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FIL's PSA is 4593

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Posted 4/24/2015 2:15 AM (GMT 0)
Hello all,
My Fil's PSA is 4593. He is going to be 80 years old in May. He has back pain and is on Ibuprofen 2400 mg a day. He saw a urologist today who did a dre and found several nodules small and large.
He is 99%sure that he has prostate cancer and has prescribed hormonal therapy. he has scheduled a biopsy on thursday. Super worried about this and wondering what his treatment options would be. (he does not have insurance)
2013 psa 14
2014 psa 15
2015 Jan psa 969
2015 April psa 4593.
Thanks for your help.
Posted 4/24/2015 2:33 AM (GMT 0)
When was hormonal therapy prescribed? I would have thought in January.

Still, we have a guy here (Todd1963) that had a 3200 PSA - 9 years ago. He is doing very well. That stated it's also uncommon that a PSA that high does that well.

Your FIL likely has metastatic prostate cancer. HT may in fact back the PSA all the way down and relieve the pain. But also JEVTANA may be a logical choice if he is not a candidate for docetaxel chemotherapy. I would highly recommend a strong medical oncologist. If you tell us where you are geographically we can make some suggestions with docs that specialize in more advanced disease.
Posted 4/24/2015 3:05 AM (GMT 0)
Thank you! Hormonal therapy was prescribed today here. He had a battery of tests done in India and they totally missed it in Jan.
He is here with us in the sanfrancisco Bay Area. Thank you for any recommendations about oncologists. We went to the primary doc for back pain/rib cage pain.
Posted 4/24/2015 6:25 AM (GMT 0)
In SF Peter Carroll. Out to UC Davis it's Primo Lara. We call him Lucky. I still haven't asked him why.

You guys should look into these types of oncologists moving forward. PSA's over 900 won't be over looked. The climb from 15 was very concerning. That stated the next tests will help define the disease state. Since HT was started the first three months are very important notes for treatment direction. Stay close here the patient peer to peer history is very positive.

Post Edited (Tony Crispino) : 4/24/2015 12:35:31 AM (GMT-6)

Posted 4/24/2015 1:14 PM (GMT 0)
Ok. Thank you.
Posted 4/24/2015 2:06 PM (GMT 0)
Welcome to HW.

Tony's given you the best suggestions. Just wanted to say hello.

Please keep us updated on your progress and feel free to stop by and ask any questions you have.

Those are scary numbers but the HT will really help and he has a number of good options at this point,
Andrew
Posted 4/24/2015 2:49 PM (GMT 0)
Just another guy popping in to say hello. I agree with everything Tony has said. A good oncologist should be able to successfully manage your father-in-law's disease for a long time.
Posted 4/24/2015 4:30 PM (GMT 0)
Good morning,
4500+ wow. Another gosh danged over achiever.!the doctor who sat back and watched the PSA rise should have his license to practice revolked. What a bunch of crap. Fire him immediately!!! Your husband is sick. Not 99% certain.... 100% no if and or but's he is sick. Surgery will not be an option. The biopsy will reveal the aggressiveness of the cancer. That is the bad news!!!!

There is good news!!!! open your heart and mind.... This is not a death sentence. My PSA was over 3200 and I had a ton of mets. I too was on ibuprofen for pain prior to diagnosis. It has been 9 years. Lots of good well tolerated treatments for advanced disease. Lots of time left.! You have a very important job to do. You gotta get fil's mind right. He has to believe there is hope. He has to want to fight. Hang in there. The road will be bumpy but it is not a dead end anymore than life is a dead end. :-) Todd
Posted 4/24/2015 4:38 PM (GMT 0)
Thank you all for your kind words.
Just to be clear, my father in law is the one whose psa is elevated. psa was 969 in Jan. The test was done in India. My father in law and sister in law are thinking that nothing is wrong.(my husband is traveling and will be back home Sunday) But thankfully he had his first dose of hormonal therapy yesterday. Biopsy is on April 30 and discussion of results is on May 5.
Posted 4/24/2015 9:51 PM (GMT 0)
FIL father in law..... Got it. Same rules apply
Posted 4/24/2015 10:45 PM (GMT 0)
Hello !

You will receive a lot of care and support from this website, so please keep in touch through HEALING WELL.

Your father-in-law has started on hormone therapy, under the direction of his urologist. That's a good starting point.

At this time, it is VERY important that you get a medical ONCOLOGIST involved on your father-in-law's medical team. The oncologist will have additional knowledge that will be needed to treat your father-in-law's condition.

I have both an oncologist AND my urologist involved in my case. Adding an oncologist to my medical team added another important layer of knowledge about additional treatments for advanced prostate cancer. You need to add an oncologist to your medical team as soon as possible, in my opinion.

I believe the hormone shots are a good starting point for your father-in-law. You should start to see some improvement in his PSA numbers. Chemotherapy infusions may be suggested, depending on your father-in-law's health and medical condition. Oncologists oversee chemotherapy treatments, in most cases.

Please keep us updated on your father-in-law's medical case. We are all here to support you, going forward.

Sent with caring thoughts,
Cyclone
Posted 4/24/2015 10:56 PM (GMT 0)
Thank you so much for your input. Will try to see a medical oncologist as soon as possible. He does not have insurance and so things are getting delayed. Trying to find him any insurance now.
Posted 4/25/2015 12:28 AM (GMT 0)
Nothing to add to the good advice you've gotten so far, just want to say, welcome and as everyone's told you, with proper treatment, your FIL can live a good life for many years.

Hope you figure out the insurance thing.
Posted 4/30/2015 3:52 AM (GMT 0)
The biopsy has been postponed. We were not told that he needed to stop taking ibubrufen.
Posted 4/30/2015 4:15 AM (GMT 0)
Yes, they should have mentioned that awhile ago. Ibuprofen is a blood thinner and normally you need to be off of it for 10 days or so before any thing like a biopsy or other surgical procedure.

Keep us updated,
Andrew
Posted 4/30/2015 6:03 AM (GMT 0)
Dear DIL,
So sorry you have come to us with such worries, and not unfounded! I wish I had found this forum as soon as my husband was finally diagnosed. From what I've seen here, a PSA that high generally means something was missed earlier. My husband had a PSA of nearly 2000 @ dx, and he was put on HT prior to biopsy. That was the worst he ever felt and the sickest he ever was. Once you FIL gets past the initial SEs from the Testosterone depletion, he will likely start to feel better quickly.
We live in Nor Cal also, and you might be able to get insurance under covered CA. Hope you can get a good team for your FIL. He is fortunate to have you as his advocate now. Keep in touch.
Beth n Gary
Posted 4/30/2015 9:40 AM (GMT 0)
A 14 PSA in 2013 should have raised some alarms. Just me ... I raised alarm when I was 3.7 and I'm not a hypochondriac
.
Posted 5/7/2015 5:44 PM (GMT 0)
My father in law's biopsy results are in. He has Adenocarcinoma
7 out of 12 cores.
The affected cores were totally involved
Gleason score of 7 (4+3)
Perineural invasion seen
The doc gave him a shot of Lupron. He has been on Bicalutomide for the past 10 days.
Referral for bone scan and CT scan given
Posted 5/7/2015 5:59 PM (GMT 0)
Good to hear he got the Lupron. That should start bringing the PSA down.

Let us know what the scans show.

Andrew
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