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Old 06-05-2008, 08:45 AM   #1
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when a psa is high and the biopsy is normal

when a psa is high and the biopsy is normal

 
Old 06-05-2008, 11:13 AM   #2
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Re: when a psa is high and the biopsy is normal

I have this exact situation, I had a normal biopsy {done last Dec}, my psa & free psa levels are high {psa ~ 6.6, free psa ~ 12- 15 %}. I am having both tests repeated later this month. The urologist recommends another biopsy within the next two months. I am going to discuss the new results with my doctor & then decide.

Tell me about your situation.

Mike

 
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Old 06-05-2008, 11:39 AM   #3
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Re: when a psa is high and the biopsy is normal

My husband's psa was 5.9 he had a biopsy in April and it was neg. The Urologist said to do another pas in Oct. He just did some blood work with his reg. Dr. and the psa was 12.9. Whats the between a pas and a free psa?

 
Old 06-05-2008, 05:33 PM   #4
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Re: when a psa is high and the biopsy is normal

Hi: When they did the biopsy there is a good chance that they didn't hit the area where the cancer is ( If there is any cancer.) I had 4 biopsys before they finally found mine. You should wait at least 3 months between biopsys so the prostate can heal. Another thing refrain from riding a bike and having sex before he goes in for his PSA. Good Luck Rich

 
Old 06-06-2008, 08:08 AM   #5
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Re: when a psa is high and the biopsy is normal

Dickiedo's experience is almost identical to my son-in-laws father. It took four biopsies to detect the prostate cancer. He also had a rising PSA and rapid psa doubling time which made his urologist virtually certain he had cancer although the first 4 biopsies couldn't detect it.
Other than a saturation biopsy, which is difficult and unpleasant, a typical 12-16 core sampling is exactly that--a sampling. Its comparable to plunging a needle into an orange 16 times trying to spear a pit. Of course a biopsy uses ultrasound to guide the needle to the suspected area if it can be seen,but the tumor cells are often in microscopic clusters and the needle isn't so there's a lot of false negatives. A rising PSA, PSA doubling time of less than a year or two and a low Free PSA > 25% are typically suspicious indications of prostate cancer and investigation should be pursued.

 
Old 06-06-2008, 08:41 AM   #6
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Re: when a psa is high and the biopsy is normal

Quote:
Originally Posted by Dickiedo View Post
Hi: When they did the biopsy there is a good chance that they didn't hit the area where the cancer is ( If there is any cancer.) I had 4 biopsys before they finally found mine. You should wait at least 3 months between biopsys so the prostate can heal. Another thing refrain from riding a bike and having sex before he goes in for his PSA. Good Luck Rich
Hello what were your psa & free psa levels right before each of the 4 biopsies ? where the values trending upward ?

thank you,

Mike

 
Old 06-06-2008, 11:01 AM   #7
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Re: when a psa is high and the biopsy is normal

Quote:
Originally Posted by beoria08 View Post
My husband's psa was 5.9 he had a biopsy in April and it was neg. The Urologist said to do another pas in Oct. He just did some blood work with his reg. Dr. and the psa was 12.9. Whats the between a pas and a free psa?
You have received good responses with important points, so I just want to cover a few additional points.

Right off, a PSA that jumped so fast, especially with a negative biopsy, could be produced as a result of infection, inflammation, or by trauma from the recent biopsy, and not cancer. Of course it could also be a mix of infection, inflammation, trauma and cancer, or it could be a quite aggressive cancer with a very short doubling time, though that would be unusual.

Did the regular doctor say anything about trying to rule out an infection as the cause of the elevated PSA and jump in PSA? Be sure that result goes to the urologist, and then your husband (or you) needs to follow up to make sure the report just doesn't get filed without attention. When the urologist sees the jump to 12.9, he won't want to wait until October to take some kind of followup action. He'll probably want to check to see if he can find an infection to explain the sudden increase. Or it's possible that the latest PSA was done close enough to the biopsy that the prostate is releasing a lot of PSA as it recovers from the trauma of the biopsy, as Dickiedo suggested. The urologist can judge whether that is the case.

A PSA measures the amount of "prostate specific antigen" enzyme in the blood. There are several sub-types of PSA that make up the enzyme, with the main ones being "complexed PSA," meaning PSA enzyme that is bound to a protein in the blood, and "free PSA," meaning PSA enzyme that is not bound to a protein in the blood. If you divide the measured free PSA result by the total PSA result, you get the percentage of free PSA. Complexed PSA is more associated with cancer, but free PSA is associated with BPH.

I hope the result turns out to be something benign. I think there's a good chance for that. But as other responses have emphasized, it's not something to forget about.

Good luck,

Jim

 
Old 06-06-2008, 11:02 AM   #8
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Re: when a psa is high and the biopsy is normal

I am curious as to what your respective psa & free psa levels were before each of your 4 biposies. Did you observe increasing values that warranted additional biopsies ?

Mike

 
Old 06-06-2008, 05:37 PM   #9
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Re: when a psa is high and the biopsy is normal

Hi Mike: In my case my PSA keep rising so my urologist said even though he didn't find any cancer the first time he said that I should have another biopsy in a few months. My PSA was not that high it went from 10 when I had my first biopsy to 15. That was back in 1995 I am still fighting it just like a lot of other guys that didn't want to join this club. Rich

 
Old 06-09-2008, 11:28 AM   #10
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Re: when a psa is high and the biopsy is normal

Hello Rich.

My urologist wants to do another biopsy based upon the free psa level, which was ranging between 10 - 15 %, my psa level has flattened out @ 6.6 {since 11/07 -4/08}. I am having both tests repeated this week & then discuss with my primary care about what to do next. my first biopsy was negative {16 samples were taken}, last december '07.

Did they sample different areas of your prostate each time you had the biopsy repeated ?

Thanks,

Mike

 
Old 06-09-2008, 05:20 PM   #11
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Re: when a psa is high and the biopsy is normal

Hi Mike: The answer to your question is yes. Each timje they did a biopsy he did it in a different area. There also is some areas that they can't get at. I think they have made a lot of improvements since I had mine back in 1994-95.
Good Luck on your next one Rich

 
Old 07-26-2008, 06:31 PM   #12
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Re: when a psa is high and the biopsy is normal

Quote:
Originally Posted by Dickiedo View Post
Hi: When they did the biopsy there is a good chance that they didn't hit the area where the cancer is ( If there is any cancer.) I had 4 biopsys before they finally found mine. You should wait at least 3 months between biopsys so the prostate can heal. Another thing refrain from riding a bike and having sex before he goes in for his PSA. Good Luck Rich
DICKIEDO...so they finally did find cancer? What was thre PSA and Free PSA levels when they found it? What treatment did you opt for?

 
Old 07-26-2008, 06:34 PM   #13
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Re: when a psa is high and the biopsy is normal

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Originally Posted by mike999 View Post
Hello Rich.

My urologist wants to do another biopsy based upon the free psa level, which was ranging between 10 - 15 %, my psa level has flattened out @ 6.6 {since 11/07 -4/08}. I am having both tests repeated this week & then discuss with my primary care about what to do next. my first biopsy was negative {16 samples were taken}, last december '07.

Did they sample different areas of your prostate each time you had the biopsy repeated ?

Thanks,

Mike
MIKE999 Did you have a second biiopsy? If so, what were the results?

 
Old 07-29-2008, 09:46 AM   #14
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Re: when a psa is high and the biopsy is normal

Hello:
Yes I had a second biopsy the doc took 24 cores and they all came back negative ! the psa values are variable to say the least.

 
Old 08-04-2008, 11:08 AM   #15
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Re: when a psa is high and the biopsy is normal

Quote:
Originally Posted by mike999 View Post
Hello:
Yes I had a second biopsy the doc took 24 cores and they all came back negative ! the psa values are variable to say the least.
MIKE what is your latest PSA levels and free PSA levels. What is the explanation from the doctor on why your PSA constantly is up?

 
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