PSA from 4.8 to 6.9

Have you been prescribed antibiotics for that prostate infection that you likely have?

jdcd57-

Where you go depends on what you already know. A few questions:

(1) Was an effort made to rule out other sources of elevated PSA?:
- prostatitis
- enlarged prostate (BPH)
- urinary obstruction
- sex or bike-riding 2 days before the PSA test

(2) Are there any clues on your biopsy report?:
- evidence of acute or chronic inflammation
- HGPIN

If other causes have been ruled out, you might want to talk to your Uro about the least-invasive, and lowest-cost diagnostics first. That might include a PCA3 urine test after a prostate massage, and a PHI blood test (don't get blood drawn right after the prostate massage). Those are both covered by insurance or Medicare. PHI includes PSA and free PSA as part of it, so you would have this instead of your next PSA test. Your Uro can order a PHI test through the following link:

/www.accureference.com/phi/

There are several other, more expensive blood tests, but they are all about equal in detecting PC. If PCA3 and PHI are negative, you might want to wait 6 months and test again. If they are positive, you might want a different kind of biopsy next time.

There are 2-4 kinds of biopsies worth considering. The more widely available ones are:

• Multiparametric MRI-targeted biopsy. This looks for areas suspicious for higher grade cancer, and they can take some extra cores from that area. This depends on having an experienced radiologist.

• Transperineal template mapping biopsy. This very systematically takes a lot of cores (often, about 30) from every part of your prostate.

They can even do both of those together. You often have to go to a large regional cancer center to have these done.

Can prostate cancer mess with digestion system?

MRI. I was in the same boat. It went MRI, then a second biopsy targeting the findings of the MRI if they can find cancer. From there they can determine if you have something to worry about. The worst part is waiting for the call.

Is there any natural over the counter drugs that can help with PSA?

Hi jdcd57,

I'm in a similar situation as you--although my numbers are more alarming. My PSA jumped from 5.2 to 8.3 in 2 months. I'm still going through a number of tests that you may want to request before I submit to a biopsy.

PCA-3: This came back with a score of 13 which is terrific--in the lowest quadrant meaning unlikely that biopsy would return with signs of aggressive cancer. But this test is not 100% (no test is these days). If the cancer isn't near the ducts of the prostate, it may not express making the score artificially low. But it does have a fairly high accuracy.

FKScore: This seems to be one of the newest tests available. The 4Kscore Test relies on the measurement of four prostate-specific kallikreins in the blood: Total PSA, Free PSA, Intact PSA, and Human Kallikrein 2 (hK2). The blood test results are combined in an algorithm with patient age, digital rectal exam (nodules, no nodules), and prior negative biopsy (yes, no) to give physicians a personal score for each patient. The 4Kscore Test predicts the risk percent score from <1% to >95% of a man having aggressive cancer in a prospective biopsy. There link for more info is: http://4kscore.com/
(Self pay for this test is about $400). I'm waiting for results now.

FreePSA: This is a more reliable test than just the PSA from what I understand.

I'd also recommend getting a 2nd opinion (a 2nd urologist). My first urologist told me: "Let's wait 6 months and see since your PCA-3 score is so low." I wasn't happy with that answer at all since my freePSA is at 6.1% - VERY low and indicative of a more aggressive prostate cancer. (Please correct me if I'm wrong on this, folks).

My 2nd urologist thought the advice of the first was reckless and absurd and so he ordered the 4KScore for more data.

If this test comes back with unfavorable results, I will advocate fiercely for an MRI of my prostate so the biopsy, if it must be done, will be more accurate. With an MRI, the doctor can have a road map of my prostate and a better idea of where the tumors are located.

Hope at least some of this may be useful to you. I know what you're going through because I'm going through it, too. I'm just grateful that we caught this just as my PSA numbers were starting to spike.

Brad, A jump from 5.2 to 8.3 in two months is much more likely to be from inflammation or trauma than PCa.

The 4K test seems to be popular. At Johns Hopkins, they have chosen the PHI test, which I believe also costs less than the 4K. Either test should be able to give you the direction you need.

jdcd57 said...
Guys I appreciate all the comments! Now when i had my biopsy 6 mos ago they did give me a antibiotic 2 days before biopsy and 5 days after. Was this antibiotic for infection or Prostatis?

Not sure, based on your last sentence which could be read two ways, if you knos that prostatitis is the word for a prostate infection. Sorry if I'm just clarifying something you already knew...


That was a good preventative practice to give you an antibiotic before/after the needle biopsy because the procedure itself can cause really bad infections...it's pretty rare, but men have died from it, which is one of the reasons not to over-do prostate biopsies.


But that course of antibiotics was clearly not targeting the prostatitis that you may have. By the way, it's really common to have prostatitis, and it is ususally symptom-free...although it can also be severe (I had a case that put me in the hospital overnight once). Prostatitis can a) make your PSA jump around by several ng/mL's, b) can coexist with BPH, prostate cancer, or other prostate problems, and c) be a challenge to diagnose and treat...it may take several rounds of directed antibiotic treatment.


take care

jdcd57 said...
Guys I appreciate all the comments! Now when i had my biopsy 6 mos ago they did give me a antibiotic 2 days before biopsy and 5 days after. Was this antibiotic for infection or Prostatis?

This is standard prophylactic treatment to try to prevent infections caused by the puncture wounds during the biopsy. If antibiotics were given for prostatitis, the course of treatment would have been much longer than the few days' worth you were given.

ASAdvocate--just wanted to thank you for your response. I've thought the same, that a jump from 5.2 to 8.3 in 2 months seems more indicative of inflammation than growing aggressive cancer. When I've asked 2 urologists this question: I get a shrug and vague answer. They say, yes, it could be inflammation but it could also be inflammation coupled with aggressive prostate cancer. In other words, they don't know.

Seems there would be some studies on how fast PSA can rise from PCa vs prostatitis or something else. Yet, I can't find a thing when I search the Internet.

I get 4KScore this coming Tuesday. Depending on that, I will push for a mpMRI before biopsy. I'm also going for a CDP after Thanksgiving but most likely I'll have had the biopsy by then.

I'm so grateful for this forum and for everyone's support.

I have now noticed some burning when i urinate and more frequent urination.

Tall Allan answered your question about digestion problems...If the prostatitus is effected by the antibiotic {sometimes it is'nt}yes the psa will go down. Back in my single days I would have to take penicillen to rid a burning urine stream...you may have a variety of Urinary tract and prostate issues issues..Do you ever ask your doctor these questions? Also you need to study diseases of prostate and urinary tract on your own not just from internet...preferably from books by professionals of such...sticky threads at the top of the thread list you posted on will have some.good luck...ps make sure when you are asking for help you provide as much information as you can...with your doctors{especially with doctors} and forums like this...