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Cancer: Prostate Message Board
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Old 08-23-2009, 08:02 AM   #1
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Time for another biopsy?

Have not been to this site in quite a while but it has always been helpful. I am very concerned with my PSA test. However maybe I am not being objective. My first PSA was at 52 and it was 4.6. My familty doctor sent me to a urologist and after retesting he scheduled me for a biopsy. The first biopsy found nothing. He immediately recomended a second biopsy. His results here were more worrysome as he indicated he found some precancerous cells. He continued to monitor my PSA and a year or so later he did a third biopsy. PSA was still around 5. This biopsy produced no results again. It is now some 10 years later and I am 66 years old. My doctor/urologist has monitered my PSA. It has slowly risen. He thinks I have BPH. I recently tried to get additional life insurance and was turned down because of a PSA test of 10.1. My urologist says it can vary with labs and his test shows it less than 10. Since it has taken about 15 years to double my PSA he seems to not be worried. However I am worried. I am thinking it is time for another Biopsy. Anyone seen a simular situation that justifies this testing? Thanks for any help!
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Old 08-23-2009, 01:52 PM   #2
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Re: Time for another biopsy?

I have an earlier post on this board titled "One Man's Story" which lays out my experience dealing with BPH and subsequent PC. I've extracted the portion dealing with elevated PAS which may answer some of your questions.

"... I've been dealing with prostate issues for 16 years having my first biopsy in 1992 ...

...Over the next several years my DRE was always negative and my PSA ranged from 4.5 to 12.5. During this period I had three more biopsies with 8 to 18 cores - all negative. My prostate was very large and for about 2 years I was on Proscar and Flomax...

...Then in 2001 my PSA spiked to 18.5 and a fifth biospy was necessary. This one was a bit different. I was sedated and about 28 cores were taken concentrating in the transrethal area of the prostate. They too were negative...

Over the next few years I continued semiannual trips to urology for DRE and PSA tests. DRE still negative and PSA ranging from 9.8 to 12.5. I was in a gray zone. My urologist said that I could request a biospy if I wanted one, but the elevated PSA was most likely due to my enlarged prostate. The best course was to monitor the trend of PSA readings and do biospy if there was an uptick....

...Then in June 2008 my PSA reading was 9.8 (on proscar) which was a true value of 19.6. So on to a sixth biopsy. DRE was still negative. Cancer was detected in one of the 18 cores. Pathology report showed Gleason of 3+3 and T category of T1c. I then had a bone scan and CT scan to see if cancer had spread. Both were negative (and painless).

...He (urologist) said a normal prostate is about 25 grams. Mine was 119 grams and would be sent for pathelogical analysis. He later told me that the margins were clean and that no cancer was found. Evidently the biopsy was a lucky shot..."

As you can see I went several years with elevated PSA and no biopsies because the rate of increase of PSA was slow. It is important to continue monitoring PSA so a biopsy can be taken if the PSA rate increases significantly. After all the objective is to catch PC early to assure the best outcome.

If PC is detected in the future, you will have plenty of time to evaluate treatment options.

There is lots of help on this board. Best of luck to you.

 
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Old 08-23-2009, 02:39 PM   #3
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Re: Time for another biopsy?

Thanks for your quick reply. I feel much better with the path my urologist is taking and will continue my regular 6 months visits with PSA and DRE to continue to monitor my situation. Thank again!
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Old 08-24-2009, 09:13 AM   #4
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Re: Time for another biopsy?

Quote:
Originally Posted by KennyH View Post
... I am thinking it is time for another Biopsy. ...
I'd err on the side of caution and consider another biopsy. I might also want to see a different urologist to get another opinion-- perhaps you could start with that and see what he or she would recommend.

 
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