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Cancer: Prostate Message Board

Psa


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Old 07-22-2017, 12:29 AM   #1
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Psa

Hi, I'm new here and had some questions to ask if that's ok.
I've been sick for 5 years with lung problems. Had a tumor and some mediastinal nodes taken out that were benign but I've never improved. Recently my doctor ordered some blood work and the Psa came back at 5.78. He put me on cibrofloxacin for a couple of weeks. He reordered the PSA and I insisted on the FREE PSA as well. PSA was 4.40 and the free was .35 with 8%.
He's referring me to a urologist, but my question is if I'm positive for PC could that also be causing my lung problems?
First they said I had COPD now severe asthma. I don't think they know what I have. I'm wondering if they could be related.
Thank you for your time.
I'm 62.

 
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Old 07-23-2017, 01:45 PM   #2
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Re: Psa

Hi 716,

You have asked two questions, one regarding PC, and one about a connection of PC to your lung issues.

The PSA test is a wonderful multipurpose sentry that detects whether something is wrong with the prostate: benign growth (BPH), an infection/inflammation, or lastly, least likely, prostate cancer (plus a few other causes that are rare). That PSA of 5.78 was clearly elevated (by a point or two) for the average man of 62, but ďchallengingĒ the PSA with Cipro is a typical first approach to see if the elevated PSA may be caused totally or in part by an infection. That drop to 4.4 strongly suggests that infection by a bacterium targeted by Cipro is involved, at least in part. While the free PSA is low, free PSA, like PSA, is also influenced by infection. My informed laymanís opinion (no enrolled medical education) is that the free PSA result tells us little if anything in a setting where infection is highly likely to be involved (which is based on medical research). (Now if your PSA had not dropped after the Cipro but the free PSA was 8%, then it would have been more puzzling: possibly infection caused by a different bacterium, or possibly cancer.)

There is a possibility that you might have an infection combined with BPH, or combined with prostate cancer, or combined with both. I expect that the urologist will feel comfortable with ordering follow-up testing, possibly continuing the Cipro, but wonít do anything dramatic. Until recently the likely next big step would have been a biopsy, but increasingly now the next step in a case like yours is what is called a multiparametric (meaning measuring several aspects) MRI. If you are in the US, where the MRI is often a General Electric system, that may involve an endorectal MRI; in Europe, where the equipment is usually a more advanced Phillips or Siemens unit, that bothersome endorectal coil is not necessary. Again, itís likely the urologist will not think any of those steps is necessary at present.

It is possible that prostate cancer is contributing to your lung issues, but it seems highly unlikely. The lungs are not often affected in a symptomatic way by prostate cancer, and it is even more unlikely when the evidence you have suggests at most a low-risk case. Cases where PC impacts lungs involve metastasis, which happens only after the disease has progressed a good bit, and that seems most unlikely based on what you have provided; also, the lungs are a fairly unusual metastatic target for prostate cancer. All this does not rule out one of the extremely rare types of prostate cancer that does not produce PSA or only a little, but worrying about that is borrowing needless trouble.

Good luck with your health.

 
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Old 07-23-2017, 04:51 PM   #3
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Re: Psa

Thank you for all of the info. I've since checked my previous blood tests and found a psa of 1.70 8/27/10, 3.79 12/26/14 I don't know if that makes any difference or not

 
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Old 07-28-2017, 04:25 PM   #4
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Re: Psa

Hi again,

Your three first PSA values are in a fairly consistent line for the kind of "exponential" doubling pattern that is typical of prostate cancer, but those values could also be the result of infection and/or inflammation. Because Cipro does not decrease PSA that is due to cancer, it is almost certain that the recent decrease in PSA means that part, at least, of your elevated PSA is due to infection.

Let's take a look at the three older values and what they indicate about PSA doubling time. If 7/1/2017 is used as the date of the 5.78 test, then you have a doubling time of 44.9 months (3.7 years) using just the first two values and 46.8 months (3.9 years) using all three values. (Memorial Sloan Kettering Cancer Center in New York City provides a nice "nomogram" for easy calculation of PSA doubling time.) However, because of the infection, which has been revealed by your recent drop in PSA while on Cipro, those values cannot give you a "true" doubling time for the cancer, as there may well be no cancer at all.

Last edited by IADT3since2000; 07-28-2017 at 04:26 PM. Reason: Added a word right after posting.

 
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Old 07-28-2017, 07:07 PM   #5
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Re: Psa

Could the 5.78 have been elevated because of intimacy? When he ordered the original blood tests he wasn't investigating prostate trouble. I had lost my equilibrium several times and collapsed, the blood tests were not targeting anything specific. I've since learned that intimacy can affect the psa, it's possible that that happened the night before the test, perhaps that's why it was elevated?

 
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Old 08-06-2017, 12:51 PM   #6
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Re: Psa

Yes. It's likely there was some elevation due to very recent intimacy.

 
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Old 08-06-2017, 04:50 PM   #7
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Re: Psa

Quote:
Originally Posted by IADT3since2000 View Post
Yes. It's likely there was some elevation due to very recent intimacy.
Thank You for all of your responses, I'm seeing a urologist Monday, I'll make sure I tell him what happened.

 
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