Hello, new here and currently awaiting biopsy results.

If my math is right, these are the year to year percentage increases over the previous year. Not sure what the standard for fast or slow velocity is.

2010 - 0.81
2011 - 0.97 (+ 16.49%)
2012 - 1.24 (+ 21.77%)
2013 - 1.82 (+ 31.87%)
2014 - 2.2 (+ 17.27%)
2015 - 2.9 (+ 24.14%)
2016 - 3.6 (+ 19.44%)

Pratoman said...

Have you tried taking a course of Cipro, or other Antibiotic, to rule out infection? My understanding is that when PSA is between 4 and 10 is when that might be called for. Although i think in situations of infection, you'd probably see a faster and more dramatic rise.

Pratoman, all I've tried for antibiotics is for my biopsy they gave me a cipro injection followed up by several days or oral cypro. Intended of course to add protection from the biopsy intrusion, but I would think it would also likely address an underlying infection? But also it's been a consistent rise over 6 years now so I'm not sure if that's the behavior of an infection.

One other thing I think I forgot to mention is about the same time my PSA started going up, I also started experiencing some slight discomfort in where I can only describe as the prostate (and now that I've had a biopsy I'm pretty sure that's what hurts) - like a slight inflammation or burning sensation, very subtle. Except sometimes after sex it gets pretty painful, usually after I take my first pee post-sex, it gets swollen feeling for about 10 minutes or so, inside. It doesn't hurt when I pee, like with an STD (married 29 yrs, no STD's here), but after that the prostate pain increases and it feels like its been agitated and lasts about 10-15 minutes. I did bring this up with my primary a few years ago, and the UO stuck a camera up my urethra to have a look and he went as far as to the prostate, but did not pass through it. He thought it looked fine and that was the end of it. But it still continues to this day, off and on. I think I'll bring it up again when I see the UR this time. It's a strange coincidence in the timing and location.

Post Edited (Gumby26) : 1/8/2016 8:44:34 PM (GMT-7)

Hello Gumby,why not get a 3T-mpMRI to see if there is a lesion,then a fusion biopsy targeted in that area if needed.A second biopsy without a MRI might be negative again.Good Luck.

Gumby,I would ask for an MRI.Usually after the first biopsy an insurance co. should OK an MRI with psa going up.Press your Dr. to make it happen.Just my thought.

I've been told by 2 RO's that a 3Tesla multi-parametric MRI can detect lesions that are G7 or higher. They can then use that to do a targeted Bx. I am scheduled for that MRI in January. The RO says the results can be used to help dose the RT, or if doing surgery, can be used to determine nerve position and urinary sphincter length. These are predictors for ED and IC. That was the first time I had been told that bit of info. I am hoping to use the results to help decide between RT and RALP.
Anyway, if you get one, be sure it's 3T and multi-parametric. A regular MRI is 1.5T and insufficient to detect the lesions.

Gumby, looking at the entire trend, you have a slow steady rise over a period of years. Your PSA is slightly elevated for your age, but not by much. It really sounds like your doctors are working in a meticulous and conservative manner. You may, in fact, have something there. In fact, you likely do. The question really is, how much of a concern is it?

Keep on keepin on, you'll get your answers.

Well I had my MRI, and I'm not entirely sure what it all means. But what I'm taking away from it, is that my suspicions all along were probably right. That something slow was growing over the long term and it just hadn't gotten to the level of detection before, not to mention even being treatable yet. I'm surprised he's asking me if I still want the biopsy.

Your MRI of the prostate shows a 19 % chance of finding cancer on the next biopsy. Most likely this would be low grade disease that could be followed, and the lesion that was found in the prostate was very small. Please let me know if you would like to proceed with the biopsy.

FINDINGS: The prostate measures 3.7 cm CC x 3 cm AP x 4.2 cm. A well circumscribed 6 mm hypointense T2 focus is noted in the the periphery of the right prostate. There is associated mild diffusion restriction and dark signal on ADC map. No obvious enhancement following IV contrast administration. No lymphadenopathy. No osseous lesion.

IMPRESSION: 6 mm well-circumscribed lesion in the periphery of the right prostate, PI-RADS 3.





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I like that he's leaving it up to you. The MRI tells you nothing that helps. If you don't have a good explanation for the rising PSA, and you've explored alternatives, you will need a biopsy to tell you more.

Greg,

That's the impression I'm getting about the watching, you don't want to act unnecessarily early, but also don't want to wait too long. Seems a bit of roulette trying to find the right balance and timing. I'm glad you're doing well now and thanks for your input.

Jason

Hang in there. Waiting for the result is annoying.

Here's hoping for a good report.

Let us know when the results show up.
Andrew