PSA 10.50 Free PSA 2.20 as of 8/31/2018 Do I have cancer or prostate enlargement?

hi, mr. bluebird

only a biopsy can say for sure if you have cancer in your prostate. i understand your concerns about having an MRI, but if you have an MRI, the results may show that there's no need for a biopsy, because it may not C any lesions [spots]. if the MRI does show lesions, then you can have what is called a MRI targeted biopsy. this type of biopsy will only target the specific areas that were seen during your MRI. unfortunately, i can't speak on the other areas of concerns you have. i hope this was of help to you.

Blue,

Your PSA histology shows continuous increases. This is typical in cancer cases. The PSA with ups and downs (similar to a seesaw movement) is typical in Benign Hyperplasia (enlargement of the prostate). In BHP the PSA also increases but it got periods of decreases.

Surely only a biopsy can tell you what's behind the increase. In your shoes I would get it done for peace of mind. The procedure is simple and done in outpatient. The doctor will provide anesthesia and pain killers for later so that you will feel nothing.

Best wishes for a negative to cancer outcome.

VG

BLUEBIRD3291 said:

almond milk and soy milk causing prostate cancer?
almond milk contains 20% of vitamin E. Too much vitamin E will cause prostate cancer. Does almond milk and soy milk will cause prostate cancer?

Bluebird,

The title of yor thread is "Do I have Cancer or BPH ?"

You shared that a previous biopsy was positve, so you definitley have prostate cancer, since this cancer never goes away without curative treatment (surgical removal or radiation).  You may or may not also have BPH.

No broadly accepted studies hold that lots of vitiman E "cause" PCa.  I'm not saying that no studies suggest this, just that it is not broadly accepted.   Diet in general has nearly nothing to do with the emergence of PCa either, and neither does smoking or drinking alcohol.

Close relatives with PCa is an indicator, but even that guarantees nothing.  PCa strikes vegans as often as it does bacon addicts and chain smokers.

max

Bluebird (蓝 鸟)

I wonder how much has that book affected your reasoning but the true fact is that many people around the world have done radiotherapy to cure cancer successfully. Surely many have not benefited as much but there are not many other options if one wants to get cured.

In any case one needs firstly to find out if cancer exists, and where it is located. Contained cases can be dealt with surgery dissecting the whole gland. In the presence of spread then radiation, hormonal or chemotherapy are the most recommended treatments. Without a proper initial diagnosis no one should get involved in a therapy.

Both MRI you describe above have the same capability in detecting prostate cancer. However, both also got limitations in finding small size tumours. Anything that is less than 6 mm may not be shown on the image. The MRI exam can be done without a contrast agent (ex; Gadavist) but the results would not be so descritive. Gadavist is not recommended to patients with Kidney disease above grade 4. The half-life of Gadavist is approximately 7 hours meaning that your body gets rid of the stuff in one day.

The best diagnosis for prostate cancer should involve several tests and exams such as the PSA, DRE, MRI, Bone scan, biopsy and symptoms. From these multiparametric data the doctor will ponder and deliberate a clinical stage which becomes the basis to choose a treatment.

The grade of cancer described in the book refers to the level of aggressivity of the cancerous cells. Aggressive ones are more prone to spread so that they are more difficult to get killed, however, the success of the therapy do not depend on the aggressivity of the cancer but on the extent of the spread. In other words, without a biopsy to find the level of aggressivity of the cancer and image studies to find the extent of the spread, no one knows if a treatment is worth do it.

If you are in good health, at 73 years old you still can afford any type of therapy. After 75, surgery may not be recommendable. Older guys that got low aggressive contained cancer may opt for doing nothing and those with indolent types of cancer may prefer to follow a palliative approach using hormonal drugs.

I was diagnosed with PCa in Japan in 2000. That followed surgery in Tokyo. The Japanese medical system is highly regulated and professional. You can go there (3 hours flight) for consultations and diagnosis if you do not trust the doctors in Taiwan.

I was in your country several times years ago and found that holistic treatments are prevalent, in particular at the Wanhua District. Holistic is in my opinion not the best choice to get cured.

Best wishes,

VGama

As mentioned earlier, only a biopsy can show cancer. And since you don't want to undergo an MRI exam, the choice is easy as to what to do if you want to pursue your question.

I wouldn't worry about almond and soy milk. Their relationship to prostate cancer is speculative. 

Finally, a DRE can only examine a part of the prostate. Therefore, a negative DRE doesn't prove that there is no cancer.

The typical cut off threshold level used by doctors to judge prostate cancer from a "percentages free PSA" result is between 15% to 20 %. That means that higher percentages may not be related to cancer. In any case, the quantity of %fPSA also depends on the volume of epithelial cells at the prostate gland. Small glands got lesser number (higher %) and big glands got higher number of cells producing more PSA, which turns the free PSA as a not so trustful marker to identify cancer. Another means used by doctors is to calculate the density of the PSA but one needs to know the size of the gland.

If you intend to avoid a biopsy, you can try crisscrossing the data from other biomarkers that are used in the PCa diagnosis by some doctors, such as;

PCa3 (genetic analysis of cells in the urine)
PAP (prostatic acid phosphatase)
CEA (Carcinoembryonic Antigen)
NSE (Neuron Specific Enolase)
CGA (Chromogranin A)
PHI (computer generated Prostate Health Index–pro-2PSA)

Surely these (like the PSA) are just informative data to formulate a judgment (for instance, when the PSA is high, there is no hyperplasia and the 12-plated biopsy is negative). However, in the end one needs to confirm the judgment via a stained piece of the prostate tissue and analyze it under the microscope.

You need to find a doctor you trust. You can also use a medical oncologist to oversee your process in the diagnosis, or consult another urologist friendlier to your wishes.

Here is a link about the relationship between total and free PSA;

https://www.verywellhealth.com/percent-free-psa-2782266

Best,

VG

Hi,

Only a biopsy will tell you if you have PCa, You will need a biopsy to confirm if you have cancer.  Throw your family history, what you eat or don't eat, ect. out the window as a predictor.  An MRI will tell the doctor where to take the biopsy samples at.

Dave 3+4

BLUEBIRD3291 said:

What is Gleason 4+3= 7 ?.
How many days you make your decision on Radical prostatectomy from first date you find your prostate cancer? There are a lot side effective on Radical prostatectomy. There is a statistics on internet to indicate percentage of side effective on Radical prostatectomy from major prostate surgery centers in United States. Some are high and a few are low. The more educated people the more suspicious and they are not totally trust their doctors. I am one of them because I earned my master science degree from one of New York universities long time ago. The academic training make me much suspicious and I do not fully trust what my doctor told me.

My wife and I researched and studied case studies for around 6 months.  We got opinions from Surgeons and Radiology onocologists. Actually, talked to RP and non- RP folks.  In my case, common side effects:  incontinence; erectile dysfunction.  Fact:  surgery is permanent.  My choice was based on what the doctors told us.  Results:  At this time, my PSA is undetectable; the incontinence is 99% gone away; I am intimate with my wife.  Basically, Gleason 4 + 3= 7 means to me, tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor.  If you read a good bit on this site, you will see some folks that analyze until they are paralyzed (unable to make a decision).  The best thing to do is study this cancer.  Find doctors that you trust; make a decison.  To me, the most helpful research was actually talking to the folks who have been treated surgically and then people who have been treated hormonally; radiation; and and chemo. There are many options.  This decision is yours.  Looks like you are studying your issue.  Good luck on your journey.