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Get my PSA results online - yet GP Called - never good

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Posted 12/11/2015 9:51 PM (GMT 0)
Hello all,

Been some time since I have posted. Blood draw yesterday and I can now go online to get results. My plan was to look online after Christmas so as not to be distracted. My GP gets copied in on my results and I never hear anything from her unless my PSA jumps up.


Got home today and there you have it....a voicemeil...... PSA is up from 6.7 to 7.6.

My PSA has increased 2.0 over 6 years from 4 to 6. My PSA has remained about 6.2 for 2 1/2 years and now in the last 10 months has increased 1.4. Not sure why the velocity has increased. In any event I see my uro in January, I expect the 3rd biopsy is now in order. If its positive, hoping low score and I am good with AS if a potential strategy.

Actually wish I had never taken the first PSA test....its been a long 7 years...............|Greg
Posted 12/11/2015 10:17 PM (GMT 0)
Sorry to hear about that.

Let us know what your URO says.

Andrew
Posted 12/12/2015 12:04 AM (GMT 0)
Newtopc-

I remember a call like that! From my URO telling me to call the RO and set up an appointment after the RALP failed. (I can remember a time when I didn't even know what all the acronyms meant.)

Sorry to hear about the uptick on the PSA. Have a beer and "forget about it" until after the holidays. Enjoy life and keep us posted on how things go.

Regards-
Hawk
Posted 12/12/2015 12:18 AM (GMT 0)
I'm in the "PSA isn't the only score" camp.

What about PCA, or other diagnostics?

Do you have BPH? Are you on or have you started TRT?

PSA is only one of a number of indicators.

I would think after two negative biopsy's, and a negative MRI a PCA3 might be next up.

Was the MRI multiparametric? 3T? Pirads score?

Seems to me that at this point if another biopsy is in order I would want to go for MRI guided or Fusion biopsy.

With the information you have given, I would certainly go for PCA3 and fusion biopsy.
Posted 12/12/2015 1:15 AM (GMT 0)
Thanks Andrew and Ken, We talked about a PSA 3 test and I would be happy to pay for it; my uro said, so if it comes back in the grey zone which has the most probability....are we any further ahead...better to go the biopsy route and try to go for knowing rather than guessing. So we did not do the test. As to the MRI all I got was an all clear, but with the new technology it was not rectal, it was imaging only. So not sure which of the three you mentioned is the one I had. It was done at Princess Margaret Hospital in Toronto Ontario which is our cancer Centre. Greg
Posted 12/12/2015 1:19 AM (GMT 0)
And Hawk.....already taking your advice....but its Rye and Pepsi or in American lingo.....whiskey and coke!!! Cheers
Posted 12/12/2015 2:01 AM (GMT 0)
Greg,

You might ask if they do a PHI test in Canada. It's available in the US and Europe, but I'm not sure about Canada.

Multiparametric MRI can be done with an endorectal coil, but if it's a 3T machine, they usually forgo that. Unlike a conventional MRI, it is pretty good at seeing higher grade PC. That's why they now use it to perform targeted biopsies instead of random ones. You can ask them if they will do a multiparametric-MRI-targeted biopsy next time.

You have some of the best practitioners and equipment in the world in Toronto.

- Allen
Posted 12/12/2015 3:08 AM (GMT 0)
www.healingwell.com/community/default.aspx?f=35&m=3133587

Post Edited (Ken) : 12/11/2015 8:22:03 PM (GMT-7)

Posted 12/12/2015 3:58 AM (GMT 0)
I'm really glad you're monitoring this, but I think it's way too premature to worry about your reading. As for your GP, I'm glad he's responding to any potential jump, but that doesn't necessarily mean anything dire.

I know it's easy for me to say this but: take your time and see what your doctor says. Know that PSA is not an indicator of cancer. If you need follow up, consider the PHI test or an MRI if you think you need more info.

Good luck to you and do get back to us and let us know what you hear.
Posted 12/12/2015 4:42 AM (GMT 0)
I think you should get 40 needle saturation biopsy with ultrasound to hope fully pick up some smudges at which to aim. I know I sound like an old fuddy duddy. But I remember not that long ago and even posted. ' its gotten so you need to take a test to see if you need to take test to see if you need ad nauseam..' Doing what i am suggesting will get you to the answer, quicker and cheaper. If you have a normal size prostate and prostatitus has been ruled out via antibiotics{I know they don't always get it , but still...} you psa is too high for your age period. Having said that if you do nothing you could probably go another 10 years but then you will present with a higher volume and higher grade IMO. I am a firm believer that gleason cells become more aggressive over time and if not that some less aggressive can make the inner environment more fertile for an aggressive kine. the preceding sentence is A total personal intuitive assessment, with nary a nicks worth of data. Younger man either present with a high psa{ yours is not terribly highy btw}aggressive cancer gl8 and above or at a routine psa test and thru the luck of the needle draw a indolent cancer{which is what I think you have}. Guys 60+ usually present with a mish mash of grades in multi clusters and have had the cancer for years prior to diagnosis.. Both age groups if they never had a psa quite often, especially your age will present with a whooper of a psa and advanced cancer. This does not mean you will btw...as I said, imo your biopsy will be agl6 low volume.. My surgeon said I probably had the cancer for a good 10-15 years. I was diagnosed at 66 post op path gl4+3 tertiary 5. Udetactable fro short of 5 years...went from .07 ti .14 in a year to .15 6mos later for a doubling time of 18 mos. Il take it live my life and when I get bone pain if ever I will consider treatment then and only then. I had had one treatment open prostectemy with everything contained no epe no ece negative margins, primary tumor well away fro prostate wall,9% involvement, the only buumer was post op up grade of 3+4 to what I indicated earier. Goos luck. You traveled this far go for the pin cushion effect. Biopsie pain is all in the mind. I actually giggled during the procedure tho mine was 12 or 15 needles but he had some good ultra sound images to shoot for
Posted 12/12/2015 4:59 AM (GMT 0)
I'm in the "you don't appear to have an aggressive cancer" camp.

But I concur with the prudence of finding out if the 2012 biopsy missed anything.

Whether saturation or blind. Looking is important at this juncture, imo.
Posted 12/12/2015 5:29 AM (GMT 0)
Hello,my signature tells my story.I asked my Uro for a PCA3.When that came back a 38 with PIRAD 4,I then asked him for a 3tmpMRI with fusion Biopsy,sedated..I did not want a biopsy without having the 3TmpMRI first.Then my Uro had Quest send my slides to John Hopkins for a second opinion.All of these decisions were made from research mostly on this wonderful HW site.SemperFi
Posted 12/14/2015 10:25 PM (GMT 0)
Thank you for your comments. I will ask about the saturation biopsy....not looking forward to that...and the PHI. He has never mentioned that test to me. I will be suggesting another biopsy...he knows I have a type A personality so he includes me in the decision making. Will let you know his plan on Jan 14th. Have a great Holiday all. Greg
Posted 12/14/2015 11:19 PM (GMT 0)
You might have to get PHI elsewhere. The urologist has to be registered with them for some unknown reason. Call the number on the following website. They can tell you if your Uro can do it, or if not, another nearby uro who can do it:

Prostate Health Index (phi)

- Allen
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