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Old 07-24-2008, 09:52 AM   #1
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Infection And Elevated PSA Levels

I know a prostate infection can raise PSA levels. Does anyone know if an infection can effct the Free PSA levels also?

 
Old 07-24-2008, 11:12 AM   #2
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Re: Infection And Elevated PSA Levels

Hello: I have read that an infection can influence free psa %s as well. Have you confirmed that you have an infection ? what were your psa & free psa levels previously? what are they now ?

Mike

 
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Old 07-24-2008, 11:54 AM   #3
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Re: Infection And Elevated PSA Levels

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Originally Posted by builder View Post
I know a prostate infection can raise PSA levels. Does anyone know if an infection can effct the Free PSA levels also?
Yes (based on what I've read, like Mike. I haven't experienced this personally and have had no enrolled medical education). Prostatitis includes both infection and inflammation of the prostate. Here's what the Primer says about it: "Prostatitis can be a non-cancerous cause of an elevated PSA. However, prostatitis can result in low free PSA percentages that make laboratory distinction from PC [prostate cancer] treacherous. If prostatitis is confirmed, it sometimes responds to treatment with an antibiotic such as Cipro, usually given for 4-8 weeks. Be sure to allow at least six weeks of antibiotic treatment before rechecking the PSA." This is on page 38 of "A Primer on Prostate Cancer - The Empowered Patient's Guide."

Take care,

Jim

 
Old 07-24-2008, 11:59 AM   #4
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Re: Infection And Elevated PSA Levels

My PSA has been in the 4.45 10 month ago from one lab and the 2nd lab was 5.4. Last week I went to two labs again in two days. 4.7 from one lab and 5.1 from the second lab. It was It was 2.6 three years ago. I am 55. I had a free PSA done this time at only one lab and it was 13.3 %.The DRE was normal. Also 10 months ago I was having a slight irritation when I urinated. It felt like my bladder was full all the time. All tests were negative for bacterial or STD's so the doctor thought it may be a prostate infection and gave me antibiotics. The symptoms went away. But once again I have to urinate all the time. I don't have the tingling burning sensation anymore, but the 13.1 % worries me and looks like I need a biopsy. That is why I am asking if anyone knows if infection in the Prostate would cause free PSA levels to be off also.

 
Old 07-24-2008, 01:38 PM   #5
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Re: Infection And Elevated PSA Levels

Are you a diabetic ? The frequent urge to urinate is one of the symptoms..what is your blood glucose level ?

 
Old 07-24-2008, 01:39 PM   #6
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Re: Infection And Elevated PSA Levels

Hi again builder,

Those PSA values look pretty stable over 10 months, though elevated of course, and up from that fairly reassuring 2.6 level three years ago. From what you describe, I can see why your doctor was focusing on an infection as the cause.

It gets to be a tough judgement call: go ahead and have a biopsy, with a strong chance there is little or no cancer and that the result will be negative in either case because either there was no cancer to find or the core was not taken where the cancer was, but with a chance of finding cancer, or hold off on a biopsy with a small but definite possibility that any cancer could gain more of a foothold.

Here is what stands out to me in what you've written, mostly on the good and hopeful side. On the good side, the PSA is quite stable over ten months, assuming the same lab had the two readings in the 4 range and another the two in the 5 range. The difference between the labs could be the use of different PSA tests that check different places on the PSA molecule, and it could also be due partly to different lab procedures. The slight variations, including what looks like a downturn from 5.4 to 5.1, could be due to your own day-to-day variations in PSA production. That's not the way PSAs generally behave (stable or a downturn) in response to prostate cancer, but it is one of the patterns consistent with infection, perhaps boosted by enlargement, as I understand it as a layman. That said, cancer could still be there.

Also on the good side, you have had strong evidence of an infection at work previously, and have good evidence that there is still something other than cancer going on, which would influence PSA (causing it to be higher than it would otherwise be) and free PSA (causing it to be lower than it would otherwise be). I've read that many of us who are in our 50s or older have some degree of prostatitis.

Again on the good side, that negative DRE.

On the negative side, you have a PSA somewhat above the old cut off of 4 and a rise of more than 2 over three years.

Did your urologist indicate the current size of the prostate? The rule-of-thumb, based on research, is that healthy prostate tissue makes about .066 units of PSA for each cubic centimeter of prostate. It would take a quite large prostate of about 71 cc to explain all 4.7 units of PSA, but it's possible you have both a somewhat enlarged prostate - not surprising at age 55, and some infection, each contributing to a higher than expected PSA. Of course, there could be some cancer in the mix too, but if so, it might be a lot less than just the PSA would indicate if there were no enlargement and no infection.

Have you considered a PCA3Plus test? That is increasingly being used to help separate the PSA sheep from the PSA goats and can help in cases like yours.

Have you considered taking finasteride for six months to see if your PSA drops by half or more, which would suggest something other than cancer? Finasteride is proving useful for prostate cancer treatment, as I see it, but it was approved to treat enlarged prostates. (Just this spring there was a presentation at a major urologist conference that again pretty much proved that finasteride was safe - not fostering high grade disease but rather making it easier to detect.) Avodart would probably do about the same thing. However, infection might throw off these results too. At least you would have a good shot at taking care of any BPH.

You could also adopt nutrition, exercise and stress reduction tactics that appear to substantially help prevent and support treatment of prostate cancer.

Trying again to identify an infection might work.

Of course, having another PSA test in a month or so and watching for any change is another option.

It's easy to view all this from afar. Not so easy when you're in the hotseat and need to decide what to do. Good luck with it.

Jim

 
Old 07-24-2008, 02:04 PM   #7
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Re: Infection And Elevated PSA Levels

Hey builder I was in your shoes up until yesterday. I had my biopsy and the build up to it was the worst of it all. Also my psa has crept up over the past 3 years. It started at 2.7 and last sep. it was 3.7, so doc put me on finasteride and in June it was 3.0 so. I am just learning here so I do appreciate all the input from the other guys.
Hey Jim, and Mike, my prostate is 55cc. that is after being on finasteride for 10 mo. so I guess it is shrinking, the doc said it was extremely large before the biopsy, I was still a little groggy so I didnt think quickly enough to ask alot of questions after the procedure, he did say I had a nodule on the front side that was benign and the back was smooth and he was very pleased, but, I guess I wont know the real deal until the results? To be honest I cant remember how many samples, I think it was 12.
I have been having alot of back pain over the last several weeks so not really sure if I had any pain from the procedure. Also, can the prostate being enlarged cause the back pain?

 
Old 07-24-2008, 02:32 PM   #8
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Re: Infection And Elevated PSA Levels

JIM and ROCK... The doc said my prostate was nice and small when he felt it 9 months ago. I am going to ask about a PSA3 test. Thanks Jim & Rock...how uncomfortable or painful was the biopsy? Something that might be related or unrelated. Last year I had a huge jump in my Testoserone levels. The level double to 675 in October 2007 at about the same time my PSA levels jumped.
It has always around 350 since 1999. It is back in the 350 range. I was on no supplements. I asked the doctor about that and he did not know. Also can you have a an ongoing prostate infection if it isn't enlarged or without a lot of symptoms other than me having to urinnate all the time

Last edited by builder; 07-24-2008 at 02:59 PM.

 
Old 07-24-2008, 04:45 PM   #9
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Re: Infection And Elevated PSA Levels

Quote:
Originally Posted by rock51 View Post
... I was still a little groggy so I didnt think quickly enough to ask alot of questions after the procedure...

Roger that. It's not a time when any of us would do well on Jeopardy.

I cant remember how many samples, I think it was 12.

You can get a copy of your biopsy report. If it doesn't give the number of cores, you can ask the doctor who did it. Even if it doesn't seem to matter now, that information may help in the future.

.... Also, can the prostate being enlarged cause the back pain?
I don't know the answer to that. My guess is that enlargement on its own would not cause back pain.

Hope those results turn out the good way!

Jim

 
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