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New, anyone care to guess what the doc might do

Coupe35
Posts: 42
Joined: Feb 2010

I’m 67 years old white male. For the past several years my prostate has been slightly enlarged. My PSA have been around 2.3. I have a physical every year. This December my PSA was 5.9  I have an appointment with the urology Jan 2nd. Anyone care to guess what he might do beside the old finger up the rear. Do you think he will repeat the blood test or go ahead and schedule a biopsy or?

Beau2
Posts: 228
Joined: Sep 2010

I would guess he would do the DRE. If he finds something suspicious with the DRE, he would likely recommend a biopsy. If he does not find anything suspicious with the DRE, I would expect him to recommend another PSA test in a couple of weeks. Probably after you take some antibiotics to rule out the possibility of an infection. Remember to avoid sex, bicycle riding or any other activity that would impact the prostate for at least 24 hours before a PSA test.

Just my guess ... here's hoping that this is just a false alarm ... in a lot of cases it is.

hopeful and opt...
Posts: 1283
Joined: Apr 2009

There is a high tech  diagostic test, PCA3, will help determine if a biopsy is needed.

 PCA3 test
This test is a new investigational ( only an indicator) urine gene test that is available. The test is a molecular biologic assay. This test has a specificity of 75% and a sensitivity of 57%. (What that means is that among 100 bad tumors, for example, they only can identify 75 of them. And among 100 good tumors, they identify them as bad in 57). The test is done by a doctor who does a DRE and vigorously massages(the fun part...my doc is very experienced, has muscles on his finger, and can make a grown man cry) the prostate; the patient gives urine and the results are sent to Bostwick Laboratories(the only laboratory that does this) for analysis. It is a pretty expensive test, at I think about $500.

So the way the results work, 35 is the magic number, so the less one score is below 35 the better. Mine was 8.3 "Prostatic cells are present but do not over express the PCA3 gene", "value of 35 or greater suggests a high likelihood of prostate cancer"

It is also stated that only a prostate biopsy can diagnose prostate cancer. The test's preformance has been established by Bostwick Laboratories. It has not been approved by the United States Food and Drug administration and should not b4e used as the sole evidence for or against the diagosis of prtostate cancer. Clinicco-patholological correlation iws indicated.

Coupe35
Posts: 42
Joined: Feb 2010

Well, I saw the doc today and he did the DRE and felt a knot so with a 5.9 PSA, swollen prostate and knot he say it’s sure to be cancer so I’m having a biopsy the 29 of Jan. I guess all I can hope for now is it will turn out to be a slow growing one. At least I hope so, because the end of the month for a biopsy is a long time to wait. If it’s fast growing I’m in trouble. According to the booklet I got there, it is at least a stage 2 since he can felt the knot.

Beau2
Posts: 228
Joined: Sep 2010

Since the DRE revealed a knot, it is possible that you have PCa ... or you could just have a non-cancerous knot on your prostate.  The biopsy should give you more information. The pathologist will prepare slides of your biopsy samples and determine if any of the samples appear to be cancerous. The pathologist should also grade any cancerous cells (ie. determine the Gleason score).  You may want to consider requesting your doctor send the slides to another lab for a second opinion if the pathologist determines cancer is present.

While you are waiting for your biopsy, you may want to do some research on possible treatments.  Googling can give you a lot of information.  Dr. Patrick Walshes book, "A Guide to Surviving Prostate Cancer", is also a good place to get an overview. There are also several other good books out there that cover PCa and I am sure other guys will let you know the titles.

Good luck as you go forward.

hopeful and opt...
Posts: 1283
Joined: Apr 2009

taken in your biopsy. Check with the doc in advance to make sure that this happens.

Prostate cancer is a very slow growing disease, so Jan 29th is fine.

Check to see if there are any local prostate cancer support groups in your area that you can attend.

Read books, internet and research.

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