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2 biopsies 4 psa's

trfouts
Posts: 14
Joined: Sep 2009

last august was told psa was up to 4.1 from 2.1 in one year, had a biopsy clear except for 2 areas one possible and one suspect, took a wait and see approach, jan. 2010 had a second psa and another biopsy, PSA was upto 6.1 but biopsy indicated nothing at all. April 2010 had another PSA upto 6.8 doctors are very confused, Primary says maybe time to have it removed? Uroligist says not so fast. Now Urolgigist wants me to go to Moffit cancer for further observation. Anyone else had this kind of a roller coaster ride? I am 55 years old

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

I would agree with the Urologists trying to send to further study. My reco is to do it in short order as many more tests as you can for this reason:

If the biopsies just happened to miss the cancer and there really is some there you want to find it as early as you can....the PSA rising like it has in fairly short time frame seems to me it indicates something is going on and you need to do whatever you can to find out and pinpoint what it is. That's my oppinon from purely a non-medical person...you need to decided what is right for you and what you can live with. Best of luck getting it all sorted out.

Randy in Indy

trfouts
Posts: 14
Joined: Sep 2009

Thanks Randy that is prety much my thoughts,My uroloigst got me accepted at The H.Lee Moffitt cacncer center for futher testing my first appointment is June 21. They are one of the best cancer center in the nation, and they are just 15 miles away in Tampa. Also just some history i grew up in Terre Haute ,But had to get out of that town 25 years ago.

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

I now live in a very rural area south of Indianapolis...close enough to the city but in a perfectly ULTRA low stress area surrounded by 150 foot trees and a 15 acre lake....very peaceful...my biggest stress is trying to get around slow moving farm machinery on country roads. I have lived in Manhattan and about 7 other places in the US and this I must say is the most peaceful and least stressful of all of them. I love it here! But then I loved it everywhere I have been for many different reasons...that's just the way I roll.

Sounds like you are totally under control and have a plan going to H. Lee Moffitt...Best of luck in finding the answers.

Randy in Indy

bdhilton
Posts: 752
Joined: Jan 2010

I had one biopsy (15 samples -9 had cancer present) and then got scheduled for surgery…From what I am reading here you seem to have a good urologist and does not want to cut on you unless it is 100% necessary and you are showing cancer…from my perspective the further testing is prudent and he is looking out after you…on the Flipside I did not like the one biopsy I had some I can just imagine what several are like……Like your urologist, my Urologist would never suggest surgery until he saw cancer …best of luck and how may samples is your urologist taking on these biopsies? Hopefully more (over 15) than less… Best of luck...

trfouts
Posts: 14
Joined: Sep 2009

Both biopsies where only 12 samples by two differnt doctors the first doctor wanted to cut right away and had a very dirty office and i got a major infection from a dirty cath, so i got another urolgist. the new uroligist that is sending to the cancer center wants to see about doing a higher count biopsy.

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Several things can cause an elevated PSA -- sex within 72 hours of blood test, BPH, an enlarged prostate, an inflamed prosted, and so forth. There is also a variance beyond standard deviation between testing laboratories. As some have pointed out, the needle biopsy may simply have missed the cancer or it isn't there. If it missed it, it may well be that it is small. The only real thing a PSA can predict is that the higher the PSA the more liklihood you have cancer. Once cancer is detected, it is useful in charting the progress of the disease.

I can't imagine a doctor recommending to have your prostate removed without a positive indication of PCa. If your primary doctor suggested that, I would start looking around for another doctor.

There are some advanced imaging techniques that might detect cancer, even at microscopic levels, so may wish to look into that.

Good luck and get second opinions.

trfouts
Posts: 14
Joined: Sep 2009

Thanks Kongo , My Primary has had PC and he simply stated at my age an dhaving a very enlarged prostate along with the rest he would have his removed

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

I appreciate your doctor's perspective based on personal experience but it still seems to me to be an overly aggressive approach without having a more persuasive manifestation of PCa than the PSA test, particularly with an enlarged prostate which may be the source of PSA rise without any cancer being present at all. There aren't any mulligans with removal and if it turned out that the PSA rise was caused by benign factors you would be hating this guy for the rest of your life.

jminnj's picture
jminnj
Posts: 129
Joined: Nov 2009

I agree that you should be prudent and get all the information/testing you can before making a decision. Having said that I can tell you from my own experience that my PSA went from 1.7 to 2.1 to 2.9 over 3 years, (I am 47 years old) and only one core was positive. I elected to have surgery and even with those low numbers 35% of my gland was cancerous. Go see another doctor for a second, third, fourth opinion.

Good luck to you.
Joe

bdhilton
Posts: 752
Joined: Jan 2010

Joe...This is what makes this cancer so hard to deal with or even call for the long run….Anything can happen or change on a “dime”...so that is why I call this whole prostate thing a journey once you find out….. I see that your prostate was 35% cancerous…post surrey I am 4+3, T3B, 18% cancerous (cancer in all sections)prostate with right seminal invasion, right mid positive margin (first PSA 4 week post surgery ZERO PSA)and pre surgery I was 3+4/4+3, T2B, right base and mid only, PSA 2.82… Point is clinically you really have no clue what you really have unless you have surgery…now that is a fact…enjoy each day…enjoy life and keep getting 300's in your bowling,,,

Best to all

erisian's picture
erisian
Posts: 109
Joined: Dec 2008

'Overdiagnosis'

http://csn.cancer.org/node/187174

It allegedly happens to a lot of men. If you are one of them, and you find out about it, then you are one of the lucky ones who might be spared from unnecessary treatments with permanent effects.

And for a second or third opinion, consider seeing a medical oncologist.
I hope this turns out well for you.

CharlieG's picture
CharlieG
Posts: 67
Joined: Mar 2010

Brother had three separate biopsy events and still no positive results. All the while PSA going up, up, up.

Took the samples to Johns Hopkins and their lab found cancer in the second biopsy sample.

Get a second opinion!

10 years later, I had to have 2 Biopsies to find mine - the second one was a "saturation biopsy" where they took 41 samples and did find cancer in 2 of them.

Test, watch, test and don't be affraid to ask for a second opinion.

trfouts
Posts: 14
Joined: Sep 2009

i got the phone call last wed 4/28/10 from Moffitt cancer center in Tampa and they have accepted my case for further studies . My appt is June 21 ,hoping to get this figured out.Just found out i will be seeing Dr. Pow-Sang at Moffitt anyone have any opinions?

trfouts
Posts: 14
Joined: Sep 2009

On Sept.9th 2010 I had a Radical Prosectomy Everything went very well.Cath was removed on Day 8, So far kegels seem to be working getting better daily.Path report Had the gleason score as 3+3=6 and t-2 cancer was confined to the prostate lymph and seminal vessel was clear.Seems like i could take on the world at 18 days until i do too much and have to take a rest but getting stronger daily.Only problem i see is the tenderness in the scrotum area like a deep bruise when it sit on firm chairs or bleachers at football games,But have cushion will travel

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