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How do you know if you have cancer

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Posted 2/6/2009 5:54 AM (GMT 0)
Sorry if this as been asked many times before but I am still new to this it seems to me that unless a biopsy finds cancer you never really know if you have cancer or not. If you have a PSA of higher that 4 it is a marker for cancer but alot of people have cancer wuth a PSA of much lower than 4. so you go and have a biopsy and come back clear but then you are told that the samples taken might of miss a cancer so it does not mean you are clear. If there is another way of finding if you have prostate cancer why is it not used first

I am just out of my first biopsy which seems clear and it sounds like I am going to have 3 monthly checkups but with BPH and a PSA of 9.7 if the PSA increases how will the doctor know if it is cancer or BPH getting worse

Oh I do not understand all this

Posted 2/6/2009 7:04 AM (GMT 0)
Hi Colin,
Welcome to HealingWell. I hope you don't have cancer, but if you do, this is a great place to get support and information. The patient to patient interaction is amazing here. On your PSA, it alone does not confirm cancer. I have seen PSA's of 10 that continuously test negative. Unfortinately I have seen a PSA as low as 1 be cancer. Most of the time there are no symptoms. So a biopsy is necessary to do an initial sampling of the tissue. Did you say you have received your back? And it was negative? If you continue to increase, I would ask for a saturation biopsy on your next go. This is where more samples are taken while you are under general anesthesia. Your doctor will know what it is.

I hope they never find cancer. And welcome to our site.

Tony
Posted 2/6/2009 9:51 AM (GMT 0)
Hi Tony

I had a 12 core biopsy done which said that it showed BPH, Atypical Hyperplasia (which they are doing another check to see what it is) and low grade PIN and most people on here said that was good and not to worry (thread https://www.healingwell.com/community/default.aspx?f=35&m=1374451) but it seems that the Doctor could not say that I did not have cancer because he might not have hit the cancer cells on the biopsy so what I was trying to find out is there a definite way to find out if I have Prostate Cancer
Posted 2/6/2009 10:15 AM (GMT 0)
Colin45,
Welcome to the best patient to patient site about prostate cancer. Firstly, indeed a PSA of 4 can be a marker for prostate cancer. But it can also indicate BPH as well as being indicative of a low grade prostate infection. A free PSA test can also show whether there is a likelihood of cancer but at lower PSA levels (below 10) it can also be misleading. The most dependable is the biopsy. The biopsy can indeed miss cancer by virtue of the needles missing any tumour but usually the urologist is guided by any ultrasound irregularities he may see on the ultrasound. The more needles (as Tony suggested) the better the profile of the gland. Rejoice that the doctor found nothing but keep on carefully monitoring your future PSA's and be vigilant. As Tony suggested an increasing PSA may warrant a more detailed biopsy sampling.
Bill
Posted 2/6/2009 12:05 PM (GMT 0)
Billymac-explained the fpsa test which another parameter to look at, but only as a possible clue. The newer urine test PCA3 is another tool that can be used (see-google Bostwick laboratories for info on that)it is said to be quite accurate, I don't know. An oncologist can do other tests to like: PAP, pyrilinks but those are just kind of marker tests and might be only useful on advanced prostate cancer patients. I am a patient diagnosed in 2002 with plenty of PCa 12/12 (all 80-90% levels), but since treamtents and stuff....my PAP and pyrilinks (and other)tests do not reveal anything at this stage and other blood tests and marker items are all in normal ranges  (nice to see of course), but no warranty on  PCa.

Did you know there is such a thing as a PCa sniffying-detecting dogs??? I have heard about such, might have been in England, hey dogs got the nose, how they trained them is beyond me. Maybe there is a detection center in England or wherever, PCa is stranger than fiction my friend.

Biopsies are the most definitive test that they have currently as for accuracy and even then, it is not as good as we patients actually need for total assessment. Per Dr. Strum- (ruling out protatitis first and perhaps some bph increases) velocity over time (continuously) and psa doubling times (within one year), are your red flag that should or could lead to biopsies.

website info on dogs for PCa:   www.nurseweek.com/news/Features/05-05/CancerSniffingdogs.asp

 (there are others if you google prostate cancer and sniffing dogs)

Maybe some one else has something to add to this.

Posted 2/6/2009 1:20 PM (GMT 0)
Colin, hello and welcome, hope we can help you.

With what you wrote and posted, your doctor will be keeping a close eye on that rising PSA. At some point, I am sure they will want to do a more extensive biopsy as Tony suggested above. It took 3 spread out over 15 months to confirm my cancer, other men have had more than that and still don't have cancer. One person said the biopsy is like blindly sticking a long needle into a loaf of raisin bread, and if the needle doesn't pull out a raisin, then it must not be raisin bread. something like that. hope that it is never PC for you, but we are here to help and support you.

David in SC
Posted 2/7/2009 12:32 AM (GMT 0)
Hi colin45.

Hope you don't have it

Mika
Posted 2/7/2009 1:01 AM (GMT 0)
Colin,
There are several ways to indicate a likelyhood of PC rather than BPH.
PSA3 and Saturation biopsies have already been mentioned in replies to your post and are effective.
Free PSA, PSA doubling time, and PSA velocity are also indicators.
Scans such as endo rectal MRIS and color doppler ultrasound can identify most tumors, but you need a biopsy to really know for sure.
If tests such as free PSA, PSA3 and your PSA doubling time indicate PC then I would either get a saturation biopsy or a color doppler targeted biopsy.
I was one of those guys who went through 13 biopsies before anything was found. Color doppler or saturation biopsy would have picked it up years sooner.
JohnT
Posted 2/12/2009 8:53 AM (GMT 0)

Hi again just had my final Diagnosis with Immunohistological Study which was on the Atypical Hyperplasia which on the new report is changed to Basal cell Hyperplasia as follows

Study reveals CK-HMW positive cells all atypical glands from both sides. No adenocarcinoma in both specimins

What does CK-HMW positive cells all atypical glands mean

It seems like I am on another three month wait to see if my PSA of 9.7 goes up or down

Posted 2/12/2009 1:27 PM (GMT 0)
JohnT: By all accounts, you are our King of Biopses, not sure anyone could top yours. I am still awarded the King Of Catheter Troubles. Both awards we could live without out! lol.
Posted 2/12/2009 2:16 PM (GMT 0)
Think you may have the wrong thread

Posted 2/12/2009 2:57 PM (GMT 0)
Colin

CK stands for cytokeratin which is characteristically, squamous carcinomas. The HMW stands for High Molecular Weight

High molecular weight cytokeratin is completely negative for adinocarcinoma

Hope this helps
Posted 2/12/2009 4:03 PM (GMT 0)
Yes thanks that helps me understand a bit more I have now to wait now for 3 months to see if my PSA goes up or down to see if I have to have a 26 core biopsy or not the problem is this 9.7 PSA was the first PSA reading that I have so i have no guide lines to go by I suppose i just have to be patient which is a problem for me 

Posted 2/12/2009 4:39 PM (GMT 0)
Yeah Colin...having patience is probably one of the...if not the biggest...problems in dealing with this disease. Even if you do have cancer and then remove the prostate with surgery, or any other mode of treatment...there is still that anxiety and dealing with patience for the next PSA test. It becomes a lifetime routine I am afraid.
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