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  • Husband 55 with increasing PSA

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    Old 06-18-2018, 06:37 PM   #1
    murphy496
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    Husband 55 with increasing PSA

    We go to the Urologist tomorrow morning 8am. My husband saw his regular DR June for his yearly stuff and they did a PSA test. He has had one done for the last three years. His PSA in 2016 was 2.6 this was his first check. In 2017 his PSA was 3.5. Now in 2018 itís 4.1. He has no issues with peeing or needing to go more. No burning or anything during peeing. I guess Iím wondering whatís the chance that this is cancer? Also for the first visit what questions do we need to ask? Iím pretty scared but trying to be positive for my husband.

     
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    Old 06-19-2018, 10:29 AM   #2
    murphy496
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    Re: Husband 55 with increasing PSA

    Ok, we had our appointment this morning and go in for a biopsy on July 10. The DR said due to my husbands trends we needed the biopsy. He did do blood work a K4 test which should be back in 5 days. So now we are just waiting.

     
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    Old 06-23-2018, 01:08 PM   #3
    IADT3since2000
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    Re: Husband 55 with increasing PSA

    Hi and welcome to the Board!

    First, it is fairly likely that your husbandís PSA increase is due to benign growth or to infection/inflammation. On the other hand, there is a fair chance that it is caused, at least in part, by prostate cancer.

    Second, you and your husband should know that prostate cancer patients have the best survival record of any major cancer: about 95% of us are alive, most of us doing well, at the fifteen year point after diagnosis, compared to our age-matched peers.

    That 4k test result should reach you by Tuesday, and if not call the doctor to make sure it hasnít slipped through the cracks. If favorable, it probably would be smart to cancel the biopsy. If unfavorable, then the biopsy is probably going to be needed, but there is an increasingly used intermediate step that could help avoid a biopsy or make it more effective.

    That step is called a multiparametric MRI, and it is increasingly being used before a biopsy for patients like your husband. Like the 4K, it too can indicate that a biopsy is not needed, and if it suggests some likelihood of prostate cancer, it can indicate the likely shape, size and aggressiveness of the cancer, and most importantly its likely location or locations. (Prostate cancer in the prostate itself is often in more than just one spot.) That helps the doctor do a better biopsy.

    If the doctor still thinks a biopsy is necessary after reviewing the 4K results, ask him about whether it would help to have a multiparametric MRI. If you want to do some homework, you can find out about this technology by looking at search results on www.pubmed.gov after searching with a search string like this - prostate cancer AND multiparametric MRI AND pre-biopsy , which yielded 17 hits after setting the filter on the left for abstracts. You can read a brief description of the study results by clicking on the blue hypertext, and you can get free links to complete online copies of three papers by clicking the ďfree full textĒ filter.

    Good luck.

     
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    Old 06-23-2018, 07:57 PM   #4
    murphy496
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    Re: Husband 55 with increasing PSA

    Thanks so much for your response. Weíll be looking up the information on the MRI. Iíll post as soon as we get the K4 results and let you know if the Urologist still recommends the biopsy.

     
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    Old 06-25-2018, 06:23 PM   #5
    murphy496
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    Re: Husband 55 with increasing PSA

    My husbands K4 score is 8% so what does this mean? His PSA is time was 4.32. Any help would be appreciated.

     
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    Old 06-26-2018, 09:53 AM   #6
    murphy496
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    Re: Husband 55 with increasing PSA

    IADT3since2000

    My husband talked to the Urologist about the K4 score of 8 and Urologist said we could wait 6 months and redo blood work. If PSA was still elavated we then could move forward with the prostate biopsy. What do you think? Would it be ok to wait 6 more months or should we go ahead with the biopsy on July 10? The Urologist said the the K4 score of was in the intermediate range. Not sure what to do.

    Thanks for your help.

    Last edited by Administrator; 01-15-2019 at 01:19 PM.

     
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    Old 11-28-2018, 08:43 AM   #7
    nh19
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    Re: Husband 55 with increasing PSA

    Hi, I'm hoping your husbands doing well... Have you done anything further since your last post?

    Last edited by Administrator; 12-01-2018 at 05:13 PM.

     
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    Old 11-28-2018, 02:40 PM   #8
    murphy496
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    Re: Husband 55 with increasing PSA

    Quote:
    Originally Posted by nh19 View Post
    Hi, I'm hoping your husbands doing well... Have you done anything further since your last post? I'm 59 and my PSA rose from 2.8 last year to 4.2 this year. A DRE revealed a nodule so my Urologist ordered a biopsy. I'm awaiting results. The Urologist felt the combination of DRE and PSA meant a biopsy was necessary now.

    No we havenít done anything else. Heís waiting to go back Jan 10,2019 for a retest of PSA.Iím praying it comes back normal and not higher. Iíll say a prayer for you.Thereís a lot of good people on here that will have valuable information for you. I hope all goes well.

     
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    Old 12-11-2018, 04:47 PM   #9
    *tony*
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    Re: Husband 55 with increasing PSA

    I haven't posted here in a while. I wish I had known about this forum when I first got my PC diagnosis. Regretfully, I found this forum about six months after my surgery. I believe that this forum has helped me cope with my PC journey more than any other type of group therapy source. I believe that you have come to the right place for sharing your experiences. I will pray for a good outcome for your husband. Blessings.

     
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    Old 01-08-2019, 09:32 PM   #10
    murphy496
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    Re: Husband 55 with increasing PSA

    Quote:
    Originally Posted by *tony* View Post
    I haven't posted here in a while. I wish I had known about this forum when I first got my PC diagnosis. Regretfully, I found this forum about six months after my surgery. I believe that this forum has helped me cope with my PC journey more than any other type of group therapy source. I believe that you have come to the right place for sharing your experiences. I will pray for a good outcome for your husband. Blessings.
    We go to the Urologist Thursday January 10. I admit Iím pretty nervous about it. Iíll post as soon as I find out anything. Iím so thankful I found this site. I appreciate all prayers and information. Iíll be praying for you also Tony.

    Murphy

     
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    Old 01-10-2019, 03:29 PM   #11
    murphy496
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    Re: Husband 55 with increasing PSA

    Ok , just left the Drs appointment for my husbands 6 month check on PSA. It went from 4.1 last check to 4.73. The Dr told my husband he recommends doing a recheck in 6 months. My husband is comfortable Iím waiting. Iím not comfortable waiting but I canít change his mind. What do you think?

     
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    Old 01-14-2019, 11:11 AM   #12
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    Re: Husband 55 with increasing PSA

    Hi again,

    Itís always a lot easier to be away from the action, which is where I am now, rather than to be facing a need for a decision Ė here, for your husband and you, whether to do more now or sit tight for six months. Where you are can be a worrisome place. But for what it is worth, here is my impression.

    If your husband is being seen by a doctor who is highly regarded for prostate cancer, especially if at a major center that is highly regarded for research and treating prostate cancer patients, you can relax - for six months anyway. Your husbandís PSA is still fairly low even if the cause of the elevation is prostate cancer. Moreover, if my PSA ďdoubling timeĒ calculation is close to the mark, which I believe is the case, his doubling time, which should be close to the time it takes the cancer, if there is cancer, to double, is fairly slow. My calculation is 40 months (39.8), which is 3.3 years, based on a formula (ďnomogramĒ) made available by a very well-known institution that researches, manages, and treats prostate cancer. I guessed at the exact dates, using June 15 for 2016 at 2.7, June 15 for 2017 at 3.5, June 16 for 2018 at 4.1, and January 10 for 2019 at 4.7; if those dates are fairly close to the real dates, the calculation should be pretty accurate. This result, plus all the other information and clinical impression available to an experienced doctor, would be enough to justify relaxing and enjoying freedom from the inconvenience of a biopsy, possible side effects of treatment if needed, and time for technology to keep improving. Chances would be strong in this case of very little (though not zero) risk that the cancer would advance enough that choices or successful treatment would be less likely when looked at again in six months.

    If your husband is being managed by a doctor who is doing his or her best but is not that familiar with prostate cancer Ė not seeing that many prostate cancer patients and not keeping up with the field, then you and your husband might want to consider additional, earlier steps. The simplest would be getting another PSA test in three months instead of six. Another simple step would be getting a genetic test for some of the more problematic gene mutations, especially BRCA-1 and BRCA-2 (which are meaningful for prostate cancer as well as for breast and other cancers); this might be difficult to arrange or expensive prior to a diagnosis of prostate cancer (and likely covered and easy to do afterward). Another step, this time not difficult and easy for the patient but fairly major, would be to have a multiparametric MRI scan, which is increasingly done before a biopsy and which actually gives better information than the now standard 12-core biopsy. Of course you both could insist on a biopsy; that would be reasonable, but, to me, in my easy chair, overly aggressive at this point.

    If your husband does turn out, eventually, to have very low-risk or low-risk prostate cancer, that is a fairly mild condition that we now know is best handled by ďactive surveillanceĒ (AS) rather than immediate treatment. Many AS patients never need treatment for prostate cancer throughout their lives; some others turn out eventually to need treatment, but they have gained years, often many, free of side effects and have gained time for technology to improve, which is happening at a rapid pace for prostate cancer. These lower-risk kinds of prostate cancer are kind of like having high blood pressure or elevated cholesterol; there is a need to monitor (surveillance), and some mild tactics (such as mild and inexpensive medications or lifestyle changes) sometimes are all that is ever needed.

    If your husband turns out to need treatment, there are highly effective treatments with ways of reducing side-effects.

    Good luck!

     
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    Old 01-15-2019, 11:34 AM   #13
    murphy496
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    Re: Husband 55 with increasing PSA

    Hi IADT3since2000;5491452

    After reading your response I do feel somewhat better about waiting if I can’t change my husbands mind. The Urologist he’s seeing is not at a really big hospital. I tried to get him to Vanderbilt but he didn’t want to drive 2 hrs.I’m trying to talk him into doing the Multi-parametric MRI even if insurance won’t pay for it. If I have good luck and he’ll do Mri I’ll post any findings. I wish they would just do those automatically. It just make sense to me.

    I really appreciate your response. God bless!

    Thanks
    Murphy

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    Old 01-15-2019, 03:52 PM   #14
    IADT3since2000
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    Re: Husband 55 with increasing PSA

    Hi again Murphy,

    I am a big fan of second opinions when a situation is in the gray area, but sometimes that is just not practical from a family standpoint, and the burden of travel certainly deserves consideration. It's quite possible that a more distant expert would essentially endorse the first doctor's view, and that could add peace of mind and increase confidence in the local doctor's approach. I'm estimating that 95% of my care has been at facilities within ten miles of my house, but I did travel at least two hours each way a number of times, and the input from those consultations was important.

    My local doctor appreciated the advice of some distant experts and was willing to implement their strategy. In part it reduced his responsibility for following their advice on leading-edge treatment. That might work out for your husband, even if the "experts" advised changing from the current course. The "experts" might be better able to justify a mpMRI to insurers, for example, providing the local doctor with valuable information he would not otherwise have been able to get.

    Again, good luck!

     
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