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Cancer: Prostate Message Board
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Old 07-24-2009, 01:28 PM   #1
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Howie63 HB User
Waiting for an Appointment

Hi --- PSA history f

July 2007 1.7
July 2008 1.6
July 2009 3.3

Blood work done at GP office DRE performed by GP prior to blood work -- as was other PSA tests
GP said prostate was somewhat enlarged but not uncommon for a man my age. Did not find ant=ything abnormal.

Made appointment with a top Urologist a Hopkins but appointment is not until 8/23. Person who made appointment asked me what my diagnosis is told her about PSA change. Said they would call if an earlier appointment opens up. GP was not concerned with length of wait. I will retest about 2 weeks prior to appointment.

Of course I started to stress when I got the results. I also started to have more frequent urinations and some pelvic discomfort. Took some Ibuprofin and symptoms went away.

Any thoughts?

 
Old 07-24-2009, 02:54 PM   #2
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daff HB User
Re: Waiting for an Appointment

Quote:
Originally Posted by Howie63 View Post
Hi --- PSA history f

July 2007 1.7
July 2008 1.6
July 2009 3.3

Blood work done at GP office DRE performed by GP prior to blood work -- as was other PSA tests
GP said prostate was somewhat enlarged but not uncommon for a man my age. Did not find ant=ything abnormal.

Made appointment with a top Urologist a Hopkins but appointment is not until 8/23. Person who made appointment asked me what my diagnosis is told her about PSA change. Said they would call if an earlier appointment opens up. GP was not concerned with length of wait. I will retest about 2 weeks prior to appointment.

Of course I started to stress when I got the results. I also started to have more frequent urinations and some pelvic discomfort. Took some Ibuprofin and symptoms went away.

Any thoughts?
You didn't mention your age, but the increase in PSA certainly merits the urologist visit, irrespective of your age. Depending on the PSA results, he may recommend a biopsy, which is the only real way to determine if you have prostate cancer. But's that's jumping pretty far ahead. By chance, did you have a free PSA test along with the standard PSA test (that, in conjunction with your age, can give a probability score as to your having cancer)? If you haven't gotten that, I'd suggest you ask for it when you are retested.

A rise in PSA can come about because of a prostate infection, not cancer. A test reading can also be elevated if there was a DRE prior to the blood being drawn, or sexual activity or other stimulus of the prostate, within a couple days of the test. So refraining prior to your next test would be a good idea.

The wait until August 23 may seem long, but it's probably not going to have much bearing on things. And getting that additional PSA test will be very important. You might want to do some reading about the subject so you can raise any issues with the urologist. This thing takes most of us by shock, but you have some time to become better educated, whether or not you have any real issue right now. Can't hurt. Good luck and feel free to post again. This is a great source of info, even though we're not medical doctors...

 
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Old 07-24-2009, 07:56 PM   #3
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Re: Waiting for an Appointment

Hi Howie,

Welcome to the board! I'll insert a few additional thoughts in green to those key comments daff already posted.


Quote:
Originally Posted by Howie63 View Post
Hi --- PSA history f

July 2007 1.7
July 2008 1.6
July 2009 3.3

Blood work done at GP office DRE performed by GP prior to blood work -- as was other PSA tests

It's possible the DRE may have made a difference this time but not in the past. Did the same doctor do all three? Was the DRE a quick "finger wave" or did the doctor spend some time probing? The former might not make much difference in PSA, per my layman's hunch, while the latter would be more likely to make a difference.

Were all three done with the same brand of PSA test and analyzed by the same lab? Variation in either can make a difference.


GP said prostate was somewhat enlarged but not uncommon for a man my age.

I'm guessing that you are 63 based on your user name on our board. Do you know if your prostate was enlarged in either of the two previous years? It's quite possible that it has been on a growth spurt over the past year, though my impression is that BPH is usually a pretty gradual process. Prostate gland tissue that is healthy accounts for about 0.066 units of PSA per each cc of the gland. If all 3.3 units of PSA were due to healthy tissue, that would mean that the gland was about 50 cc in size (50cc X 0.066 = 3.3); a gland of 50 cc would be large but not huge. Ask the Johns Hopkins urologist about the size of the gland. He'll be able to make a good estimate just from the DRE he does.

It's possible that some of the increase is due to BPH, perhaps some to use of a different lab or brand, some to the DRE before the test, and some to infection. Of course, it's also possible that prostate cancer accounts for some or all of the increase.


Did not find ant=ything abnormal.

That's a good sign of course, and well done to the GP for giving you a DRE. But, naturally, a urologist is a lot more experienced in doing DREs.

Made appointment with a top Urologist a Hopkins but appointment is not until 8/23. Person who made appointment asked me what my diagnosis is told her about PSA change. Said they would call if an earlier appointment opens up. GP was not concerned with length of wait. I will retest about 2 weeks prior to appointment.

Great idea! Make sure the test is done with the same lab and brand of PSA test kit. It would probably be wise to call a couple of days before the test to make sure.

Of course I started to stress when I got the results. I also started to have more frequent urinations and some pelvic discomfort. Took some Ibuprofin and symptoms went away.

Any thoughts?
One name for the PSA test is "Prostate Specific Anxiety" test. A lot of us can attest to that. I would say your stress reaction and response indicates you are a normal human being.

I know it's hard, but try to relax and take this in stride. That increase in PSA is certainly worth a follow-up as you are doing (and what better place than Johns Hopkins?), but even the amount of increase is not high enough to warrant extra concern.

Please get back to us with the new PSA result.

Take care and hang in there,

Jim

 
Old 07-25-2009, 06:31 AM   #4
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Re: Waiting for an Appointment

Howie,
Sorry you are onboard - but glad you found this site - it will be unbelievably beneficial - it got me through my decision process and surgery.
Jim's information is the best - all I can say is "ditto"
most important - be informed - ask questions !
and keep us informed -

 
Old 07-25-2009, 11:25 AM   #5
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Howie63 HB User
Re: Waiting for an Appointment

Yup --- I'm 63 and thanks for talking me off the ledge -- a friend of mine who is an anesthesiolgist (sp) and my GP keep telling me to chill out and don't go to the internet for information but i'm an internet junky.

Thanks for your replys and to anyone else who replies to this thread in the future. I will keep you posted on what happens

Howie63

 
Old 07-25-2009, 12:41 PM   #6
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Re: Waiting for an Appointment

Quote:
Originally Posted by Howie63 View Post
...and don't go to the internet for information...
Howie,

That can generally be good advice if you aren’t careful, but on the other hand it can also be a powerful tool to get good information right at your fingertips.

In my own personal journey (which began 6-months ago, in January of this year, with a diagnosis of PC), I found that I was able to benefit from this site and grow my knowledge & awareness beyond what I was able to obtain from other publications & literature because the respondents were generally men who had also recently traveled down the path that I was undertaking and were openly sharing their experiences and lessons learned.

Chinese proverb: If you want to know about the road ahead, speak to those on the return trip.


If you are an "internet junkie", then you should already know never to make decisions (especially medical decisions) based solely on what you've read on the internet. For online discussion boards like this, you should have your own personal “filter” up for some of these characteristics:
  • Be aware that the respondents on this board are not medical doctors. One should recognize, then, that the responses to questions may have varying amounts of verifiable substantiation via peer-reviewed medical publication. On the other hand, you can find feedback and individual responses based on personal experiences from very “savvy layman” on this site.
  • Be aware that some respondents, while not trying to “sell” anything themselves, may quite naturally become “evangelists” for their own treatment solution. [Put yourself in their shoes to see how natural this seems: Some of the respondent’s have just been “cured” of cancer. How wonderful is that(!), and imagine the relief and gratitude. Amen and halleluiah! Feeling good about what has happened to them, it is time to spread the word to the uninformed.]
  • Be aware that some discussion sites do seem to attract some "spammers" who do seek to "push" some unsubstantiated claims about new, not-throughly-tested treatments. I have not seen that here on this site; not without the legitimacy being quickly challenged.

With these bullets in mind and in order to make the most of this board, I would encourage newly diagnosed visitors to ask questions. Rather than ask “what should I do?” (you didn’t ask this, Howie; I am only using this as hypothetical example), this board is better equipped to respond to questions like “my test result said X, but I don’t really understand what that means; can you help explain?”, or “in the experience of others, what will Y procedure really be like?”

The internet is a great source of information if used correctly, and I am a positive supporter of the quality of information on this site.

Hoping for a good follow-up test result for you.

best wishes…

 
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