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  • PSA Doubling,Negative biopsy, positive MRI

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    Old 02-14-2010, 03:56 AM   #1
    Rob Johnson
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    PSA Doubling,Negative biopsy, positive MRI

    I am 52, PSA jumped from 1 ( Jan 09) to 2.5 ( Jan 10). Have been using testosterone supplementation for 7 years (AndroGel), % free PSA is 9%, Had MRI (DCE) last month (before biopsy) showing cancerous lesions (7mm is size)-Urologist says wait 6 months and MRI is of no value because it was taken BEFORE biopsy. He also said to continue with Androgel (testosterone gel).

    I stopped taking AndroGel last month (some "experts" feel if an aggressive cancer is there it will "fuel it".

    Do I have another MRI to see if another scan indicates cancer?
    Have a biopsy sooner than 6 months?
    Have a PC3-A test to get another indicator.
    Seek out an expert somewhere?

    Becaue of the apparent aggressiveness of the PSA, I am thinking waiting 6 months is too long to wait. Anyone with experience or suggestions is GREATLY appreciated.
    Rob

    Last edited by Rob Johnson; 02-14-2010 at 03:59 AM.

     
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    Old 02-14-2010, 07:43 AM   #2
    medved
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    Re: PSA Doubling,Negative biopsy, positive MRI

    I see no good reason to wait 6 months. I would see a well-regarded urologist and either (1) have a biopsy, (2) re-test psa and use those results to determine whether to have a biopsy, or (3) try PCA3 test to get more info.

     
    Old 02-14-2010, 10:22 AM   #3
    Aguy44
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    Re: PSA Doubling,Negative biopsy, positive MRI

    Rob: Don't worry about time. Prostate cancers grow slowly. That is why there is a "watchful waiting" option for many patients with cancers that go on for many years.
    Since the biopsy was negative, you don't have a Gleason score that define which cancer is aggressive, and which is average. Your fear of having "an aggressive cancer" is therefore unwarranted. You don't say how long it took for PSA 1 to jump to 2.5. It took my PSA 1 year to jump from 1.8 to 4.1, and I was diagnosed with
    a microscopic cancer, 40% of one core - out of 6, Gleason 3+3, and not felt at all with digital exam. If your jumped from 1 to 2.5 in 2-3 years, that's not aggressive, and if
    you stopped "Androgel" your PSA may go down to 1 again, and you may not even have
    a carcinoma - as the MRI test may suggest. My suggestion: Throw away the "Androgel" FOR GOOD! - even if 100 doctors tell to continue it. Then wait for 6 months [it is not long time], and you may find then that you don't need anything. Your sex life may become a little bland, but is better to be bland than to become almost useless with prostate surgery or radiation. P.S. PSA is not an indication of cancer, and there are men with PSA 12,15, or 20 that have no cancer. "Quick PSA Rise" is an indication - note, here "indication" of cancer to be checked out - not a proof of cancer.
    Don't lose any sleep about having an aggressive cancer, but certainly expect to lose some taste in bed.

     
    Old 02-18-2010, 03:31 AM   #4
    Rob Johnstone
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    Re: PSA Doubling,Negative biopsy, positive MRI

    Quote:
    Originally Posted by Straightguy View Post
    Rob: Don't worry about time. Prostate cancers grow slowly. That is why there is a "watchful waiting" option for many patients with cancers that go on for many years.
    Since the biopsy was negative, you don't have a Gleason score that define which cancer is aggressive, and which is average. Your fear of having "an aggressive cancer" is therefore unwarranted. You don't say how long it took for PSA 1 to jump to 2.5. It took my PSA 1 year to jump from 1.8 to 4.1, and I was diagnosed with
    a microscopic cancer, 40% of one core - out of 6, Gleason 3+3, and not felt at all with digital exam. If your jumped from 1 to 2.5 in 2-3 years, that's not aggressive, and if
    you stopped "Androgel" your PSA may go down to 1 again, and you may not even have
    a carcinoma - as the MRI test may suggest. My suggestion: Throw away the "Androgel" FOR GOOD! - even if 100 doctors tell to continue it. Then wait for 6 months [it is not long time], and you may find then that you don't need anything. Your sex life may become a little bland, but is better to be bland than to become almost useless with prostate surgery or radiation. P.S. PSA is not an indication of cancer, and there are men with PSA 12,15, or 20 that have no cancer. "Quick PSA Rise" is an indication - note, here "indication" of cancer to be checked out - not a proof of cancer.
    Don't lose any sleep about having an aggressive cancer, but certainly expect to lose some taste in bed.
    Every Urologist says continuing AndroGel is pefectly safe. Why do they seem so unconcerned? It appars that the PSA went from 1 to 2.5 (or so) in 12 months.

    Last edited by Rob Johnstone; 02-18-2010 at 03:35 AM.

     
    Old 02-18-2010, 01:44 PM   #5
    Rob Johnstone
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    Re: PSA Doubling,Negative biopsy, positive MRI

    Quote:
    Originally Posted by got View Post
    Hi Rob,

    Your Free PSA is what lit up my receptors, as a Free PSA of less than 10% is indicative of prostate cancer. There are doctors who say the Free PSA will replace the biopsy someday as it's accuracy is better.

    My husband was also on Anrogel and I threw it out after his diagnosis, where there's a question ~ why risk it?

    From 1. to 2.5 in a year....I couldn't sit and wait either.

    The MRI will need to be confirmed with a biopsy, as cancer & calcium look the same in a MRI, so they can be confused. That's why your doc doesn't value the MRI now.

    7mm = .28 inches

    Don't waste your money on another MRI, I'd get the biopsy.

    Good luck!
    I read that free pSA is not valid if the pSA is under 3 or 4. Does ANYONE KNOW if that is true? In Rob's case, an important test that looks bad may not be relevant! If it is not relevant, what other tests might be performed?

    Last edited by Rob Johnstone; 02-18-2010 at 01:46 PM.

     
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