Rapid rise in PSA

There are other factors besides cancer that can cause a rise in PSA - such as sexual activity prior to the test. However, in my mind, getting a biopsy is certainly the right thing to do. It is not a painful or difficult procedure, and can let you know if you have something down there that will require treatment. While I know it's difficult, don't let your emotions get you down. If there is something, it's much better to find out early when it's treatable, rather than much later, when it is advanced. Keep reading and posting once you get your results.

Thanks hawkfan and IzzyBlizzy for the quick response. I think I will proceed with the biopsy. Although you bring up a good point. My uro suggested that a yo-yo in PSA without treatment over a short period of two weeks is usually more indiciative of prostatitis. He said he does see it in PC prior to diagnosis but nowhere near as often as in inflammation or prostatitis. I have no idea though. Has anyone heard that before?

I'll let you all know how the results turn out and what they find. I am having a 12 core sample biopsy on 4/10.

____________________________
Age 53
PSA 11/04 1.4 DRE neg
PSA 11/05 1.2 DRE neg
PSA 3/07/07 10.1 DRE neg
PSA 3/24/07 6.0 DRE neg
Bioposy scheduled for 4/10/07

Newbie:

With the flucuating PSA a "free' PSA would be worthwhile if you are questioning the biopsy - if it is under 19% the biopsy would be a good idea.

When you have a PSA test remember for 72 hr prior do not have sex, ride bike, do heavy exercise and always have DRE AFTER the blood is drawn.

Good luck.

Dutch

I, too, am a newbie to this forum and just wanted to let everyone know how great it is to know there are folks out there willing to share their experience(s) with the dread PC word. HealingWell web site is like the Consumer Reports of health care. My PC stats of two weeks ago:



age - 63

PSA 4.50 (up from 3.25 in 2005 and 2.0 in 2002)

Urologist took ten biopsy samples that came back with 3 core positives in the left Apex.

Pathologist report - Gleason 3+3=6; Grade T1c.

Urologist was open-minded enough to suggest the radical or the lap dance (robotic laporoscopy), or Brachytherapy. Of course urologists will suggest surgery first because that's their specialty. Unfortunately, I have a history of Deep Vein Thromboses (yes plural) in my right calf, so surgery is risky. He said because of my normal size prostate - 25cms, I was a good candidate for Brachytherapy. Anyone had any experience with Brachytherapy??

biker90,

Many thanks for your quick response. After roaming around the net like the Greek God, Diogenes with a lantern looking for an honest man, I'm fully aware of all the options, procedures and side effects associated with each. I was really looking for someone who has had the Brachytherapy procedure and how they made out with it. I'm in the greater Phoenix area and am now faced with evaluating the "seed-man" (radiation oncologist) to make sure he aims the seeds in the right spot. Thanks again for your support.



Bob

Hi peeweeaz and newbie,
Sorry this is happening to you, too.
Newbie, Dutch's words are sage about a free PSA. For some reason, PSA can be bound up in prostate cancer cells, and so there is less circulating. I posted a blurb from the American Journal of Family Practice that came out in 1998 or 99, that said that free PSA percent might avoid biopsies, if the percent comes out above 20 or 25 %. Mine, unfortunately was 8, and so I thought, I am toast. But my doc said no, it doesn't mean spread cancer, it just means more likely that it is cancer than infection or BPH. Try to get a free percent before the biopsy, although the biopsy wasn't as bad as I thought it was going to be.

peeweeaz, I am not a surgeon, but as anyone who has read any of my posts can tell you, I am VERY OPINIONATED about surgery vs. any kind of radiation therapy. Granted that both these doctors to be mentioned are surgeons, but you owe it to yourself to have a look at both Dr. Patrick Walsh's book on surviving prostate cancer, and Dr. Peter Scardino's Prostate Book. My doctor, again who is a surgeon, gave me the long-term statistics: 91% chance of no recurrence with surgery vs. 75% chance of no recurrence with radiation, cryosurgery, or HIFU. I worry a lot, so the extra 16% was a comfort to me.

Surgeons will tell you have surgery (if they think surgery will cure you), and radiation guys will tell you to have seeds, beam radiation, proton etc. They are all good docs, who are also trying to make a living. My standpoint is related to Hawfan's. Look up some of his posts after his surgery. Our preference is to have the darn thing out of our bodies and in a jar of formaldehyde somewhere, where we know exactly how far the cancer cells got to in the gland: in my case, contained in the capsule, and in his, unfortunately, with some penetration. Biopsy can often be an inaccurate estimate. Mine said cancer on only one side, the right and only in the base. When the post-op pathology report of examination of the whole gland (which you give up when you have radiation, as contrasted to surgery) came, I had cancer, albeit scattered small collections of cells, all over the gland. Hawkfan was likewise, except that a close examination showed the capsule had been breached.

To me, seeds and radiation are like shooting fish in a barrel, and hoping you got 'em all, without being able to see if you did. Surgery is like diving into the barrel with a net and getting everything out, while being able to look around to see that everything is out, but still worrying that there are some fish eggs that still may be left to grow up some day. One can shoot them then, if they grow up--radiation after surgery is preferable to most doctors, rather than surgery after radiation when there is radiation fibrosis (scar tissue all over the area). Seeds and beam radiation are not without their side effects, and I didn't want to deal with complications to the colon and rectum.

peeweeaz, are your DVTs gone, or are you on continuous Coumadin? I learned all about DVTs and Lovenox and Coumadin after my surgery. Prior to my surgery, my doctor's staff hounded my about wearing my TED hose and keeping my feet up and exercising after surgery, and I followed their instructions faithfully. However, they didn't ask me to wear TED gloves or walk on my hands or keep my hands up, and I got a DVT in my right ARM(!), elbow to armpit, I believe, because the nursing staff at the hospital didn't flush my IV enough after they stopped the IV fluids and antibiotics before I left the hospital. So, two days after discharge from the surgery, I was back in getting anticoagulated for the arm DVT (the first arm one my urologist had in over 2500 open and robotic prostatectomies). DVTs are a risk, I know, but maybe you can work with your internist or hematologist and a urologist to get the (IMO) less-long-term risky prostatectomy. If you get a robotic laparoscopic procedure, the blood loss is minimal- they usually don't ask you to donate your own to put it away for this kind of surgery.

Just my "high horse" thoughts, but keep us posted, guys.
dj

Newbie:

Never heard of a turn around time on a PSA test that fast. If it is that fast why not the "free" PSA test now which might give you the answer you are looking for.

Dutch

DJ, Dutch, lawink,

You guys and the rest of the posters are great sharing your venture into world of prostate cancer. DJ, you should have gone into medicine. I've never seen such extensive research that you apparently have done. I'm in awe. I've done a little research into Proton Thearpy and, although it looks promising, I understand it's done only in about nine centers throughout the country and is still considered experimental. The closest one to me would be California. Not having unimited funds to travel around the country looking for the perfect cure, I'm going to have a consult with a radiation oncologist next week to ask (to put into DJ's words) how good he is at "shooting fish in a barrel". Re my past DVT problems, my urologist said he wouldn't do the surgery without the consul of a hematologist. However, even if the blood man were to give his ok, if you have a pulmonary embolism on the operating table, you're toast. This way if the "seed guy" misses I may have to wear Depends or a colostomy bag (God forbid), but I'm still above the ground. I'll keep everyone posted and thanks again.

Bob

Hi ~ Newbie,

Biopsy on Tuesday…..

Thinking of you and wanted you to know!!!



In Friendship ~ Lee & Buddy

Dutch:

I stand corrected. I think most of us who have extensively researched various treatment options for our condition would agree that, rather than experimental, proton therapy is probably the wave of the future. I guess what I was trying to say was until more treatment centers are established and up and running, it is probably out of reach for those of limited financial means. I notice many of the testimonials from those who have had proton therapy are doctors who, most of would agree, are not of limited financial means. I'm happy that you were able to receive the therapy and apparently are doing quite well as of this time.

Bob

Newbie - best wishes today as you have the biopsy. don't be surprised to see blood in your urine and semen for a while after this. take care and we'll all be anxiously waiting along with you for your results. kat

Hi ~ Newbie, Thinking of you! Just a little note to let you know we are right where you left us!!!   Holding your hand. You reached out once ~ please let us know how you are doing.   Hope to hear from you soon…. We continue to keep you in our thoughts and prayers. In Friendship ~ Lee & Buddy