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bump, bump

hopeful and opt...
Posts: 1304
Joined: Apr 2009

My PSA rose to 4.2 this month, six months ago in June,11 it was 3.6.....before that it was steady at at 2.5 for at least the last 5 years. My free PSA was 14 this time and 18 in June.

I've had 3 biopsies, the last two were negative(the last one in June, 11). In 3/09 when I was diagnosed it was 2/12 cores, less than 5 percent involvement in each core. gleaaon 3=+3=6.

3/10 I had a pca3. the results were low at 8.3 which is a good thing.

I also had an Aureon molecular test for the 3/09 biopsy. It showed low risk.

Any other details about my case is listed if you click my name

Any comments are appreciated

rch
Posts: 79
Joined: Nov 2011

Hi
I'm sorry to hear that the PSA is rising. You have been a great inspiration and hope for those of us on AS. These #s are a bit discouraging to us. There are other members on this forum who can better advise you than I can. But in my humble opinion , with a velocity of 1.7/12 mo (4.2 from 2.5 a year ago)you should probably consider a biopsy again with more cores than just 15. I personaaly don't pay too much credence to PCA3, Aureon test or even the %free PSA. Rising PSA says some thing unless prostatitis, and you might try some Cipro to rule that out.If #s are confirmed my advise at this time is another biopsy.

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

Ira,

When these numbers show up in your own history I understand it is easy to be worried but if you take a deep breath and think about it from the percentages perhaps it won't cause so much anxiety. As one of the most active in the Active Surveillance camp you know all the reasons that causes PSA to jump up and down. Most of the PSA in the 4-10 range for a man your age is caused by BPH not cancer. What is the size of your prostate? We know that as we age PSA gradually increases along with BPH. All in all, under the new guidelines a PSA score of 4.2 is still a very low PSA score and may well be about average for someone in your situation. By the way, was there anything unusual with the DRE?

We know that PSA is very, very iffy as a cancer predictor at these relatively low levels. You could pretty much flip a coin and get just as good a prediction of cancer as you can with a PSA test at this point. You do have a history, I understand, I just don't think the rise in PSA you've seen given is a sign of growing PCa given all the other things that could be causing it.

If I were in your shoes I would take another test in six weeks and see if indeed it was a true upward trend. I would discuss with my medical team the potential of a non specific urinary infection or prostitis which might be addressed with Cipro or some other drug. I would avoid the happy-happy 48 hours before the blood draw. If another PSA test comes back with it still going up you can always go for another biopsy. You know my thoughts about biopsies in general but it would help you resolve your questions.

All in all, I would not seek another course of action unless my PSA rose above 10 and BPH had been ruled out as a source of the PSA and would commend Anthony Horan's "The Big Scare: The Business of Prostate Cancer" to you. If you have already read it, I would read it again. I recently reread it and picked up a lot of information that hadn't stuck the first time around.

Thinking of you,

K

hopeful and opt...
Posts: 1304
Joined: Apr 2009

and reassurance.

My DRE was normal.

I was careful, doing the right things ( or not doing the wrong things ) before my current PSA.

As far a I know my prosate is small

My doc does not want to use Cipro, but wants to retest PSA in 3 months. He mentioned my history, and advised against being a PSA junkie. He is also wiling do another biopsy at that time..

I am wondering what I can do to be proactive.

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

Geez, Ira, you are already about the most proactive guy with prostate cancer that I've ever had the pleasure to know. I recall that you're already doing the diet thing (are you taking in any dairy?), you've had all the scans and second opinions, and you're with a great medical team that specializes in AS for prostate cancer. I wonder what else you could be doing that would have any impact? Hang in there, we're all rooting for you.

K

hopeful and opt...
Posts: 1304
Joined: Apr 2009

Still no dairy, or red meat.....almost no fowl, now, I'm even cuting down on fish....lots of exercise.

VascodaGama's picture
VascodaGama
Posts: 1543
Joined: Nov 2010

Ira

It surely was not the results you wished for. In any event, the rise is small and many things could be behind the cause. Cancer is just an equation making part in the calculations.
Low volume and grade 3 (or maybe a lower 2) are motives to be consider too. The scheduled biopsy in three month may not add any new info to your diagnosis, even with a rise of PSA.

I am tempted to suggest you a vacation on all the matters with PCa, including the habitual visits to this forum. You need to relax even if you know that you are “sleeping” in the same bed with the bandit. You know what is better for you and know that to be anxious is a bad "bump".

How about a trip to Europe and enjoy some Mediterranean food and wine. I would be your partner/guide in a drive through the Iberia and the local wineries.

Wishing you find that peace of mind for the holiday season.

Merry Christmas to you and your family.

VGama

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