Husband increase in PSA

Hi Everyone,

My husbands PSA recent test was 4.2. The doctor has referred him to a urologist who we see on June 21st.

We know there are many reasons it can increase but just was wondering if there are any specific questions that would be good to ask at initial visit.

Thanks in advance.

Hi Xmaslover -- What was his previous PSA number, and when was that tested? In my case the amount of elevation over time ("velocity") was an important factor in deciding how to proceed.

nels

Hello X, Welcome.
if this was a large, sudden jump, it could well be prostatitis, a prostate infection. if its a longer slowly rising trend that is now over 4.0 prompting the referral, then it would be something worth watching at the least and possibly acting on.

Please try to find out the med that your husband is using for BPH. Some, like finasteride, may make PSA appear 50% lower than the actual level would be w/o the drug. The 4.2 alone would not seem too worrisome for someone with enlarged prostate but the jump in one year is -- especially if it is being artificially reduced. Make sure he tells the urologist what drugs he is taking.

Jim

Maybe pretend he has it, and start reading on prostate cancer now.
Its a very dysfunctional industry and bad/incorrect information is constantly encountered, even from doctors.
Maybe one of Dr. Scholz books would be a good start.

Hi All,

I’m back looking for some guidance. Hubby is having a biopsy on July 24th. Any feedback on things we should think about or recommendations for making him comfortable after.

Not sure what to expect.

Thanks

Some cards on the table, things to prepare you ...

Usually, a "FLEET" enema at home, before the biopsy.

Sometimes, they give you a short-course prescription for antibiotics, to prevent infection.

I WAS nervous, because I didn't know what to expect. Plus, I was shook, because my PSA was skyrocketing up over 100 ... so I had worries on my mind.

My urologist and his assistant were very professional and caring. You lay down on an exam table, and they were very caring.

Procedure didn't last too long.

It's a bit uncomfortable, and "jarring" ~ because as they extract core samples, there's a VERY loud "clicking" sound ~ sounding almost like an automatic desk stapler, used to staple papers.

It almost sounded like a VERY muffled automatic nail gun, when one's neighbor across the street, is having his roof re-shingled ~ and you hear it from a distance.

I think I winced a bit, from the sound, each time a core sample was taken.

I was silently "counting the clicks" ~ slowly ~ knowing it would soon be over.

Thankfully, it was!

The care nurse handed me some "wet wipes" afterwards, to clean up.

I was thankful it was over, but I wasn't in pain. Reassurance there!

Each situation is different, but I had passed some noticeable amounts of blood, during the procedure.

I honestly didn't realize this until I stood up and noticed the lab table.

So, I needed some private time to clean myself up ~ and get re-dressed.

I would suggest bringing a very small bag with an extra pair of underwear or boxer shorts.

I would also suggest bringing a bath towel for the car seat, just for peace of mind.

Important to hydrate afterwards and just relax. By then, it's over! Whew!

Relax for a few minutes more, before driving home. Visit the restroom first & be on your way!

I WAS imagining this medieval "torture chamber." It's not fun, but it's far from the torture chamber scenario I envisioned. It's brief, routine, perfunctory, & procedural. It IS a common procedure.

Here's what's uppermost in my mind ~ nearly EVERY fellow here has had this procedure. That includes me, of course!

In my case ~ and every case is different ~ I needed medical help as soon as possible, and the biopsy WAS the missing piece that was needed to lead me forward.

It can confirm what - if any ~ treatments may be needed. So, that's the relevance and significance of the biopsy.

My biopsy helped my medical team get a plan going.

That was ten years ago , and that prostate biopsy is certainly in my rearview mirror, nowadays!

Overall, in all honesty, it went very well & seemed "routine" for my urologist, who performed the biopsy.

Hope this insight helps ~ I tried to share honest feelings and specific details!

With my best ~
CYCLONE ~ # Iowa State University

Thanks Cyclone. Great information

Yes to the enema and mentioned antibiotics. He was wondering about any bleeding and how much time to take off of work after.

Thanks for the idea of a towel for the car. He does want to get this over with and find out one way or another to ease his mind if negative or come up with a plan if positive.

One other thing worth mentioning: More than half of the damage that prostate cancer does to men's lives happens because they become fearful and rush into treatment without doing their homework first. It is usually a slow-moving disease and there is almost always time to consider options even after a positive biopsy.
The biopsy will probably be negative (most are) and even if it is positive it may represent disease that can safely be watched to see if it progresses. There are many options for treatment and some have better stories with side effects than others.

Xmaslover said...

...immediately if positive wants it out.

Possibly the the most dangerous feeling in all of PCa.

Antibiotics and they can prescribe something to help him relax like a Valium if that helps.
And make sure they numb the area first. It’s been over 10 years but from what I remember my Uro used some type of injected anesthetic first.
Was not very painful at all and over quickly, I expected much worse.

Agree with Sr Sailor -- if possible definitely get the transperineal biopsy rather than the transrectal. I had the former in April at Mayo / Rochester. Aside from the initial tiny pin-prick of the anesthetic needle, it was vaguely uncomfortable but almost entirely painless.

Definitely undignified. I commented to the medical team (which, with my permission, included a med student observer) that with 5 people present, this procedure shattered my all-time record for crowd size attending that "nether" aspect of myself.

It's over in 20 mins. at most. Then he'll be given a big jug of something to drink (gatorade in my case) to encourage a urination before dismissal to make sure things flow. Which for me was slightly reddish, with a tiny bit of clots. Looked strange but I was forewarned.

Mild tenderness after, faded in a day or two. I had two little bandaids down there but when they came off after a few days I could not detect any wounds at all. Pee returned to normal pretty quickly but ejaculations for a couple months were a wacky color chart of maroon, oxblood, burgundy, mahogany, burnt umber etc. My wife & I found levity in trying to accurately describe the precise brownish-red hue.

Results from the procedure may take a week or more. Even then, no haste is warranted, there is solid research indicating he should wait 7-12 weeks for things to calm down before beginning further treatment. Otherwise the risk of nerve damage, side effects, and bad outcomes are higher because of the angry inflamed shanked state of things.

So lobby for patience.

Fingers crossed you're soon out the other side of this!

nels

When you get the biopsy results, paste / post them here!

There are a lot of guys who can chime in on reading those tea leaves, as they've read them before...

So there can be at least some tentative decoder-ring in the short term, and some prep for questions to ask in the follow-up.