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Posted 5/10/2011 9:01 PM (GMT 0)
Hi Everyone :) Glad to find this board. I am looking for some guidance from the experts here. My husband has had his PSA levels continue to rise for the last couple years and we are concerned enough that he is seeing a urologist this coming Monday. Here are his stats...

PSA 2007 - 3.6 at 41 y/0
PSA 2008 - 3.3 at 42 y/0
PSA 2009 - 3.2 at 43 y/o
PSA 2010 - 4.1 at 44 y/o
PSA 2011 - 4.92 at 45 y/o. Because of this high result, they also ordered the below tests. This was just 2 weeks ago.
PSA, free was 0.34
PSA, % Free (Calc) was 6.91

Specifically, I am wondering if anyone can give me any guidance as to what the result of those last two tests that were added really mean. I understand the test themselves, but can't really find any good info on what the "normal" ranges for free and % should be. I feel my hairs standing on end that these are poor scores, but really don't know.

Are we right in getting him in to see a urologist or are we (okay, I) just panicking for no reason? I am looking for some good, honest advice and can handle anything you throw at me. We've been down the cancer road before (with me) so we've been there and done that.

Most of all, thanks for reading and I wish all the best for all of you!
Posted 5/10/2011 9:16 PM (GMT 0)
Welcome to HW.

Obviously your rising PSA is a concern, without knowing the cause. Many doctors consider 4 to be a trip point, particularly in a 45 year old man.

Probably the most common cause of a rising PSA besides PC, is bph, or an inflammation of the prostate.

Your free PSA is good, ( normally anything above 25 % is ok). This may well indicate a non PC cause.

It sounds as tho you are proceeding in the right direction. See the uro, and if he suggests a biopsy, I personally would agree. It won't hurt anything, and will give the doctor a clearer picture of what is going on

Just try and relax, and take it one step at a time. Catching it early is a very good thing.
Posted 5/10/2011 9:22 PM (GMT 0)
TN, take a deep breath, no need to panic. You are doing the right thing in seeing a urologist. The PSA by itself is not cancer-specific, it could be from an infection or prostate enlargement. That's why they also run the free PSA. If it's low, below 15% or so (going by memory) it's an indication that it may be cancer instead of other things, but just an indication. What it does suggest is that a biopsy may be needed, which is the best way to find out what's going on (though even that is not 100%).

In my case my PSA was 4.1 with a free of 12% and it was cancer. But I know others with similar numbers who didn't have cancer. And, bottom line, even if cancer is found, chances are it's an early stage that's very treatable, if it even needs to be treated.

So once again, take a deep breath, take the next step with the urologist, and know that you're doing the right thing.
Posted 5/10/2011 9:22 PM (GMT 0)
TN, while I'm certainly no expert, I can advise you to take a breath....relax....exhale.

Your hubby does not appear to have a rapid rise in his PSA (velocity), meaning it could be a number of things that are NOT prostate cancer. Best thing to do is not panic and draw conclusions, this could be nothing more than an infection.

Your URO may want to perform a transrectal needle biopsy of the prostate. It's as much fun as it sounds, but will bring you both much further down the road to understanding what it is you are dealing with.

If this biopsy confirms a PC diagnosis, even then, you will have time on your side to learn, interview doctors, consider procedures and make an informed decision.

So, my advice again.....slow down and wait until more facts come in so that you both don't go crazy agonizing over that which you don't know.

And do know this, this board is replete with survivors who, like me at 9 weeks post op, are completely healthy and doing just fine.

Good luck!
Posted 5/10/2011 10:26 PM (GMT 0)
You should ask the urologist for a PCA3 test and also ask him to estimate the size of his prostate from a DRE and compare to his psa. A prostate should generate .066 for every cc of prostate tissue. His benign psa equates to a 70 cc prostate, which is considered large for a 45 year old.
JohnT
Posted 5/10/2011 11:11 PM (GMT 0)
His stats are similiar to mine.

If the urologist suggests a biopsy, do it.

Posted 5/10/2011 11:31 PM (GMT 0)
Goodlife, pardon the correction but I think you misread TN2GS husband's stats: his % free PSA is 6.91 (0.34 is the figure above that one).

TN2G, not sure how to interpret the free PSA figure of 0.34 but the % free is low and warrants investigation. If I remember correctly, the % of free PSA should be 25 or higher...my husband's was 11% and coupled with his rising PSA, led him to have a biopsy.

Frankly, I would look into further tests for your husband. While a prostate biopsy isn't the most pleasant thing (according to my husband and the men here), it's not the worst thing either.

Come back and let us know how things are going.
Posted 5/11/2011 12:11 AM (GMT 0)
Sephie,

I interpreted the .34 as 34 %. Pardon me if I was incorrect.


Goodlife
Posted 5/11/2011 2:24 AM (GMT 0)
Thank you to everyone for your replies. I sincerely do appreciate the guidance and suggestion to take a breath and just work through the appointment and see what happens. The last couple posts regarding the percentages and the confusion surrounding them is exactly what I was confused about as well. The GP did do a DRE and said he found nothing unusual with that. Will definitely let my husband know to ask the urologist for a PCA3 test and go from there. I assume likely next steps after that would be a biopsy?

Again, thank you to all you kind folks out there that are holding my (cyber) hand through this confusing process :) I will definitely be checking back in soon and will update everyone as soon as we have a clearer picture of what is going on.
Posted 5/11/2011 10:04 AM (GMT 0)
Goodlife, hope you didn't mind my post...I had to read TNG2S' post a couple of times to figure out the % free.

TNG2S, do come back as the folks here are truly wonderful people with lots of experience and knowledge...and big hearts! You'll find tremendous support here so don't hesitate to come back and ask questions (or even to vent).
Posted 5/11/2011 6:32 PM (GMT 0)

Sagittarian said...
His stats are similiar to mine.If the urologist suggests a biopsy, do it.

I agree.

My PSA was 2.1 at age 33 and rose to 2.5 at age 36. My DRE was positive (tumor nodules felt) which lead to a biopsy. My biopsy yielded PC, but it can also rule out PC.

Remember, a biopsy can MISS the tumor(s) so continued monitoring is important too.
Posted 5/16/2011 9:09 PM (GMT 0)
Well, I have an update although not too much info. My husband saw the Urologist today and he did recommend a biopsy so no surprise there. He also did another DRE and stated nothing seemed to be out of the ordinary. Biopsy is not scheduled yet, as far as I know. Thanks for all the support everyone...I will let you know when we are to next steps. Sigh...
Posted 5/24/2011 4:57 AM (GMT 0)
Well, here we are. Almost two weeks later. He has still not scheduled his biopsy. I think he is so afraid of the answer, that it's keeping him from finding out. This is frustrating, but I have to remember that it's his body and ultimately his decision. I am sure he will do it at some point. It just seems to me that the sooner you have answers, the sooner you feel empowered by your decisions. Sigh.
Posted 5/24/2011 5:24 AM (GMT 0)
Get the biopsy, The mind makes it hard core, the body shrugs it right off, minor , really. I mean you can do this, do that, but in the final anlysis, its the biopsy that is going to give you the information you want and need, Think NIKE.
Posted 8/26/2011 7:19 PM (GMT 0)
So after 4 months, my husband finally went in for his biopsy. It was on Thursday, Aug 25. They also did an ultrasound. His DRE is normal, but they were able to see a small darkened area on the left lobe. They took 16 samples. We are hoping to get results early this week as they do everything in house there. He is so nervous after seeing two urological oncologists at UCSF and having them both say there is definitely some concern. My husband has been reading many online articles in the last 2 days and just wants some results so we can move on.

Seems impossible that at 45 he would be dealing with this. However, I went through breast cancer at 35 so I guess you just never know.

Any advice, thoughts or guesses as to its likelihood of being malignant are most welcome. Thanks for listening and just being here to lean on!

PSA 2007 - 3.6 at 41 y/0
PSA 2008 - 3.3 at 42 y/0
PSA 2009 - 3.2 at 43 y/o
PSA 2010 - 4.1 at 44 y/o
PSA 2011 - 4.92 at 45 y/o. Because of this high result, they also ordered the below tests.
PSA, free was 0.34
PSA, % Free (Calc) was 6.91
Posted 8/26/2011 7:21 PM (GMT 0)
Forgot one thing...prostate size was 30 upon ultrasound viewing. Thanks :)
Posted 8/26/2011 7:24 PM (GMT 0)
Good luck, and strong nerves, as you await this biopsy report.
Posted 8/26/2011 7:35 PM (GMT 0)
TN2GS
We all hope that the biopsy is negative and that we do not have to hear from you again and can cancel your club membership. However if the results are otherwise I hope that your husband will join us and you in this forum as he will need a lot of good advise from those of us who have made or are making their PCa journey.

45 years of age is not an impossible age for dealing with PCa. There are far too many in the club here under 50 and even a few under 40 taking their PC journeys. Hopefully if his BX is positive it has been found early. There are many treatment options available for him that will give him a good quality of life and allow him to live to a ripe old age. PCa is one of the most curable of all cancers when found early. Here is a link to a thread asking for ages at original diagnosis and you will see 24% of those responding here were under age 50.

https://www.healingwell.com/community/default.aspx?f=35&m=2185655



Terry the Water Guy
Posted 8/26/2011 10:28 PM (GMT 0)
If you are at UCSF then get an opinion from Dr Peter Carrol as he is one of the best prostate doc's around.

JohnT
Posted 8/28/2011 6:03 AM (GMT 0)
Thanks for your replies. To JohnT, my husband is seeing Dr Carrol. We have a few close friends that are physicians and they both said he was absolutely the best prostate doc on the west coast. Just so happens that my husband spends a lot of time in San Fran for work anyway so it worked out well :)

Hope to hear something on Monday. The wait is driving me nuts!

Thanks again...

Anne
Posted 8/28/2011 4:53 PM (GMT 0)
TN2GS

Suggest be very careful of what you and your husband read on-line, there is a LOT of wrong / out of date information out there on the web.

If someone points you to a link / information here - I would trust that information.

Best wishes to you and your hubby

Bud
Posted 8/28/2011 5:47 PM (GMT 0)
TN2GS:

We are all waiting for the results and hope they are negative. If you get a positive it is not the end of the word but a change in the world as you guys know it. Lots of great guys here that know way more than I will ever know about PCa. Great Guys and hear only to help.. Please keep us posted.

Cajun Jeff
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