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Cancer/BHP PSA velocity

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Posted 12/15/2010 4:51 AM (GMT 0)
Had a slack period of time the other night and started rereading some of the "history" that my wife started keeping when we started the PC adventure.  Thanks to those who recommended keeping a record of all tests etc.  Like many others I was treated for several years for BHP symptoms.  I was told by the doctor treating me at the time that my very rapid rise in PSA (.6 to 20+) in 2 years was the result of BPH as cancer would not rise that quickly.  When I asked how high the PSA could go and it still not be cancer he said about 140. 

 I have done several searches concerning how a bad case of BPH would effect the PSA velocity and have found very little.  I have wondered if part of my PSA level could have been related to BPH.  On another site I found one research article that said straight BPH symptoms would not cause a rapid rise in psa levels.

I guess my question would be has anyone heard of a fast rise in PSA that was caused by BPH instead of cancer?

I have been playing with the PSA calulators and a lower PSA sure gives better percentages.  I check in several times a week, haven't posted very often but really appreciate reading about the life expericences of everyone as we each deal with PC.  We are all the same but all very different. 

An after thought, is there a spell check on this site?  I have decided after 60 years I that I can't spell worth beans.

Bob

Posted 12/15/2010 5:05 AM (GMT 0)
I would think a freePSA test would be ordered with a raising psa, if it is thought to be bph, just to verify.
Posted 12/15/2010 5:11 AM (GMT 0)
Well, I am not an expert but it does seem that many people have a combination of some BPH and some cancer, so part of the rise could be due to the BPH and part to the PC.

There is a formula (I forget it but someone here will likely remember it and post it) as to the amount of PSA that is generated by cc of normal prostate tissue. It would help if you could share the number of positive cores, the total volume of the cancer, and the total volume of the prostate. For example, if you had a 3 cc tumor and a 65 cc prostate (small tumor, big prostate) it's more plausible that much of the PSA was from the BPH not the tumor.
Posted 12/15/2010 6:26 AM (GMT 0)
Proscapt, I will list the information that I have. 

The strange thing about this whole thing is that my biopsy report with 18 cores showed one core with a small (less than 1mm) amount of grade 3=3=6 on the right side with nothing showing on the left.  When the doctor called me with the report he called it a very small amount of cancer.  The prostate size was 35.7 cc.  I had a previous 12 core biopsy several months earler that showed nothing.  Due to my high psa and being in a panic, I told them to take the prostate out. 

After surgery,  the path report indicated a carcinoma that measured 1.4 cm in dia which was on the left side of the gland from apex to base with no carcinoma found on the right side.  Gleason went from 6 to 8 which makes me glad that I decided to take it out.  I have read of many who were upgraded after surgery.

The report did mention high grade prostatic intraepithelial neooplasia ( what ever that is) adjacent to the tumor and on the right side.

The above has me wondering how the cancer moved from right to left and how 30 total cores didn't find a top to bottom tumor. 

As I mentioned earler, it would be intesting to know what part of the final PSA score was BPH and what part cancer.

Bob

Posted 1/23/2011 11:37 PM (GMT 0)
Bob,
It sounds like you were right to have the prostate surgery. Prostate is unlike other cancers in the body in that the majority of patients have more than 3 sites of the cancer on their prostate. So your cancer did not “move” from one side of the gland to the other. The high grade (HGPIN) that they found on your prostate are precancerous cells that have not become cancerous yet but have the propensity to do so in time. The prostate biopsy is done with random sampling, so it is not unusual to “miss” cancer cells, especially if the prostate is big as with BPH. In other words you the doctor is trying to find cancer cells in a bigger target, a much easier task with a smaller prostate. The important aspect from your surgical resection is that the surgical margins were negative, and you had localized disease i.e. there was no spread of the cancer beyond the capsule and no lymph node involvement. I suspect you will do very well. Take care.
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