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Dad's PSA up from 9 to 21

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Posted 3/12/2018 2:36 AM (GMT 0)
Well my dad got his PSA results last week, they were 9 in January and now 21. It's kinda discouraging to say the least. His scans were clear at the time. The doctor was going to put him on some other meds but hadn't determined what she wanted him on yet. My dad went and talked to the nurse and told her that he'd been on a course of antibiotics for a sinus infection and the doctor is thinking that it's the reason why his PSA is going up. He has him Casodex, which stopped working for a while but she said that it may start working again because sometimes when you stop and restart they may work. I told my dad I didn't like how it seems she is rolling the dice with his PSA, assuming the rise is from the antibiotics. Seems to me she should give him the meds anyway to control his PSA since it is rising so quickly. If she keeps that up it will be 100 and likely in his bones by that time. He has to go for his Trelstar injection on Tuesday and will likely say something to her about it then. What are your opinions on the doctor's decision?
Posted 3/12/2018 1:03 PM (GMT 0)
What is your dad's history and details?
Posted 3/12/2018 6:15 PM (GMT 0)
We need some more details...How old is Dad ? Has he had a biopsy ? Results of biopsy ?
Posted 3/12/2018 6:22 PM (GMT 0)
One other thing to check is what scale the PSA results are being reported on. Most of my tests had been on the Beckman-Coulter scale. Then my last one was on the WHO standard, which gives results 20% less than the other scale.
It will be in the fine print somewhere. Make sure you are comparing apples to apples...
Posted 3/12/2018 7:22 PM (GMT 0)

Fairwind said...
We need some more details...How old is Dad ? Has he had a biopsy ? Results of biopsy ?


If he's scheduled to have a Trelstar (another type of GnRH agonist, in the same class of drugs as Lupron) injection, it's probably a safe bet that he's been biopsied in the past and diagnosed with PCa.

But more details/history would be helpful, like will this be his first Trelstar injection or has he been on it for a while. If he's been on the Trelstar for a while, I think a rising PSA probably means he's castrate resistant.
Posted 3/12/2018 7:53 PM (GMT 0)
Hi Lisa smile just wanted to pop by and say hello. We have chatted on here before (not sure if you remember) If it’s any consolation or will calm you nerves somewhat, an infection can definitely cause an increase in psa. So that’s something to take in to consideration. Try your best not to jump ahead of yourself and fear the worst (I’m guilty of that) at the same time, don’t be afraid to ask questions at the next appointment.

I know that when my Dad’s psa started to rise last year, they waited a number of months before introducing something new. I wondered why they waited as long as they did, apparently one of the reasons was because he had had an infection which was thought could have increased his psa.

Every case is so different, there are many reasons I guess these drs choose to do things the way they do. Unfortunately my Dad’s pca is the aggressive G9 so again, his treatment will no doubt be different from your dads.

The best advice I can give is keep yourself informed, note down the questions you want to ask... Someone once suggested to me to record the session on your phone (if they allow it) so you don’t miss anything.

Sending you lots of love and prayers x
Posted 3/12/2018 9:13 PM (GMT 0)

LisaInIndiana said...
My dad went and talked to the nurse and told her that he'd been on a course of antibiotics for a sinus infection and the doctor is thinking that it's the reason why his PSA is going up.


That's a RED FLAG.

I have never heard of PSA increasing due to a course of antibiotics.

Antibiotics are often used to treat prostate infections, and to lower PSA.
Posted 3/13/2018 2:46 AM (GMT 0)
I'm sorry, yes I should have written the details, how stupid of me. Anyway, my dad is 69, diagnosed at 64, Gleason 7 (not sure which way), had radiation then PSA stayed low for a year or two. He relapsed and PSA started creeping up again. He has been on Casodex and Trelstar, (he's taken the Trelstar for several years) then secondary HT, Zytiga, Estramustine, and another I can't think of off the top of my head. PSA had been controlled by the Zytiga around 7 months. In November he had a throat infection and his mother died and the doctor said maybe this stress and infection caused the PSA to rise. So he went back next time and now it's 21. Well between 9 and 21 he had a sinus infection so that is when he was on the next round. He told her that and she thinks that may be why his PSA is going up. So my question is why does she roll the dice and think that the infection may be causing it when his PSA is shooting up like a rocket like that? I think the risk is too high to wait another month to decide what to do! By that time, his PSA will be higher, plus he'd have to wait for about 2 weeks to get the meds and then schedule a training to go there and hear how he's supposed to take the medicine.

Yeah, I thought it was totally bizarre saying that the infection and antibiotics made the PSA go up. I have read on here that prostatitis can make it go up but he didn't have that. She's supposed to be a really good doctor though, from what everybody seems to say. He is going to go to the doctor tomorrow and question it when he gets his shot.

Yes Kathy, I remember you! How is your dad doing on the Zytiga? Has he had any scans lately? Please let me know!
Posted 3/13/2018 7:08 AM (GMT 0)
Hi Lisa smile thanks for asking about my Dad.. some days are better than others. He's back to the hospital in 2 weeks so will update you then. No scans since December.

Please keep us updated with your Dad's situation. People on here are far more well informed than me, I did think a UTI or such like could increase psa but as people have said.. Don't just sit back ...Keep asking those questions. X
Posted 3/14/2018 3:17 PM (GMT 0)
So it appears he has systemic PCa and his PSA is going up at that rate? I certainly hope you have him with an excellent medical oncologist that specializes in PCa. What is the specialty of the doctor that is saying stress and antibiotics are causing a rise in PSA in a man that has systemic PCa? Has he had any scans to determine whether the cancer is metastatic?
Posted 3/15/2018 2:21 AM (GMT 0)
Hi Kathy! I just responded to your post about your dad in the other thread. We might as well continue it over there.

JNF, the doctor told my dad his PCa is stage 4 and that it's "somewhere" and it's "in his blood." He has had scans and they have been clear so far so she doesn't know exactly where it is. The doctor he goes to is supposed to be one of the best oncologists around. She specializes in medical oncology and hematology. She has been doing it for over 20 years. I am a little nervous about her saying that stress and antibiotics can increase the PSA as well. Maybe I should say that it's possible she said his sinus infection could have caused his PSA rise. I don't remember exactly.
Posted 3/15/2018 3:34 AM (GMT 0)
Are you at the Indiana University Medical Center in Indianapolis? they are one of the best for urological cancers and developed the cure for testicular cancer about 20 yers ago. Wonderful place for PCa.

If you have any concerns an additional assessment is always a great thing to do. It either confirms you are on the right track with great doctors or tells you that a change in direction is best. Either way great.

It is all about your dad, not the docs.
Posted 3/16/2018 5:14 PM (GMT 0)
No, I am not at the IU Medical Center. I will mention it to my parents but getting them to go down there would be like pulling teeth. They wouldn't stop going to their doctor because that's just how they are. They trust what she says.
My dad neglected to tell me he is on Adovart for his PCa. I don't even know if I want to research it. I read a little bit and it just says how it's not approved for treatment of PCa, or one site said how it is good for early stage PCa. I am pretty much at the point of saying, "Does it really matter if I look the drugs up or not? Who am I to determine what is right for him in his particular situation?" She told me last time to quit worrying, that it is only making it worse on everyone concerned. She seems like she is not too concerned, that she has a handle on it. But it's hard when it's your loved one and just another number to a doctor.
Posted 3/16/2018 8:00 PM (GMT 0)
Where are you located?
Posted 3/16/2018 8:20 PM (GMT 0)
Avodart is a medicine that reduces the production of DHT. It is not the main medicine but is often used to compliment the core medicines like Lupron and Telstar and Casodex.

You say you are in Indiana, but not at IU and that your dad won’t “go down there”. I am from Indiana and that tells me he is in northern Indiana. Where precisely? We might have other members in his area that can be supportive. What is the name of the oncologist and where does she practice. Most oncologists have specialties, what is hers? I hope she has treated a lot of advanced stage PCa men like your dad and will be very good managing his disease. However, you don’t sound confident. Hopefully some men on the board can be of assistance.

He has had many treatments. Has she brought up the use of chemotherapy called Taxotere? Often it is used in conjunction with these other medicines to control the cancer.
Posted 3/16/2018 11:10 PM (GMT 0)
How do I send a PM with the information?
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