INFO PLEASE waiting on DX thank you

Hello Survivors! I have been reading a lot of the threads and I needed to vent I hope its ok! I am the wife to my wonderful husband who is awaiting biopsy results from last Friday.I have read so much information to be prepared for the worse and hope for the best. So just a couple of questions His psa was 14,8 a year ago (supposedly his primary sent a letter to that fact but we never saw it) in December he went to a urologist per me making the appointment for what appeared may be prostatitis his psa was 12.7 he put him on cipro and flomax for 3 weeks, also had normal pelvic cat scan at this time w/contrast and then 2 weeks of rapiflo and another antibiotic (as he was having side effects from the other). he repeated the psa and it is 19.6 called thursday scheduled biopsy for friday. exams were normal and he did not see obvious abnormalties in the biopsy exam (but he stated that does not mean anything). Is it possible for psa to be that high with no cancer I can't find that answer and the lab doesn't have a free % only a free psa which was 1.9 (lab stated that >10 they do not do fpsa% ) it probability >50% when psa is >10. I am the researcher in the family and although he is a nervous wreck hes not a huge computer guy. He is 51 and his dad had pca 10 yrs ago with seeds. Any info will be much apprecciated Also why would a psa go from 14 to 12 to 19 is that indicative of ca too? Honesty is what I'm looking for the dr is calling me with details of results 9drs away and will be calling from vacation ) because my husband is a truck driver and I want to ask the right questions etc and be overally prepared if the dx is ca thanks in advance!

Post Edited (mycrooner) : 2/25/2014 6:06:51 PM (GMT-7)

Reltnie,
Thank you for responding I do it's twice the size of normal at 60g I just fear the worst as I'm sure everyone here has and have already done my research for drs we are blessed by living in the Boston area and i have had treatment for years for carcinoid (slow growing tumors) in Boston. The urologist had stated that if pca was found then removal would be his only option. I now realize that may or may not be true and it may be his best depending on the outcome of the biopsy. I just don't want to be overwhelmed at news I want to ask the right questions etc of the urologist and prepare for whatever treatment is decided upon by my husband by the information that we get, Thank you and congrats n your success! Keep up the good work :)

I would think, that if his PSA is still that high, after all those antibiotics, then a good chance that it may be cancer. Only a biopsy would, or should, prove that point. Though, sometimes, a single biopsy will miss the cancer. I had 3 biopsies over about a 15 month period, and it was only on the third one, was the cancer found. And there was a lot of cancer, the first two simply missed it. And I never had a positive DRE. Just a fast rising PSA. In the last year, it rose from 4.x to 16.x.

Any doctor that would suggest that surgery is the only answer, is a doctor you need to walk away. Assuming it is cancer, the Gleason score, the number of positive cores, the percentage of cancer in the positive scores, and the preliminary staging of the cancer would all determine which primary treatment would be best. No way a doctor would know that ahead of time.

As a general rule, uro/surgeons push surgery, as radiation oncologists push radiation. If he happens to have a more serious biopsy diagnosis, then seeing a good medical oncologist would be in order, as usually they don't have a "dog in the fight".

Good luck

David

You are getting some good and bad feedback from the doc.

It is possible to have PCa but not feel any problems in a DRE (rectal exam).
Absolutely true. The prostate has only one side presented to the rectal wall, so one half can not be felt. It is entirely possible to have a problem in one are and not the other.

Surgery is the only treatment.
False. There are several treatment possibilities, as you have discovered, but some are more indicated depending upon age and health of the patient, and widespread cancer can make surgery pointless. Each treatment has its own risk factors. None of us have the information to say what treatment is correct, as we are not doctors. We can only offer our experience.

Size of the prostate has to do with the PSA level.
Certainly. PSA is produced by prostate tissue. More tissue, more PSA. It could also be caused by a chronic infection.

I understand that he has had a biopsy, but you don't have results yet. You might want to look at the two threads at the top of the forum, where many of the questions you might want to ask are discussed.

I will say this my crooner, your posts indicate that your husband has one heck of an advocate in you. Your words vibrate with a natural savvy, not just with what you are dealing with in this situation, but life in general. I will say this upfront, the odds , in my view, with the info you have provided, is that your husband has Pca. So when you meet with doctors,RO's, MO's etc, use that savvy and be not shy about it. Ask the questions you want. Do not concern yourself with the questions, concern yourself with answers. You need not explain yourself to them, they need to explain themselves to you. Thats why they get the big bucks. Surgery is definitely not the only treatment available. But it may in fact be the one that could be the most beneficial all around. That decision will be made by you and your husband with the knowledge you will gain from all the data points you can glean. I hope I am wrong about my sense of the biopsies results. It could be a deep seated infection, which is not affected by antibiotics. It happens.
The large prostate is possible reason for that particular thesis. Regardless of outcome, you have every reason to expect, many, many, many years together,either via, no cancer, a cancer that is curable or a cancer that can be managed into a chronic condition rather than a terminal condition. Remember what I said about savvy, use it…...

mycrooner said...
Hello Survivors! I have been reading a lot of the threads and I needed to vent I hope its ok! I am the wife to my wonderful husband who is awaiting biopsy results from last Friday.I have read so much information to be prepared for the worse and hope for the best. So just a couple of questions His psa was 14,8 a year ago (supposedly his primary sent a letter to that fact but we never saw it) in December he went to a urologist per me making the appointment for what appeared may be prostatitis his psa was 12.7 he put him on cipro and flomax for 3 weeks, also had normal pelvic cat scan at this time w/contrast and then 2 weeks of rapiflo and another antibiotic (as he was having side effects from the other). he repeated the psa and it is 19.6 called thursday scheduled biopsy for friday. exams were normal and he did not see obvious abnormalties in the biopsy exam (but he stated that does not mean anything). Is it possible for psa to be that high with no cancer I can't find that answer and the lab doesn't have a free % only a free psa which was 1.9 (lab stated that >10 they do not do fpsa% ) it probability >50% when psa is >10. I am the researcher in the family and although he is a nervous wreck hes not a huge computer guy. He is 51 and his dad had pca 10 yrs ago with seeds. Any info will be much apprecciated Also why would a psa go from 14 to 12 to 19 is that indicative of ca too? Honesty is what I'm looking for the dr is calling me with details of results 9drs away and will be calling from vacation ) because my husband is a truck driver and I want to ask the right questions etc and be overally prepared if the dx is ca thanks in advance!

Hi there,

As the others have noted, it is possible to have a high PSA and not have PC -- just as it is possible to have a very low PSA and HAVE PC.

No doubt, part of the reason for the high reading is the BPH (the enarging of the prostate). But usually it would not boost it that high.

We'll be waiting along with you for the results of the biopsy. Without discouraging you too much, we have one member here who required over 10 biopsies before his PC was finally discovered. Indeed, as others have said, it is possible to have a non-suspicious DRE and still have PC. This was the case with me.

You can look with hope in the fact that his other tests have been okay. So, if PC should be DXd, it is very possible it would be localized (still confined to the prostate).

Since his dad had PC, his chances of having PC someday are about double the normal risk. In my case, both my Dad and one of his brothers had PC, so my urologist said my chances were triple. Turned out he was right.

If PC should be diagnosed, and if surgery and radiation are both viable options, he should indeed consult with specialists in BOTH forms of treatment. Learn all about the pros and cons of both radiation AND surgery.

For a bit of personal insight, I also had a large prostate when DXd. In fact, mine was almost 4x the normal size at 100 grams. As my prostate continued to grow, the urination problems I had were getting worse and worse.

I met with a radiation oncologist at Mayo Clinic who ruled out radioactive seeds for me because the seeding needle would not have been able to reach all corners of the prostate with all it's nooks & crannies -- because such a prostate tends to spread out behind the bony structures, etc.

However, in my particular case, he did say that EBR (external beam radiation) could cure me. He also said surgery could cure me.

In my particular case, the BPH related urination problems were really "crimping" on my quality of life. So the radiation oncologist said surgery could cure both the cancer AND the urination problems. So he actually recommended that I opt for surgery.

So this might be something to consider if your husband should be DXd with PC. If he has BPH, chances are that it will continue growing as the years go by and urination problems could begin (if not already started).

But, in any case, if he is DXd, it is wise to visit both radiation and surgery guys so you can keep educating yourself on all forms of treatment.

In the end, I hope & pray that it is NOT PC. And that, if it is, it will be a very curable type.

Good luck!
Chuck :)

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Firm erections now briefly happening in early mornings, 2 years post-op.

Let us know.

Keeping my fingers crossed that you get good news

mel

I couldnt open that link (unavail) but I understand what you are saying. and thanks!! I believe 30% as well after researching info

I don't understand why your husband's doctor would say that "removal" would be your husband's only option if PCa was DX. I am a surgery guy myself but I don't think you would get anyone here to agree with that statement.

My PSA jumped around from 4-9 starting in 2000. I had 3 biopsies before finally being DX with a PSA of 18.5 12 years later.

Hopefully you will know something in the next day or so from the results of the biopsy. As Tom Petty says, "The Waiting is the hardest part". If the biopsy is negative this time, he needs to continue to watch his PSA from now on. When I finally was DX, my surgeon said
I probably had a tumor growing for 10 years before the biopsy needle found it.

Keep us informed, we are all waiting with you both!

Bill from Florida

Big Mac: I don't know why he said that either. His theory of the statement was that my husband was 51 and his prostate was so enlarged causing urinary problems. No matter what the outcome a second opinion will be needed. I know that my husband thinks that if the biopsy is negative then thats it its negative. Now they're saying Monday at the earliest for results (hubby called today) I called and left message for covering Dr. Anxiety is too high and it doesn't take that long for results! End of rant :) Thanks!

I just checked my records and I had my biopsy on the 27th and had an appointment with my uro on the 8th for the results. So that would have been about 11 days. My biopsy results were sent to my uro on the 2nd but since we had an appointment for consultation for the 8th, he never called any sooner.

Actually I liked it that way. I had less anxiety waiting for the phone to ring and was prepared for the worst when I met with him.

IF it is positive, ask for a copy of the biopsy and have the slides sent for a second opinion. Hopefully you will just be visiting with our little group here.

Again, good luck!

Bill form Florida