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  • psa numbers

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    Old 03-26-2009, 12:38 PM   #31
    daff
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    Re: psa numbers

    Quote:
    Originally Posted by eddief1 View Post
    Hello Daff did you and idatt2000 both have proton beam and is ther a place
    in s.c. and n.c that does this
    I had proton beam radiation (Jim did not-- he's on an intermittent triple hormonal blockade program that's been working great for him). The only place in the southeast for proton beam radiation is University of Florida Proton Beam Therapy Institute in Jacksonville. That's where I went- it's a very targeted and effective form of radiation with generally fewer side effects than many other treatment alternatives. If you ever want to read more about this, the best thing is a book by Robert Marckini called You Can Beat Prostate Cancer.

     
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    Old 04-10-2009, 12:42 PM   #32
    eddief1
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    Re: psa numbers

    Quote:
    Originally Posted by daff View Post
    The high free PSA percentage is a good thing-- and your overall PSA is in range for your age. My doctor got concerned when, at about your age, my PSA went from 2.9 to 3.9. He advised me to get another test three months later, which came in at 4.2. I then got a biopsy to learn that I did test positive for prostate cancer.

    If your doctor performs a DRE prior to your blood test for PSA, that stimulation can cause the PSA level to be higher than it normally would be. Also, sexual activity or bicycle riding within three days or so of the PSA test can also cause the level to be higher.

    It doesn't sound as if your doctor is overly concerned, but if you are, just getting PSA tests as often as every three months wouldn't be a bad thing.

     
    Old 04-11-2009, 05:00 AM   #33
    eddief1
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    Re: psa numbers

    update in november at my urologyst office my psa was 3.2 freepsa was 29%
    at my reg dr office late december it was 3.5 the hosipital had a free test in feb it was 5.5 last week back at my urologyst office it was 3.1 free psa was 28% urologyst said i have a med enlarged prostate and he believes that is causing my psa number and that they do there own blood work . It is a large place with several doctors. what size in cc would a med enlarged prostate be?

     
    Old 04-11-2009, 07:13 AM   #34
    daff
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    Re: psa numbers

    Quote:
    Originally Posted by eddief1 View Post
    ...what size in cc would a med enlarged prostate be?...
    I think 50 cc would represent a slightly enlarged prostate. This could be a good question for your doctor as part of learning whether he advises medication to shrink the prostate or not. The very good news is that you do not seem to have indications of any likely prostate cancer at this time. Is that confirmed by your doctor?

     
    Old 04-11-2009, 10:31 AM   #35
    IADT3since2000
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    Re: psa numbers

    Quote:
    Originally Posted by eddief1 View Post
    update in november at my urologyst office my psa was 3.2 freepsa was 29%
    at my reg dr office late december it was 3.5 the hosipital had a free test in feb it was 5.5 last week back at my urologyst office it was 3.1 free psa was 28% urologyst said i have a med enlarged prostate and he believes that is causing my psa number and that they do there own blood work . It is a large place with several doctors. what size in cc would a med enlarged prostate be?
    Hi Eddie,

    I see it the way daff does: way to go! Here are a few more points.

    Your PSA has been quite stable except for that test at the hospital, and that is despite the fact that you've had three different places doing the testing. That can make a difference, as research indicates that there can easily be around a 15% daily variation in PSA even at the same lab with the same brand of PSA test as I recall, and there can be at least that much variation when different labs and possibly different brands of PSA tests are used. PSA tests are not all designed the same; different tests may use a different part of the PSA molecule to measure, and the results differ a little just because of this. If you think about it, 15% of a PSA of 3.2 is .48, nearly half a point, so you can see that your scores of 3.2, 3.5, and 3.1 are all in the same small zone, probably indicating an essentially steady PSA. That 5.5 at the hospital was probably influenced by some stray factor - different brand of test, your own activities prior to the test, or a DRE before the test (if that was done) would all be usual suspects.

    It's significant that you have gone for nearly half a year with a steady PSA, arguably a falling PSA. That pattern is not consistent with prostate cancer, especially prostate cancer that is at least fairly aggressive, though it does not rule it out 100%. But that PSA pattern nearly does along with the other facts. One of those, of course, is that free PSA value - nice and high at around 29%, and steady, and another is what I assume is a negative DRE for cancer. You're making the rest of us envious.

    You could call your urologist and get his estimate of the size in cubic centimeters of your prostate; it won't be as exact as if he were measuring it with an ultrasound image, but these guys do DRE's frequently and then see a lot of ultrasound images and biopsies, so they get pretty good at estimating size based on just the DRE. Daff's figure of 50 is certainly in the range for what the urologist described in words. There is a rule-of-thumb established by research that each cubic centimeter of healthy prostate tissue will generate about 0.066 ng/ml of PSA. If you multiply 50 cc, daff's suggestion, by 0.066, you get 3.3 - bingo! (That rule of thumb is stated on page F4 of the wonderful book "A Primer on Prostate Cancer - The Empowered Patient's Guide.)

    About medications for shrinking the prostate - finasteride is generic (also known by the brand name Proscar), and it not only shrinks the prostate but has been proven by a very large, gold-standard type clinical trial to reduce the risk of prostate cancer. Follow-up analysis has boosted the degree of protection to about 30%, and that analysis has also virtually proven that finasteride is safe, that it does not foster more aggressive cancer in 1% of patients who do get cancer! (What it does is make high grade cancer easier to detect.) Finasteride also makes interpretation of PSA scores and trend lines more effective, and it also makes DRE exams more effective.

    However, we are on the verge of getting clinical trial results of Avodart for prevention of prostate cancer (the REDEEM and REDUCE trials), with results expected this spring. Early results suggested that Avodart is one and a half to twice as effective as finasteride in preventing prostate cancer, and it is probably also more potent in shrinking enlarged prostates. A few men cannot benefit from Avodart due to genetics, but that should be obvious pretty quickly based on the way a patient responds to the drug. As I understand it as a savvy layman, such men can benefit from finasteride.

    Both drugs have a long track record, especially finasteride, and both are pretty mild for most of us, with the main noticeable side effect being the growth of more hair in the male-pattern-baldness areas for many of us(me). In about 10% to 20% of men, libido is decreased and ED increased, but the rest of us may even do somewhat better in those departments. The side effects - wanted (hair) and unwanted are reversed when the drugs are stopped. Dr. Charles "Snuffy" Myers, an expert medical oncologist practicing in Virginia who specializes in prostate cancer, has stated that men interested in these drugs who still want to have children should consider a sperm bank; that's because ejaculate is somewhat reduced for many of us.

    I recommend you break out some champagne for your great medical news!

    Take care,

    Jim

     
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