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Free PSA % testing

tonic683
Posts: 12
Joined: Jun 2012

Has anyone had this test done? I have done a lot of research and found that this is an accurate test for determing cancer. I understand the lower the % the greater the chance of prostate cancer. My husband's psa went from 1.1 to 5.3 in one year. A second test was run using free PSA and it came back at 2%. He has had a biopsy and we will have results on Friday. Prostate size is 21 gms which what I read is normal for a 50 yr old. He complains of lower back pain and pains in his legs.

This waiting is killing us. Not only that his urethra is closing up so surgery is scheduled. WOW! Any thoughts or comments?

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

This is the test that my doctor ran on me. He had this performed at my first visit. The way it was explained to me is that there is a low level of psa that is always present in the system. This test is also called a Total psa test. I have this ran every 6 to 8 weeks this is because of the agressive nature of the the cancer. My surgery was in feb of 2011 and my gleason score was the bad 7. I had lower back pain before surgery, it was real bad, but no more pain after surgery. Welcome to the group

tonic683
Posts: 12
Joined: Jun 2012

Thank you! Never dreamed I would join this group. My husband also has Lyme disease which has been a year long struggle. One battle at a time!

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

keep in mind that the only true indicator of cancer is the biopsy. The psa levels do move around at times and it is difficult to determine if you have cancer just from the psa test.
The total or free psa test helps the doctor to set a baseline from where the other psa tests are measured from. My psa level was at .80 and shifted up to a 1.25, by that time I was already in stage T2C with cancer thruout the prostate.

RADIATION HOPEFUL
Posts: 208
Joined: Dec 2010

Hello Tonic 683

I also had LYME DISEASE & then learned I had prostrate cancer. APPEARS TO BE a link with the lyme disease lowering the immunity of the body allowing body cells to accept other forms of disease. I was a very healthy & hard working person with lots of stamina until I learned I had this dreaded lyme disease. I contend that the LYME DISEASE lowerd my bodies normal immunity defense & allowed the prostrate cancer to develop.

NOTE> I had a psa of 60 & a gleason score of 9-----now my PSA is 0.30 & I'm feeling good. I chose the radiation route with the monthly hormone injections. The radiation oncologist informed me I am in total Remission & I'm very THANKFUL I chose this route.
Hope this helps you & bless you on whatever route you choose.

Radiation Hopeful

tonic683
Posts: 12
Joined: Jun 2012

Thank u for everyones comments. I know what Lyme does to a person's immune system so after receiving results from a routine physical i began doing research. I am ready to ask questions after we get results. I just pray that it is contained to prostate.

tonic683
Posts: 12
Joined: Jun 2012

Thank u for everyones comments. I know what Lyme does to a person's immune system so after receiving results from a routine physical i began doing research. I am ready to ask questions after we get results. I just pray that it is contained to prostate.

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

Hi, tonic. Welcome to the forum. I can certainly appreciate the anxiety you and your husband are going through now.

While many things can cause sharp rise in PSA in a year your doctor was prudent in ordering a free PSA test before actually doing a biopsy.

As your research shows, free PSA result of 2% indicates a strong likelihood that prostate cancer is present. In fact, if the fee PSA is less than 7% and the biopsy comes back negative, the National Cancer Institute and the American Cancer Society suggest that another biopsy is in order.

When you meet with the urologist tomorrow to learn the results of the biopsy be sure that you are prepared with a list of questions. If the doctor delivers bad news, make sure you record the Gleason score, the stage, how many cores of the biopsy are positive, and what the percent involvement of each core is. If the biopsy reports are negative you should discuss the results critically and ask about a repeat biopsy.

For men over 50, BPH is the most common cause of a high PSA reading but your husband has a small to medium sized prostate compared to other men his age so BPH is probably not an issue here. Other things can cause a high PSA reading such as sex within 48 hours of the blood test, exercise that puts pressure on the prostate (like bike riding), even a hard stool or the DRE (if it is done before drawing blood). Certain over the counter medications can also cause an elevated PSA. But the higher PSA score in conjunction with the free PSA test is a very strong indicator that prostate cancer is present.

You will also want to talk to the doctor about the process for getting a second opinion on the reading the biopsy samples as this process is critical to selecting follow-on treatment options.

Be sure to get copies of all your medical records while you're at the doctor's office and start thinking about who you want to go to for second opinions after the doctor breaks the news.

Best of luck to you both.

K

tonic683
Posts: 12
Joined: Jun 2012

Does the low free PSA score and the rate of rise in PSA give any indication of how aggressive the cancer is? I am trying to prepare myself.

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

I wouldn't try to second guess the official report. Aggressiveness is determined by the type of prostate cancer, the Gleason score, and stage. There are several different strains of PCa and some are more virulent than others.

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

The biopsy results will indicate how agressive the cancer is, you need to know how many samples taken and the amount of cancer in each sample. In my case I had 18 biopsy samples taken and there was between 40 to 60 percent cancer cells in each sample. My cancer was thru out the prostate. Now as in the other postings look into a second opinion on these results. Ask the doctor to explain the results in detail. The rise in psa level is an indication that there is something going on with the prostate. Hope this helps good luck

hunter49
Posts: 204
Joined: Oct 2011

Hey Kongo what makes a PC other than Gleason more aggressive? Any info here?

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

Hunter,

Gleason is certainly one of the biggest factors in determining aggressiveness with adenocarcinoma, which is the most common form of prostate cancer. Another factor is the PSA doubling time and PSA velocity. Short doubling times and high PSA velocities are indicative of aggressive PCa. When prostate cancer leaves the prostate gland it also tends to grow faster than it did within the gland.

Besides adenocarcinoma there is also small cell carcinoma of the prostate and squamous cell prostate cancer. Both of these variants, although less common than adenocarcinoma, are much more aggressive in nature. Another aspect of these types of prostate cancer is that they are not associated with an increase in PSA so they are more difficult to detect. In an earlier thread someone wondered how cancer could be growing aggressively if there was no PSA increase...well, certain types of prostate cancer can be very aggressive and are not linked to PSA.

There are other more rare forms of prostate cancer that can also be aggressive in nature.

K

hunter49
Posts: 204
Joined: Oct 2011

Thanks K-man. Would that typ of cell be identified specifically in a biopsy or pathology report after an RP? Or does it show ittself when it is all throughout your body. Thank you.

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

The pathologist would classify it when he examined the slides. They're pretty distinctive cell types. If you go back and look at your biopsy report I'm pretty sure you will see the classification as adenocarcinoma. Adeno simply refers to the epithelium that surrounds a gland.

tonic683
Posts: 12
Joined: Jun 2012

Results are negative for cancer. Follow-up in 6 months. Thoughts?

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

I would have thought the results would have been different but as your doctor probably explained a negative biopsy doesn't mean there isn't cancer present. Prostatitis can cause elevated PSA reading and low free PSA percentages. I also wonder if there could be a connection to Lyme disease which affects the autoimmune system....that might be difficult to sort out. Does your husband have any symptoms of ProstatitisI Sichuan as a tingle, tickle, or pain associated with urination?

The NCI recommends that men with elevated PSA and low free PSA scores have a repeat biopsy if the first is negative and I hope you discussed this option with your urologist.

You may also wish to seek a second opinion from another urologist.

I hope you figure this out. The stress and anxiety is another lousy side effect of this disease.

K

tonic683
Posts: 12
Joined: Jun 2012

No, the doctor didn't mention another biopsy nor did he give my husband an antibiotic even if it was prostatitis. And no, he didn't say a word about it being a false negative.

My husband does have urethral stricture which he will get corrected by surgery next week. Doctor said this may have caused elevated PSA.

I am so confused but for now I don't want to be "Debbie Downer" by pushing for another opinion or second biopsy.

I guess just see how he does after surgery then get a repeat biopsy. I sure hope the doctor is right.

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