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Posted 11/6/2013 11:35 AM (GMT 0)
Hello again!  I know you don't remember me but I posted here earlier this year and the end result was that I thought everything had resolved itself.  I'll past most of my earlier post here so you can review:

I posted here about a month ago asking for help.  45 Years old.  12/11 PSA 2.6; 04/12 PSA 2.8; 12/12 PSA 4.46.  I had a prostate biopsy one year ago which showed no cancer but my PSA was rising to the level of my last PSA which was in December 2012 (4.46).  Have symptoms of urinary frequency. 

Then:  PSA 01/23/13 3.0 and free psa 13%

Then: PSA 04/23/13 1.9!  Doc said he didn't need to see me until January 2014 very relieved!!!

SO.....

A month ago I start having urinary symptoms again, some blood and pain in pelvic region lasted about two weeks and went to doc (primary care).  Took PSA test.  Urine and DRE normal.  He put me on cipro  for two weeks. 

Got PSA results yesterday and they were 17!!!  I am still having symptoms.  He did another psa yesterday and I get the results today.  He seems baffled and said he would call my urologist and see what to do next depending on the results.  You all are so helpful in giving me focus and advice.  What  to you recommend?  How would you proceed?  What should I be asking for from my docs?  I don't want to be alarmist but I also don't want to miss an opportunity to help myself.

Any advice would be helpful. I'll let you know results from yesterday's test when I get them (hopefully today).

Thanks!

Todd

Posted 11/6/2013 12:53 PM (GMT 0)
That PSA progression seems kinda strange. 1.9 to 17 within a few months. Hopefully the symptoms mean that it's just an infection causing the high PSA. The more learned guys will be coming along very soon to help more than I can at this point. Hope it turns out to be nothing antibiotics can't handle.

Steve
NolaVette
Posted 11/6/2013 1:01 PM (GMT 0)
It will be interesting to see what your latest PSA test results are today. How many cores did they sample last year? That is a big jump in numbers, was the 17 before you took the Cipro?

Bill from Florida cool
Posted 11/6/2013 1:02 PM (GMT 0)
Thanks, Steve.  Yes!  I thought so too and apparently so did my primary care doc who seemed baffled.  Truthfully if it wasn't for that 1.9 (which was taken at a different lab than all of the others) I can see a steady progression upward which kind of makes more sense....but even so it's quite a huge jump.  So I'm back in the "waiting for the phone call" mode I have been in for the last two years which I know nobody here is a stranger to.  I just want to make sure I'm asking all of the right questions when I need to.   Thanks again!

 

Posted 11/6/2013 1:03 PM (GMT 0)
I had a twelve core biopsy in January of 2012.  Yes, the PSA was before cipro. 
Posted 11/6/2013 2:39 PM (GMT 0)
If your PSA is still high after the Cipro, then I feel another biopsy is needed, and needed soon. I had a PSA of 4.x that rose to 12.3 in a years time, so rapid PSA growth is possible without infection.

Hope that is not the case for you, but I would rather be safe than sorry

David
Posted 11/6/2013 2:47 PM (GMT 0)
Thank you, David.  I really like my urologist a lot and find him very easy to talk to.  Hopefully after my doctor talks to him I'll get some kind of answers.  Your opinion is very helpful to me!  Thank you!

Todd

Posted 11/6/2013 4:41 PM (GMT 0)
Todd,

Your numbers are typical of prostatitis. In your biopsy report, did they note signs of chronic inflammation?Prostatitis is an evil thing. If it is responsive to antibiotics at all - and most are NOT - it can quickly acquire antibiotic resistance. This is especially a problem with fluoroquinolines like Cipro and especially if they have been used before (i.e., previous treatments and biopsies). Sometimes a longer course is required (e.g., 30 days), sometimes switching to a different kind of antibiotic (e.g., Bactrim) may work, sometimes nothing works and the prostatitis is treated symptomatically (alpha blockers, anti-inflammatories, anti-depressants).

There is also a procedure called a "4 cup test" where they capture the urine from different places while giving a prostate massage. Sometimes that can help identify the pathogen.

At 45, PC is a much less likely answer, although not unheard of.

- Allen
Posted 11/6/2013 6:36 PM (GMT 0)
Todd,

I have seen the extremes with PSA testing. I have a friend who consistently has a PSA of 17-20 and has had multiple biopsies...no cancer. I also know several guys who have a very low PSA with cancer.

As others have said, sounds like prostatitis for which I don't have much experience.

Let us know what you find out.

Jerry
Posted 11/6/2013 10:28 PM (GMT 0)
Thanks for the advice, everyone.  It's 5:30 here and no phone call from the doctor so I guess it'll be tomorrow.  I really wish they wouldn't say things like "I'll call you tomorrow!" when they mean, "I'll call you when I have a moment" which would at least have been honest!  I do hate waiting!  But I'll let you all know when I hear something.

Thanks again,

Todd

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