New Member Introduction

Greetings folks,

I've not yet been diagnosed, but will be hearing back from my urologist next week with a report and I'm preparing myself for the worst. Situation: Age 50, baseline PSA screening done in March 2009, Total 2.9 Free PSA 9%. No doctor ever talked to me about those numbers and I didn't think to ask. Repeat test in March 2010: Total PSA 4.3, Free PSA 5%. Over the years I've had a gradual increase of urinary symptoms such as frequency and urgency that I describe as minor but noticeable. I have a small bladder diverticulum (probably congenital) that was d/x in 2009 following a minor UTI that cleared up with a 7 day course of Cipro. I haven't had any problems since.

Following the latest PSA test, my primary care doc recommended I visit a urologist. The local doctor I saw examined me (DRE negative) and recommended the standard 3 week trial of Cipro. However, at the same time I made arrangements to go to UCLA Medical Center to be seen by the very excellent Dr. Leonard A. Marks.

At UCLA Dr. Marks explained that my PSA numbers were troubling and in his experience, he finds the antibiotics are unreliable and told me he would be remiss to send me home without a biopsy. Hence, I was examined, given a repeat PSA test, a PCA3 test, a pelvic MRI using a 3T scanner with contrast and a ultrasound guided 12 core biopsy all in the same week. BTW, my biopsy used image processing software that takes the MR images and overlays them with the live ultrasound to create a 3D reconstruction of the gland in real time. The doctor can then target specific areas of interest to obtain the cores. This was fascinating to watch on the monitor and the biopsy itself was a piece of cake for me. I've had far worse experiences at the dentist!

The good news was there were no "areas of interest" as far as the imaging was concerned. In other words, both the MRI and ultrasounds were negative for any visible abnormalities. Instead the core locations were based more or less on a normal pattern, only in my case, mapped to the specific anatomical shape of my gland. The prostate volume I think was on the small side (30cc I recall hearing him say).

So, I should have a report after the slides are reviewed by the pathology lab and we can decide what to do from there. No matter what they say, I'm not worried, or scared. It's life. It is what it is and whatever happens I can deal with it, especially after finding this great community of knowledgeable PCa warriors.

Heal well!

// Gary

P.S. Still getting some rectal bleeding 2 days after biopsy. Otherwise feel great. Is this normal?

Gary, Hello and welcome to HW Prostate Cancer. Glad you found us, and it sounds like you are already in the hands of a good urologist, which is important at this stage.

BTW, the rectal bleeding is not uncommon at this point. Bleeding there, as well as in your urine at first, and in your ejaculate, pretty typical. How long and how much, varies from guy to guy, and also how extensive your biopsy was, I think you said you had a 12 core.

No seeing any areas of "interest" is not conclusive by itself. With a minute speck of PCa, it may not be enough to show up as my dr. called it, "a suspicious shadow". When you get the results of the pathology of this biopsy, please come back and tell us what is going on.

At 30cc, your prostate is a little on the small size, but hey ,who's comparing.

I hope you come up clean, but if you have cancer, this is great place to belong to. A lot of knowledge, a lot of compassion and caring, and the brothers and sisters here, support each other very well.

Good luck,

David in SC

Gary,

A 3T mri with contrast should have picked up anything significant. You did much more than any 1st time patient and that is a credit to you. If you do have a small cancer it should be easily taken care of.

JohnT

Welcome Gary95, to HW.

Gary-

My stats are fairly similar to yours, PSA up and down, % free PSA on the low side.  At my last uro appt last December, doc attributed elevated PSA to minor inflammation.  Even with courses of ibuprofin and antibiotics, PSA would rise then fall later.  2 biopsies found nothing.  Uro said to see him again in a year with repeat PSA test.  I'll have my GP retest it 6 months from last test just for some peace of mind.  I really freaked when my PSA/%free PSA tests started to look bad, convinced myself I had cancer.  

In Walsh's book he states that PSA swings are usually indicative of a benign condition, hopefully that's the case for us.

Dan