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Cancer: Prostate Message Board
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Old 06-27-2012, 09:47 PM   #1
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Infinity29 HB User
PSA Velocity

First let me say that I have not been diagnosed with Prostate Cancer. My history is as follows: 11/06 1.3
2/08 1.5
4/09 1.5
9/10 2.1
11/11 3.6 (06-11 all use the same PSA method)
01/12 3.3/18% (after 30 days on Levaquin and using a different PSA method)
4/12 3.9/18% (using the same method from 1/12)
All DRE are negative

I'm very concerned with the PSA velocity, especially from 2.1 to 3.6 in 14 months as well as 3.3 to 3.9 in only 3 months. My urologist (who is not a surgeon) thinks I have prostatitus and BPH. Because of my anxiety, he has suggested a second opinion and is sending me to another urologist (surgeon who specializes in robotic prostate surgery).

I am going for another PSA/Free in a week before I see the second urologist. I'm pretty damn scared due to fast jumps in the total PSA in relatively short periods of time. My urologist says that the free psa of 18% is "respectable".... I would like to take a PCA3 test before considering a biopsy and I'm sure the next urologist will suggest a biopsy. What do you guys think? I'm worried about an aggressive cancer due to the fast rises in the PSA. Can any kind of prostatitus (non bacteriological) or anything else cause a steady rise in PSA? Thanks all.

 
Old 06-28-2012, 05:15 AM   #2
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Re: PSA anxiety

Hi Infinity,

Welcome to the Board!

You could have prostatitis that is waxing and waning, with the recent PSAs happening to catch it at various points on its swings. Prostatitis also affects the free PSA results (but not PCA3 results). There could also be some benign growth mixed in (BPH), but of course there could also be some cancer.

There is a new test that has just been approved by the FDA. It is known as the "Prostate Health Index" (the "phi" test) from Beckman Coulter. The company touts it as "2.5 times more specific than PSA for patients with PSA values in the 4-10 ng/mL range." It will be commercially available later this summer.

There is a recent book that is outstanding for people like you who have not yet been diagnosed (and for those who have been): "Invasion of the Prostate Snatchers," by Ralph Blum and Mark Scholz, MD.

By the way, your questions certainly fit under this thread, but you are also free to start your own thread where you would be able to track your posts and responses more directly.

Take care,

Jim

 
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Old 06-28-2012, 05:46 AM   #3
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Re: PSA anxiety

Welcome to the board as well.

As you most likely know PSA is not the best test there is, but it is an indicator. In addition, you should keep track of your activity prior to the PSA as many things, incluiding the obvious (sex), can casue the reading to go up. In my case one of the things that might have thrown the PSA off is they did the DRE prior to drawing blood.

The other thing I wanted to mention is a conversation I had with one of the pioneers of the PSA test once I was diagnosed with PC. He said he does not worry about the "highs" in the PSA reading but looks at the trends of the lows. When the lows continue to go up that is when he gets concerned.

Sounds like you are on a course of watching every six months (as I was) and at some point if the values continue to go up you will most likely need a biopsy. Also, keep in mind that your age will also impact the PSA readings.

Keep posting and as was siad - feel free to start a new threead.

 
Old 06-28-2012, 01:19 PM   #4
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Re: PSA anxiety

Thanks for the info. I have been reading that book "The Invasion of the Prostate Snatchers" and for me it's pretty discouraging as most options for treatment seem to have fairly significant long term quality of life changes. I'm aware that sex and DRE effect the PSA results. On top of my rising PSA I have prostate pain an hour or so after sex which can last a few days. This might be the prostititus. This is why I'm thinking I may very well have a combo of Prostititus, BPH, and possibly even some P/C going on. I'll keep watching. I call this the "Gerbil Wheel of Prostate Cancer".

Last edited by Infinity29; 06-29-2012 at 09:24 AM.

 
Old 07-11-2012, 07:48 PM   #5
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Re: PSA anxiety

I went for a second opinion today with my PSA now at 4.2 and a small nodule found in the middle of the gland. The urologist of course suggested a biopsy. He told me that there will probably be just a 1 in 5 chance of finding anything using the TRUS biopsy. I asked about the MRI guided biopsy which is supposely more accurate in targeting the suspected areas, but he does not use this method. I've found most urologists are still using the "blind" Trus ultrasound method which produces so many false negatives. Does anyone have any experience with the MRI guided biopsy that used both MRI and Ultrasound with better luck targeting the right areas? Why go through a biopsy when all I'm hearing is that more than likely they are not going to find anything and risk any side affects? Also, if a nodule is found, why can't they just do a biopsy on the nodule in addition to the rest of the gland? Aren't they able to zone in on the nodule much easier to get a good result?

 
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Old 07-12-2012, 11:25 AM   #6
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Re: PSA anxiety

Infinity, mine is scheduled for August 3rd as my Uro only goes to this office which has this new machine on Fridays. August 3rd is the first available appointment, my MRI shows 8mm suspicious spot. I believe my biopsy is a 3D mapping, MRI fusion with Color Ultrasound Elastrography (not 100% sure as I have not received a written confirmation on my appointment). This is through University of Sourthern Californaia.

Last edited by Akai; 07-12-2012 at 02:31 PM.

 
Old 07-12-2012, 03:52 PM   #7
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Re: PSA anxiety

Quote:
Originally Posted by Akai View Post
Infinity, mine is scheduled for August 3rd as my Uro only goes to this office which has this new machine on Fridays. August 3rd is the first available appointment, my MRI shows 8mm suspicious spot. I believe my biopsy is a 3D mapping, MRI fusion with Color Ultrasound Elastrography (not 100% sure as I have not received a written confirmation on my appointment). This is through University of Sourthern Californaia.
Thanks for the info. I have a printout from Urology at UCLA that does Targeted Biopsy Using Mr-Ultrasound Fusion. I'd be very interested in how yours works out. Please keep us posted. By the way......I went to a 3rd urologist today and told him yesterday's urologist found a small nodule and be careful to look for it. Guess what? He said there was nothing to find. No nodule, no lumps or bumps of any kind. Go figure! I won't be going back to that second urologist again.

 
Old 07-12-2012, 06:04 PM   #8
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Re: PSA anxiety

I had the same experiences on DREs. My family doctor said he felt a nodule, two urologists said no nodule. Obviously it is more of an art than an exact science.

 
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