My case ...

Here is my case and I am posting it for reference -

I am age of 54 1/2 working as programmer (long hour sitter). about 4 years ago my GD started PSA screen on me and the first reading was 3.5 (2013), 3.6 (2014), 3.9 (2016) and 5.1 in December 2017. During routine annual check up, my GD told me that my prostate was a little enlarged in the last couple of year. I started have a little frequent urine compare to before. I am a big tea drinker so I did not pay that much attention. But in the last couple of year I occupationally had lower back pain and sometimes testicle comfortableness. But they went away often. While I was googling I believed I might some prostatitis but as it went away I did not see a doctor.

Last summer (2017) due to unusual heavy load of work I had to sit on rough chair for long hours (10+ hours a day) and the rough edge of the chair made my lower part very uncomfortable. The urine frequency has been increasing, sometime once per hour, again I am a big tea drinker.

I was referred to my uro last December and he asked me to re-test psa with phi (prostate health index) in 5 weeks with two weeks of antibiotic. Just yesterday the result came out which is mixed: psa now is 5.89 but phi is 33, which means the chance of biopsy to detect cancer is 16.8%. I will meet my uro this Friday to discuss the next step. I want to do a biopsy.

I will keep posting my case either way, especially if the result is clean.

JK

Thanks PeterDisAbelard. I will definitely come back reporting results, even it is negative. I think most of this kind of forum are lacking negative (clean) lab result stories and I think this is very educational and informative data as well.

The steady rise in PSA is concerning. However, the biopsy will be helpful. Good luck.

As others suggest, there is a significant jump in your PSA numbers. It can be due to prostatitis, though usually you would expect higher oscillations, not a consistent increase. At this point, you are right to push for a biopsy. Relax but keep closely watching your PSA if it results negative. Do not let your PSA go beyond the 7-8 mark without further tests it if shows a consistent increase. From your comments, I see you have collected good information, anyway.

Your PHI number is pretty good. Remember, even if some prostate cancer cells are found, they may be indolent and not require immediate treatment, or, possibly never require treatment. Just take things one step at a time. Good luck.

Jiangkong
I was on finasteride for bph which masked my PCa in that it reduces Psa by half . But the important thing is the Psa doubling rate not the absolute number. Your symptoms sound like prostititus from what I’ve experienced but bph causes frequency. Prostate Cancer doesn’t cause pain unless it’s seriously metastatic to bone so I wouldn’t worry about that at this point.
Bob

Update after 6 months...

January I had 5.98 PSA and doctor also tested PHI which is 33.8%. He thought I am in 'low risk' group as PHI tells him that biopsy will only have 24% chance to be positive. He suggested me to retest in 6 months. Here we go...PSA is elevated to 6.1 and PHI is 38%. The PHI cut-off is 35% for a biopsy. The needle exercise is scheduled in the end of the month. Fingers crossed...But this time I am preparing for the worst. If it turns positive I wish it is not too late. I am in great Boston area and I think there are lots of good doctors out there. My doctor seems knowledgeable but I am seeking options and opinion when things turn bad and I can well prepared.

I am given a sheet for the instruction for the biopsy, and it seems pretty simple. Anything special I need to prepare or be aware of?

Thanks a lot!

JK

Be sure to take the antibiotic. Good luck!

Make sure you urologist numbs the prostate with a shot of Lid0caine or other numbing gent. Most do as routine, but I have heard of a few that have to be asked.

Pete, re the Valium, I had the same experience. In addition to the lidocaine. I took a Xanax before I left home, another one in the car (I didn’t drive) and a 3rd when I got to the Drs office. By the time I was told to get in the table I was sufficiently looped to smile and say thank you.

Ask for a periprostatic nerve block or a pelvic plexus nerve block. This involves not just random lidocaine injections, but injecting it into specific nerves that your Uro can find using the ultrasound. When I had it, he was able to take 17 cores without my feeling a thing - and I was able to walk out on my own. Be prepared for semen that looks like blood for up to several weeks.

biopsies are annoying, uncomfortable and undignified. Most guys get through it just fine.

You'll be fine. It won't be fun, but before long it just becomes a bad memory.

Let us know the results,
Andrew

Keep track of your temperature. If it spikes to say 101F, calmly call your Uro immediately and proceed to ER or wherever he sends you. You will be told this as part of your post instructions anyway. If this does occur, this does not necessarily mean you've caught an infection. I've had 2 biopsies and both times I ran a temp and went to the ER and stayed inpatient for 2 days for observation and IV antibiotics. Yes I was given antibiotics pre-procedure including IV antibiotics. Both cases, NO infection but simply body stress related. Good luck.