Concerned daughter with questions

Hi, I'm new to this forum. I just found out today that my father has a elevated PSA from a 2.7 last year to a 4.5 this year. He went yesterday for a biopsy. Several questions:
If it is pc, can you tell from the PSA number if it is early? Not sure if the had the freePSA drawn.
What is the likelihood that it is contained?
Dr did say upon exam that prostate felt large but when he did ultra sound, he said it did not look enlarged. Said he did not see anything unusual on ultra sound...I'm not sure if that was him just telling my dad that or not.
Any information to help my racing mine would be much appreciated. Thank you all!

Welcome to the forum. Sorry you have worries about your dad but glad you found us. Hope we can help.

So, how old is he? That 4.5 isn't terribly high. For men in their 50s and later the cutoff-value for worrying is 4.0 so he is just a bit over.

I doubt we can tell you a lot based on just his PSA. Once he has the results we can tell you more. Ask him to get a written copy of his pathology report for his biopsy. We can usually help decode the jargon.

Take a look at the locked threads in the forum. They have a great deal of information in them that will help you understand.

PSA s just a blood test that looks at a specific protein produced in the prostate. If it is over a specific level, doctors will perform a biopsy of the prostate. With a jump that large in one year it may be something else. My PSA jumped up but then kept going up and up till I could not ignore the trend any longer. It seems that your dad can't ignore it any longer either.

The biopsy will show what is going on. Remember that it is a sampling of the prostate and, as such, there is a statistical chance that the samples could miss a small cancer and give a negative result. That is why most biopsy studies are going to the 14 sample system. It reduces the false negative to a small percentage and does not cause too much damage to the patient.

If PC is found, it should be an intermediate stage cancer and that opens a lot of treatment options to him. I am also just a random guy on the Internet, but dad is doing all of the right stuff by getting it checked out.

As far as it being contained - that can't be figured out until there is something need to be contained.

Don't let your mind race to the worse case. It is way to early for you to put yourself through all of that. I know what you are going through as my son did the same thing. We talked and I hid nothing from him at all. Hopefully your dad will do likewise.

DonC
_______________________________________________
Age 61 @ DX, 62 Now
DRE: enlarged w/"ridge"
Pre-Op PSA: 6.8
Biopsy: 5 of 14 positive, 12%(3+3),11%(3+3),20%(4+3),5%(3+3),4%(3+3)
da Vinci: 10/17/2014 Both Nerves Spared
Cath: 17 days
Post-Op Path:
Histologic Type: Adenocarcinoma
77gr - 4.5cm x 4.7cm X 4.2cm - 10-20% Involved by tumor
Largest module: 1.6cm Bilateral Lobes
Gleason Grade: 3+3=6 (down from a 4+3=7 in biopsy)
TNM Staging: pT2c pN0 cM0
EPE: Absent, SMI: Absent
Margins: uninvolved, Lymph Nodes all benign
Bladder Neck Negative for Carcinoma
Perineural Invasion - present, Vascular Invasion - present
PSAs: (Roche ECLIA Meth.):
01/22/15 - <0.1 (Three Month test!!!)

At a PSA of 4.5, it's likely that nothing will show up on scans. There had to be something the docs saw, either the pattern of PSA increase, another blood test like PHI or freePSA, a DRE result or something to recommend a biopsy.

and it's normal for a man to be scared when the docs are throwing around words like, 'cancer' and 'biopsy'

We were all there at one point. There is nothing quite as stunning as a doctor calling you and saying, "I am recommending a biopsy." It puts your world in a spin and it like a punch to the gut - brings even the strongest of us down. Best you can do is to stand by him and be supportive. Let him talk when he's ready - if your relationship is good enough maybe you can tell him he doesn't need to pretend to be strong in front of you. Personally I ended up crying at the news of a biopsy as I didn't want to have to go down this path.

The hope part of this is that 4.5 isn't much PSA - even if the worst is found, there is every chance of a cure and him being here for a few more decades. It won't be easy and normal will change but life will go on.

Hang in there. It's difficult when you don't have all the information you need.
Andrew

Your dad's biopsy is going to answer most if not all of your questions. Right now he is going through hell waiting for the results and thinking that he is not going to survive. It is just in his brain and you can help by sharing some of the stuff you learn here. Don't worry about the ultrasound or DRE. You can help him by understanding what he is going through.

The biopsy is going to come back with, what looks like, a bunch of addition equations. Things like 3+3=6, 3+4=7, 4+3=7 and the like. All of those, no matter what the result of the addition, mean something different. The sticky messages at the top of the forum has a good synopsis of what these mean. If his doctor is a good one, he will spend a good deal of time explaining it to your dad. You, and he, will get answers to your questions. Then you will have a bunch of new ones. We are here for you as well as dad.

As is said above, there is a good chance that there is no cancer, but if there is he will have a great number of possible treatments open to him and is not going to kill him. That's just my opinion - I am not a doctor just a guy on the Internet.

DonC

Concerned_daughter said...
Is there a relation to a rapid increase in PSA and aggressive PC? My grandfather had PC as well, but it was in the very early stages when it was caught.

Some, but rapid increase is PSA is more often associated with prostatitis, infection, than PC.

If the worst is true, they've likely caught your father's early as well. 4.5 while concerning, isn't all that high.

Andrew

It's like Mel said, you need the biopsy report. Without it everything is speculation. I won't say don't worry because you will, just try and hang tough and support your Dad.

Cheers, Doug

If you are like my two sons (both in their 30s) you probably think your parents only had sex to produce you.
Here's a secret that I've never told them: Their mom and I have had sex a few extra times, and enjoyed it. We might even do it again some time. Shhh!
Why am I telling you this? Because ejaculation within 24 hours of the blood test will elevate PSA results. Some labs recommend abstinanece for 48 hours before testing.
It is possible his PSA spike was the result of activity the night before.
Don't panic.
Jeff

One thing that's worth mentioning as you are coming to terms with your dad's anxiety is that there are more things about prostate cancer for a man to worry about than there are for his family. The family wants him to be around, reasonably healthy and active, for a long time. The good news is that is almost guaranteed. Even if he were to be diagnosed with prostate cancer it would still be pretty much guaranteed. Here are some stats for you: Prostate Cancer: Statistics. So he'll be around.

Unfortunately, for the man himself, there are the additional questions of whether he will be impotent, or incontinent, or physically limited, or diminished and depressed. Those are some of the potential side effects of the treatments that help those 99% of men reach that ten year mark after diagnosis. Scary stuff for a man. But less of a concern for his family.

From time to time I get grouchy and I am sure my kids think "Dear old dad is a bit cranky lately." And that's it. They don't think "Dear old dad hasn't gotten any for three years." Which is fine. It's not their job to worry about that sort of thing. Nor is it yours. But, just so you know what's going on inside his head...

Concerned_daughter said...
From talking with my dad more, it seems his level last year was 2.8 and this year 4.2, but it has gone to 3 something before as well. I know we have to wait on the biopsy, just praying if it is anything, that it is early and not aggressive!

Concerned_Daughter.... Only anecdotal, but maybe it will help you calm down, since your mind is racing ahead of the results (perfectly normal). My PSA went from 3.1 to 4.3 in a period of 6 months. My final pathology was Gleason 7 (3+4) which is LOW intermediate risk, and the cancer was only 5 % of the prostate, and confined within the organ.
So the rise in your dads PSA over a year, does not necessarily mean its aggressive.

Breathe.

Doubling PSA fast is usually sign of P.Ca, My father was having PSA 6.11 with biopsy positive gleason score 9. you should definitely go for biopsy..

jannett

Wait for the results! Mine took a day and a half to confirm. In the meanwhile be patient. Use the time to read as much as you can to ask the doctor some questions whether PCA is confirmed or not. OK?

My Dad goes tomorrow for his results. He does not want anyone to go with him...should I go anyway or not? I want to go, but want to respect him wanting to go alone.