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PSA changes again - help

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Posted 5/31/2014 3:09 PM (GMT 0)
Good Morning - its been some time since I've posted here but tend to do so when frightened. A quick history -
Total PSA readings:
8/05: 1.6, 8/07 2.2, 8/08 2.4, 6/11 4.98, referred to Urologist at NYU Medical Center, 6/11 5.4, 7/11 4.7, DRE normal but enlarged - 47cc PCA3 6/11 was only 8.7:, 12 core biopsy 8/11 - negative, no HGPIN, no PIN, no ASAP, no atypia - inflammation in 4 cores. Follow up on 3/12 PSA 3.63. Second PCA3 12.4: (bostwick) Follow up 6/13: PSA 2.9, fPSA 14.1%, Preparing for 1 year follow up and just got my total PSA back - 4.7. Really dont know what to think here. Im 61 years of age without any (known) family history of PC.
In view of the recent increased reading, I really dont know what to think. My follow up with the Urologist is this coming thursday.
In the past, everyone here has been so helpful.
Bob
Posted 5/31/2014 3:11 PM (GMT 0)
Maybe try a course of antibiotics for a month and re-test?

Mel

Posted 5/31/2014 3:14 PM (GMT 0)
Thanks Mel.. will see what the doc thinks this week also
Posted 5/31/2014 4:48 PM (GMT 0)
The normal psa range for a 47cc prostate is 3.1 to 4.7, so you are in the normal range. Your PCA3 is very low and the only abnormal reading you have is fpsa. On top of this you had a negative biopsy. I think you are searching for a problem that doesn't exist and if you search long and hard enough you will most likely find something as someone your age has a 60% chance of harboring some indolent prostate cancer cells.
Your psa is bouncing around all over the place which is a sign of prostititis which was confirmed on your biopsy. The most likely issue is a small infection which may last for a long period of time.
Prostate cancer is indicated by a consistent rise in psa over time. Readings that are up and down are a sign of infection.
Go to the PCRI web site and search for Dr Stephen Strum "What Every Doctor that treats Male Patients Should Know". His article will explain how doctors should use psa to distinguish between the various issues relating to the prostate.
Posted 5/31/2014 5:10 PM (GMT 0)
John....thank you so much for your insight.....much appreciated
Bob
Posted 6/12/2014 2:30 PM (GMT 0)
Last week I had my follow up appointment with Urologist in NY - was not concerned with the bouncing PSA to 4.7, ran PCA3 test again and got the results today - Im right on the line of 25. any thoughts as to the overall meaning of this. Previously, the PCS3 cut off was 35.
Posted 6/12/2014 2:54 PM (GMT 0)
I was treated at NYU. I'm surprised you haven't had a mpMRI. NYU was among the first to use this type of MRI. I had it done there about three years ago. Which doctor are you seeing?
Posted 6/12/2014 3:20 PM (GMT 0)
University Urology. Kaminetsky
Posted 6/12/2014 5:49 PM (GMT 0)
The NYU prostate cancer center can be found here: http://prostate-cancer.med.nyu.edu

I would see either Dr. Lepor or Dr. Tanega. Since you are in in or near NYC, there are a number of top experts you can see. Some of the top docs are Dr. Eastham at Sloan Kettering; Dr. Tewari at Mt. Sinai and Dr. Samadi at Lenox Hill.

Just FYI, my PSA was between 3.1 and 3.7, my free PSA was 29% and my PCA-3 was 15. My regular urologist, who was treating me for BPH, told me not to be concerned. I was and my biopsy was positive nonetheless.
Posted 6/12/2014 7:37 PM (GMT 0)
Thanks for the information. Yes, I'm familiar with the three docs you named. My biopsy was negative. Will consider what to do
Bob
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