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rapid rising psa

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Posted 4/4/2016 12:35 PM (GMT 0)
2 out of 8 samples positive in 2007, Gleason 6, psa 6.
Opted for watchful waiting. Slowly rising psa up until late 2015. Psa has gone from 20 to 50 to 150 in last three mos.
Bone and C T scan showed no sign of spread!
Has anyone had similar situation?
Posted 4/4/2016 1:15 PM (GMT 0)
2nd: These quick jumps sure look like something other than PCA. Not sure why your docs have not recommended a round of Cipro. Just my unpro opinion. What is your Uro saying, doing?? Have you had a second opinion on your slides?
Posted 4/4/2016 4:06 PM (GMT 0)
I disagree that it is not cancer… I think it is... you need treatment . The psa of 20 should have triggered something in your medico's mind…if in fact you were not watching solo.fwiw infections spike psa but not those kind of numbers. Fear not...your entering the woods, but the cool water is streaming very close behind.. Get thee to a doctor…. Thats a nice 8 years and a testimony not to rush to judgement….its time for treatment... thats my take...

Post Edited (Bozolidat) : 4/4/2016 10:09:41 AM (GMT-6)

Posted 4/4/2016 4:15 PM (GMT 0)
Agree with bozo...How long ago did PSA go above 10, and what were the additional findings then? An infection isn't going to cause 150ng/mL...that's about 10X the possibility that could be attributed to infection.
Posted 4/4/2016 4:35 PM (GMT 0)
I concur. This seems like it could be a very aggressive cancer. This is not behaving like a G6.

Why not do another biopsy?

Mel
Posted 4/4/2016 6:06 PM (GMT 0)
What are you waiting and watching for? The prearranged funeral salesman? Go get checked out- this just seems wrong.
Posted 4/4/2016 6:11 PM (GMT 0)
It's no longer behaving like a G6. Likely you need another biopsy and some kind of treatment. It's possible that the original biopsy missed the fact that there is an aggressive PC cell somewhere or something new has happened.

Sadly, I think you've just moved beyond watchful waiting.

Andrew
Posted 4/5/2016 12:23 AM (GMT 0)
Not sure another biopsy will do anything to change the treatment he will need.. I am totally way behind the curve of scans so not sure if even that will do anything in that regard. To me a 150 psa says its on the loose {Ich mach nix on the grade}and believe a good oncologist will see this and provide HT and hopefully the OP will respond well to it and get on with his life… No regrets…waste of energy…ride tall…Oh…hope you can keep us in the loop…we are on your side…know this….
Posted 4/5/2016 12:52 AM (GMT 0)
Boy, that is sure a large increase in such a short period...my guess is cancer but no matter, you need to get on this like yesterday. It is cancer until you can prove otherwise !!!!
Posted 4/5/2016 2:07 AM (GMT 0)
2nd 16th,

I noticed you wrote "watchful waiting" and not "active surveillance." (Active surveillance would have included follow-up biopsies long before now.) That suggests you may be an older guy, perhaps with comorbidities, and you have chosen to forgo curative therapy. So what you choose to do now continues to be up to you. You may wish to put off palliative hormone therapy until you experience symptoms like pain, and difficulty urinating. If you develop pain from eventual bone metastases, spot radiation can provide lots of relief. Taxotere can relieve a lot of symptoms too, but your comorbidities may exclude that.

Prostate cancer can be "micrometastatic" and systemic before detectable metastases show up. That means it's in general circulation but has not yet planted itself in significant colonies anywhere.

- Allen
Posted 4/5/2016 1:26 PM (GMT 0)
Allen
Thanks for the info. Could the reason for the rapid rise in psa be that the cancer has grown within the prostate? Have you heard of anyone that high psa, such as mine, that the cancer stayed confined?
2/16
Posted 4/5/2016 3:09 PM (GMT 0)
It is doubtful that that high of a psa can be produced by cancer contained in the prostate. It's a matter of psa being produced as a result of tumor volume. Some transition zone cancers have produced psa in that range while being contained, but they are rare. it could be an infection as these produce high psa. There is no way that the rapid rise of your psa can be attributed to a contained tumor. Rapid rises like that are usually seen with systemic involvement or infection.
In either case you need to see a specialist and get it checked out.
Posted 4/5/2016 7:21 PM (GMT 0)
Rapid PSA progression, otherwise known as quick
PSA doubling time, unfortunately is one of the indicators of aggressive cancer. That means you have Gleason 7 or higher tumors which have a high propensity to spread beyond the prostate . Hormone therapy is called for ASAP then some combination of radiation therapy as surgery is most likely too late at this point. An mpMRI would help find how far it has spread.
Good luck!
Bob
Posted 4/5/2016 8:01 PM (GMT 0)
2/16-

I agree with John-T. It's highly unlikely that PSA that high was caused by anything but metastases. I don't think even infections can do that. Possibly severe urinary retention, but you'd know if you had that (you'd be in the ER).

With metastases, there is no point now for radiation or surgery. Hormone therapy can probably delay progression and keep you symptom free. I think you should see a medical oncologist.

- Allen
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