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Unexpected rise in PSA

Chesty
Posts: 6
Joined: Aug 2013

Hello,

I am new to this so please bear with me.  I am 62 and was dignosed in 4 months ago with Gleason 3+3 type 1 based on two positive cores, 1 at 2%, the other at 5%.  After a detailed meeting with the urologist, we are working on active surveillance.  I went for my first post diagnosis PSA test a week ago and was very surprised to have it come back at 13.8.  It had been as high as 7.y but went back to 4.3 on retest.  I am waiting for another restest in a couple of weeks.  I already know that the cancer is there so the result as an indicator is no shock.  The rise gives me some concern that there is potential that it is other than the slow growth adenocarcinoma that was diagnosed.

Since diagosis, I have tried to be more careful on diet.  Started using soy products regularly and increasing fruit and such.  I do run regularly.  I ride a bike with some frequency and purchased a prostate correct seat for that.  Last rode on the Sunday before the test on Thursday.  I plan to see what the retest does and talk to the Dr about possible prostatis if it is still high. Has anyone doing active surveillance had a sudden rise like this?

Just found this forum and have found it helpful.  Thanks,

Chesty

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

Hi, Chesty and welcome to the forum but am sorry that you found the need to be here.  Although any cancer diagnosis is frightening, you are fortunate that you were found with a relatively low risk form of prostate cancer and that there are many, many options available to you to deal with this diagnosis, including the course your are following with active surveillance.

You seem to understand some of the variables that can affect a PSA reading.  Certainly riding a bicycle that puts pressure on your prostate is one potential cause although the time span from your last ride and the test makes it unlikely that there is a direct correlation heret.  Any PSA rise from riding a bike would clear your system within a few days.   Many other things can affect PSA such as some OTC medications (Advil comes to mind), sexual orgasm within a day of the test, a DRE before the blood draw, BPH, and even passing a hard stool.  Basically anything that can put pressure on the prostate.  PSA readings have been shown to vary according to the time of day and the test itself is notoriously unreliable and subject to many statistical variances but a reading with a jump as big as the one you noted has got to be something else...and sexual relations the night before is something that could cause such a spike.  It is also possible that there is still some inflammation in your prostate from the biopsy which is causing an elevated PSA.  An undiagnosed UTI can also result in elevated PSA readings.

I think it's prudent to have another test but I wouldn't be worrying too much.  Your diagnosis suggests a low risk, slow growing adenocarcinoma.

Adding soy, fruit, and making changes to your diet is an important step for someone pursuing active surveillance.  I suggest you also consider eliminating all dairy from your diet and avoiding food with processed sugars or eating meat that is not 100% organic.  Chicken, beef, and pork sold in the USA typically come from animals that have been given high does of growth hormones which have been shown to increase certain enzymes that can cause your cancer to grow.  I would recommend reading "The China Study" as you consider your dietary choices.

Best of luck to you and keep us informed of your progress.

K

Chesty
Posts: 6
Joined: Aug 2013

I appreciate the responses that have been offered.  As this is my first test after diagnosis, essentially the beginning of active surveillance, I guess I didn't know what to expect.  At the bottom line, if the cancer doesnt progress unpredictably, I am not too concerned with the numbers.  I will access the China Study. Some of it I have already begun to implement.  Thanks again for the guidance. It is helpful coming from people who have been there. I will keep you posted on next results.

 

Chesty

Cpmont
Posts: 13
Joined: Sep 2011

While I am younger, 52 your diagnosis is similar to mine. You can find my detailed information by looking at my previous post. My PSA was  bouncing around (numbers almost exactly like yours) and I waited almost two (2) years to have my prostate removed. When it was removed it was found my cancer had become much more aggressive and now I am looking at the possibility of radiation treatment. I adjusted my diet as mentioned and started exercising daily. This resulted in a great improvement in my overall health but obviously did nothing to stop my cancer. I have come to the conclusion that diet and exercise may prevent or slow down the cancer but it will not get rid of the cancer if you already have it. I'm not a doctor but I recommend you look at aggressive treatment early and most all types available are discussed on this board. Good luck. Charles

hopeful and opt...
Posts: 1316
Joined: Apr 2009
As a man who was diagnosed in 3/09, I have been fortunate to have made a choice to pursue Active Surveilance with Delayed Treatment if Necessary. During this time I have enjoyed a quality life. I have not experienced any severe side effects of active treatments that happen too often.
 
Since the time of my diagnosis there have been techological, biological and molecular advances so the AS protocol, although still not perfect is greatly improved. Now there are, for example MRI targeted biopsies, PCA3 tests and gene tests that aid in decision making.  These  tests, along with other diagnostic tests  can be used by a selected doctor knowledgable about the treatment of AS in order  to  manage a better decision. There are docs who specialize in treating AS.
 
Generally a man treated with AS is likely to be able to have the same treatment as he would have initially choosen if his cancer progresses. In many cases, about 70 percent of those diagnosed with low grade, low volume disease the cancer is likely to be indolent, that is not likely to progress, and a man can die with the prostate cancer, not because of it.....this is my personal hope.
 
Since my diagnosis, I have been able to extensively study various active treatment options, and I have determined an option, if I have to have treatment which is right for me.
 
Like AS, there have been improvement to Active Treatment options during the past 4 years; I expect this to continue. A successful active treatment is more likely now than four years ago. I expect this trend to continue.
 
I would not be too concerned about the PSA after your biopsy. You can retest. Let us know what the number is. The critical information is the biopsy. I strongly recommend that you have a second opinion of your biopsy by a world class pathologist that specializes in prostate cancer.
 
Concurring with Kongo's recommendation, the The China Study by T. Colin Campbell is very worth reading. I've read this book as well. I have radically changed my diet to be heart healthy. I am basically a vegan now with some fish on occassion. I do not eat any meat, chicken or dairy. I eat lots of tomato sauces and varies spices such as tumeric. I dring green tea instead of coffee.
 
I have detailed my treatment history and other pertinent information for you at the "about me page" . Simply click my name.
Chesty
Posts: 6
Joined: Aug 2013

Your insight is most appreciated. I am hoping to be where you are in a few years.  With luck, I can stay in active surveillance until some better options come up.  I did have the biopsy reviewed at Mass General and they concur with the diagnosis and approach.  My urologist is very helpful and open so I consider than an asset.  Right now plan is to retest later in Sept and make decisions on need for a biopsy based on that result.  I have been drinking green tea instead of coffee for 7-8 years.  Hopefully it is doing something to keep this slowed down.  Thanks for all of the advice and support.

hopeful and opt...
Posts: 1316
Joined: Apr 2009

Kongo has detailed activities that cause the PSA to rise, so now you are informed. In the event that your next PSA is also very high, before doing anything else, I would discuss having a round of an antibiotic  for about a month to treat a possible urinary infection; then retest. There are various drugs available to treat..

lewvino's picture
lewvino
Posts: 1006
Joined: May 2009

Another welcome to you. You have all ready been give good advie to follow. I had robotic surgery 4 years ago for my Gleason 7 Cancer. I believe the number of cores positive were about 7 out of 12 cores. Recently my PSA has risen from .0 to .3 and I will be staring salvage radiation treatments on Sept 3rd.

I have done very will the past four years with very little side effects from my Surgery.

Yes the initial shock of hearing that "C" word can be scary but keep testing and stay on top of your check ups.

Yours has been found very, very early and you should do well.

 

Larry

 

Samsungtech1
Posts: 350
Joined: Jan 2011

Chesty,

Pit seems your biopsy cme back low grade, but mine did the same thing.  Mine went from 4.2 to 6.4, Ibelieve.  AS is fine, but take control of when, and how often you will be tested.  That was a big jump. The people offering advice are really knowledgeable, as long as DRE's come back OK, or biopsy's do the same all good.  If I were you I would decide on when tests are done. Do not wait on Dr. It is scary, but you should have an idea of when to test.

Chesty
Posts: 6
Joined: Aug 2013

Hello again

I have just had a restest after a 10 point rise in PSA.  This is my first cycle of testing after diagnosis (Gleason 3+3).  The Doctor seems confident that the rise is due to Prosatitis and has prescribed antibiotics for a few weeks.  Hopefully the retest will be lower and the antibiotics will work.  I hope to keep up active surveillance for as long as it makes sense.  Will let you know the results when I get them.

hopeful and opt...
Posts: 1316
Joined: Apr 2009

https://www.google.com/search?source=ig&rlz=1G1TSND_ENUS421&q=how+long+should+an+antibiotic+be+prescribed+forProsatitis+&oq=&gs_l=

As a non medical professional, the length of time for an antibiotic may be about a month....above is a google.

Chesty
Posts: 6
Joined: Aug 2013

My first post diagnosis PSA was 13.8 which was an emotional, if not a physical setback. The retest came back at 11.25 which is the right trend but still higher than desired.  My Urologist has prescribed CIPRO for inflammation and I am hopeful that that will get to the source of this rise.  I have pills for a month.  This is my first cycle of testing since starting Active Surveillance.  When diagnosed, PSA had been just under 8 then dropped to just over 4.  The Doctor seems confident that this rise is not related to any change in the cancer.  There were two positive cores at 2% and 5%, fully contained. Gleason scale is 3+#.  If I have to have this, I am hoping to stick with surveillance until someone comes up with a better choice than what there is today.  I am 62.  Thanks for your insight. It is a help.

hopeful and opt...
Posts: 1316
Joined: Apr 2009

Chesty....Last month when you first posted we recommended that you have a second opinion of the results of the biopsy that was done for you. It is very important for you to have your biopsy slides sent to a world class pathologist that specializes in prostate cancer so that you are not under or over treated. I wonder if you followed up on this?

Glad that you are having a one month course of action with CIPRO, hopefully this particular antibiotic will reduce the PSA.

Chesty
Posts: 6
Joined: Aug 2013

Hello

My biopsy slides were sent to Mass General also and they confirmed the findings.  I met with one oif the researchers who agreed that at this time Active Surveilance is appropriate.  I appreciate your follow up.

hopeful and opt...
Posts: 1316
Joined: Apr 2009

I just noticed that earlier in this thread, you mentioned the second opinion at Mass General....sorry that I didn't notice that.

Good luck with the PSA. Let us know the results.

Keep on studying. ...look for support groups in your area.....read books, etc. USTOO and Man to Man are national support groups with local chapters.

We are here for you.

 

 

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