where do I go from here

maxman526 · 07-17-2008, 07:59 PM

I recently had my third biopsy and the results were negative, I am happy with that news but I am left wondering what to do next, my numbers have bounced all over the place most recently 9.9 total up from 5.4 and 8.4 free down from 12 which is why the uro highly recommended the third biopsy I know I need to be vigilant and keep getting check but is there some point that I can relax a little and chalk it up to BPH and prostatitis I do have signs of both, I guess I hope my numbers will get better if that's at all possible.

Bob,

IADT3since2000 · 07-17-2008, 08:59 PM

Hi Bob,

Hearty congratulations on that negative biopsy, especially as it is the third negative one!

Are you aware that prostatitis can throw free PSA way off? That could explain why you have a low free PSA but no PC found in the biopsy. If you have the PC bible, "A Primer on Prostate Cancer - The Empowered Patient's Guide," turn to page 38: "... prostatitis can result in low free PSA percentages that make laboratory distinction from PC treacherous...."

I would bet you are fine, but for peace of mind you might have a PCA3Plus test run. It's results are especially useful for men with some indicators of PC but one or more negative biopsies.

Another tactic would be to go on either of the drugs finasteride or Avodart. Both were approved as BPH drugs, but finasteride has been proven to have anti-PC activity as well, and recent studies have shown that it is safe (some docs still haven't caught on).

Avodart very likely has anti-PC activity, probably even better than that of finasteride, but trial results aren't in yet. Your PSA should drop to half it's value on finasteride if you have no cancer, but any prostatitis would still complicate the picture I think.

Take care,

Jim

maxman526 · 07-18-2008, 10:04 AM

as a matter of fact because of your helpful insight I did have a conversation with my uro about the pca3 plus test and although he seemed a first not to be in favor of it because its not yet FDA approved he was willing to talk to a colleague of his in CT who is approved by the lab to perform the test and is now considering getting up and running with the lab as well, so I am hopeful I will have the test. As a side note my uro did say I was the first of his patients to ever inquire about having it done so hopefully this will be the start of something useful and as a last note I wasn't aware of the fact the prostatitis could cause the free psa to fall I've been searching for info that would explain why all of sudden my free has fallen from 20 to 8.4 in lets say a year in half that info could be the answer that I've been looking for, thanks again for your help !!!!!

Bob,

IADT3since2000 · 07-19-2008, 11:52 AM

Bob,

You're welcome! I'm glad I was able to help.

And thanks for sharing your doctor's response - very interesting!

I sense that word is getting around about the effectiveness of the PCA3Plus test, both among patients and doctors. While most of us would be able to get it if we knew just where to turn (as any urologist can do his part with just a little training and then ship the sample to one of the qualified labs), it is good that the test is becoming more widely accessible in a practical sense. It's a lot easier to get the tests and treatment we need when our doctors do know of of them and are in favor, especially if colleagues they trust are also supportive.

While the PCA3Plus is not FDA approved yet, I've heard Dr. David Bostwick, a leading PC pathologist, say that insurance coverage has been excellent.

I hope you get a good result and peace of mind.

Take care,

Jim

builder · 07-19-2008, 08:01 PM

Quote:

Originally Posted by maxman526

I recently had my third biopsy and the results were negative, I am happy with that news but I am left wondering what to do next, my numbers have bounced all over the place most recently 9.9 total up from 5.4 and 8.4 free down from 12 which is why the uro highly recommended the third biopsy I know I need to be vigilant and keep getting check but is there some point that I can relax a little and chalk it up to BPH and prostatitis I do have signs of both, I guess I hope my numbers will get better if that's at all possible.

Bob,

MAX... how bad are the biopsies? Over what period of time did your PSA go from 5.4 to 9.9? Also what period of time did you have the three biopsies. I have read that to many biopsies are not good for and may cause problems on there own. Your doctor doesn't have a clue on your condition? Did you do the antibiotic treatment also?