money with that free PSA score. In the event that you are diagnosed, please remember that most prostate cancer is very slow growing and there is seldom a need to rush in deciding what to do about it. Many cancers can simply be watched and only treated if they seem to be advancing, and most cancers that do need to be treated can be treated successfully in a number of treatment options (surgery, radiation, focal therapies), all of which have different risks of side effects from treatment.

And of course it could still be nothing.

Keep us posted. Good luck.
Posted 8/14/2013 3:23 PM (GMT 0)
Hi Peter - please delete my thread for Patel. done.

Post Edited By Moderator (PeterDisAbelard.) : 8/14/2013 9:36:16 AM (GMT-6)

Posted 8/14/2013 3:41 PM (GMT 0)
Hello Patel:

   Welcome ... and try to take your time and reduce the worrying. I was first diagnosed about 10-years ago ... still in the fight now and my first diagnosis was when I was 60-years old. And so many treatment types have changed since my first ... so that's a good thing!!!!

  

  

Posted 8/14/2013 3:47 PM (GMT 0)
Hi Patel, and welcome to HW. PSA values tend to bounce around a little so this may be nothing but an infection. During your meeting with the urologist you may want to ask him about a round of antibiotics before he sends you off for a biopsy. However, if he finds an irregularity during your DRE (rectal exam) then biopsy is almost certain. Also, your free PSA level gives you about a 50% chance of prostate cancer so he may want to go ahead with the biopsy anyway.

Whatever the case, PCa is generally curable and slow growing so you should not overreact to whatever news you hear.

Our forum is full of caring and well informed guys and gals on the subject of prostate cancer. Please feel free to ask us ANYTHING as you continue your journey.

Good luck.

Jim
Posted 8/14/2013 4:32 PM (GMT 0)
I'll too welcome you Patel. As others have said, if it were me I would press your urologist to consider a dose or two of antibiotics to rule out an infection. Can you also share results of any DRE testing you've had? DRE is also a part of the whole process of deciding where you're at.

Best to you, and we'll be here for you.
Posted 8/14/2013 4:39 PM (GMT 0)
Welcome to the forum. Sorry you have to be here, but you found the right place. Please don't fret yet, until you find out what's going on, there's nothing you can do, so, "it doesn't look good" might not apply yet. Take the time to educate yourself about Prostate Cancer, and browse this site for information about what to expect, and what the various treatments are. Armed with knowledge, you'll know what to ask your urologist, and understand what he's telling you. I have some information I'd be happy to email you if you'd like. My email is in my profile, so feel free to send me a message and I'll send some info your way. Do some searches here for "information for new guys", and you'll be off to a good start.

Mike
Posted 8/14/2013 4:50 PM (GMT 0)
Hi Patel,
There are many reasons for an elevated PSA. Free PSA is probably the most inaccurate of all the test available and can be influenced by an infection. It is used to determine BPH from PC and this can better be done by estimating the size of the prostate by DRE or ultrasound.
Also remember that only 25% of biopsies found cancer. You are unusual in that you are getting an ultrasound before meeting with a urologist as getting an ultrasound usually means that you are getting a biopsy at the same time. If this is indeed the case, then your PSA density can be accurately calculated, PSA density, the size of your prostate in cc divided by 10. If your PSA is 50% above this number than the probability of cancer is high. If lower than 50% the PSA is being cause by BHP and not cancer. For example if your prostate is 30cc than your normal PSA should be 3. If it is above 4.5 with 30cc prostate than you have excess psa that need to be investigated.
Since your psa dropped from 4.9 to 4.3 this is more indicative of an infection and this would be the first thing I would be looking at.
Either getting a biopsy now or waiting two months and taking another psa test or going on a course of antibiotics are all reasonable options in your case. My own philosophy is to eliminate all other causes of elevated PSA, BPH and infection, before having an invasive treatment such as a biopsy that could cause complications.
Posted 8/15/2013 10:04 PM (GMT 0)
Welcome Patel and best wishes to you. Keep us posted how things are going.


Don
Posted 8/15/2013 10:38 PM (GMT 0)
Hi Patel-

If the diagnosis is Prostate Cancer, then you've found a good place for support and information. I have links in my signature below for people new to the PCa journey.

-Gedman
Posted 8/15/2013 11:58 PM (GMT 0)
Welcome to HW PC, Patel.

Hopefully, an infection will rule out your membership to the club here.

Good luck, and hope you dodge the bullet.

david
Posted 8/16/2013 12:09 AM (GMT 0)
Welcome Patel. Ditto to what Purgatory posted and your membership will be short. Same boat, newbie like you. But you have come to the right place. Lots of good info, real stories and good links. I've been burning up my printers and staying up late reading every night. Few cans here on my desk and its getting a lil hard to see the screen. Might have to clean up a bit tonight. Good Luck and I will watch your post. One book I have been reading is "You can beat prostate cancer" by Robert J. Marckini.
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