Newbie Here

MichaelF1002 · March 2013

Hello to everyone. I might not have prostate cancer; that's to be determined. But here's my short story: After a bout with kidney cancer in 2010, which was caught early and so far I'm NED, I am now concerned about the demon in your neck of the woods. It started with a slow rise in my prostate -- from 2.64 to 4.72 over a period of about two years. Now, I'm 66 with an enlarged prostate and the typical symptoms of slowed flow and getting up a couple of times a night to relieve myself, so the numbers rising really didn't worry me a lot, especially with the kidney cancer on my mind, but during a recent follow-up with my urologist he found two cysts on the prostate. He recommends a biopsy. I've heard that prostate biopsies produce a lot of false negatives so one can never really be sure if a negative finding means you don't have to worry. My PSA results only came back today and my urologist (who removed my kidney and did a great job) has already scheduled me for a biopsy on April 16. Can anyone give me some advice regarding my situation? I figure a negative biopsy will leave me worrying but a positive one may be like the kidney cancer, caught early enough.

Thanks for any offered advice/recommendations. Best wishes to all here.

Michael

VascodaGama · March 2013

“Earlier” therapy

Michael

I hope you get a negative to cancer result from the next biopsy.

Then, again, should you take it as a means for celebration or defiance?

Well, I would celebrate and let others to worry for the possible false negative.

In fact your doctor has identified two spots into which he will direct two needles. They may come out negative which would lead to think that the increased PSA may be from a cause other than cancer issue.

At your age with a history of PSAs above 4 it is logical to get checked annually. The biopsy is the only way to diagnose cancer but you can follow your case with a PCA3 test if worried with false negatives.

Relax and let things take the course they may. Prostate cancer is not a fast growing “thing” that would not give you the time needed for an “earlier” therapy.

Welcome to the board.

VGama

MichaelF1002 · March 2013

VascodaGama said:
“Earlier” therapy

Michael

I hope you get a negative to cancer result from the next biopsy.

Then, again, should you take it as a means for celebration or defiance?

Well, I would celebrate and let others to worry for the possible false negative.

In fact your doctor has identified two spots into which he will direct two needles. They may come out negative which would lead to think that the increased PSA may be from a cause other than cancer issue.

At your age with a history of PSAs above 4 it is logical to get checked annually. The biopsy is the only way to diagnose cancer but you can follow your case with a PCA3 test if worried with false negatives.

Relax and let things take the course they may. Prostate cancer is not a fast growing “thing” that would not give you the time needed for an “earlier” therapy.

Welcome to the board.

VGama

Thanks

VGama,

Thanks for your response. I found it very encouraging. A PCA3 test? I never heard of it, but I looked it up on the web and now I know something about it. Thanks. I know a lot about kidney cancer, but I still have a lot to learn about prostate cancer, it seems.

Mike

Raltrt41 · March 2013

MichaelF1002 said:
Thanks
VGama,

Thanks for your response. I found it very encouraging. A PCA3 test? I never heard of it, but I looked it up on the web and now I know something about it. Thanks. I know a lot about kidney cancer, but I still have a lot to learn about prostate cancer, it seems.

Mike

Mike

I have a similar situation......rising PSA, suspicious DRE, suspicious MRI..... I requested the PCA3 test either to avoid a biopsy, or avoid false negatives with a biopsy.....PCa 3 came back at a 46, so I'm scheduled for a 12 core biopsy on 4/4.

My urologist had NEVER ordered a PCa3 test for any ofhis patients........my PSA was only 2.6, but doubled in a year.

Best of luck,

Bill

MichaelF1002 · March 2013

Raltrt41 said:
Mike
I have a similar situation......rising PSA, suspicious DRE, suspicious MRI..... I requested the PCA3 test either to avoid a biopsy, or avoid false negatives with a biopsy.....PCa 3 came back at a 46, so I'm scheduled for a 12 core biopsy on 4/4.

My urologist had NEVER ordered a PCa3 test for any ofhis patients........my PSA was only 2.6, but doubled in a year.

Best of luck,

Bill

Bill

Hi Bill,

Thanks for responding. You didn't mention your age, but I believe it's not uncommon for men my age (66) to start having higher PSAs. My doctor did not mention a PCA3 test. I plan to make an appointment to talk to him before the upcoming biopsy and I'll ask him about it. Good luck with your biopsy.

Mike

hopeful and optimistic · March 2013

Nomogram

At the Sloan Kettering site there is a nomogram that measures the rate of change for the PSA's. The speed of the doubling is measured. Slower doubling like yours are less likely than faster growing to have cancedr on biopsy.Additionally your prostate size is rising; as this occurs it squeezes on the uretha and secrets more psa's. Also at times there is extra psa's that is secreated in a short time frame.

Sinced the digital rectal exam shows two cysts on the prostate I would wonder what this is.

The PCA3 is a new test, and is an indicator only. In my own case my number was 8 which is very low, however I was previously diagnosed with prostate cancer.

Please make sure that your doc does at least a 12 core biopsy; so you will have some more confidence in the results of your test. (some docs take fewer cores in the biopsy)

MichaelF1002 · March 2013

hopeful and optimistic said:
Nomogram
At the Sloan Kettering site there is a nomogram that measures the rate of change for the PSA's. The speed of the doubling is measured. Slower doubling like yours are less likely than faster growing to have cancedr on biopsy.Additionally your prostate size is rising; as this occurs it squeezes on the uretha and secrets more psa's. Also at times there is extra psa's that is secreated in a short time frame.

Sinced the digital rectal exam shows two cysts on the prostate I would wonder what this is.

The PCA3 is a new test, and is an indicator only. In my own case my number was 8 which is very low, however I was previously diagnosed with prostate cancer.

Please make sure that your doc does at least a 12 core biopsy; so you will have some more confidence in the results of your test. (some docs take fewer cores in the biopsy)

12 Core Biopsy

Thanks, Hopeful. I'll be sure to ask him about this.

Michael

MichaelF1002 · March 2013

MichaelF1002 said:
12 Core Biopsy
Thanks, Hopeful. I'll be sure to ask him about this.

Michael

Questions to ask about Biopsy?

I have an appointment on Tuesday to talk with the doctor about the upcoming biopsy in April. I requested this consultation because I know very little about prostate biopsies, except for what I have read online and some of which, admittedly, confuses me. Are there any particular questions I should make sure to ask him concerning either the biopsy or prostate cancer itself?

Thanks.

hopeful and optimistic · March 2013

MichaelF1002 said:
Questions to ask about Biopsy?
I have an appointment on Tuesday to talk with the doctor about the upcoming biopsy in April. I requested this consultation because I know very little about prostate biopsies, except for what I have read online and some of which, admittedly, confuses me. Are there any particular questions I should make sure to ask him concerning either the biopsy or prostate cancer itself?

Thanks.

What is the PSA/prostate

What is the PSA/prostate size number? ( available after biopsy)

...the smailer the number the better

.........................................

Does the doc think that it is advisable to target cores from the two lesions, and have an additional 12 core random biopsy.

...........................................................

What dianostic tests does the doc think is appropriate in the event that pCA is found?

.....................................................................

Is the doc able to perform an MRI Guided Biopsy?

...................................................

What meaures will be taken , to limit the chance of infection from the biopsy.

...........................................................

At this meeting can the doc do a PCA3 test so you will have a benchmark

MichaelF1002 · March 2013

hopeful and optimistic said:
What is the PSA/prostate
What is the PSA/prostate size number? ( available after biopsy)

...the smailer the number the better

.........................................

Does the doc think that it is advisable to target cores from the two lesions, and have an additional 12 core random biopsy.

...........................................................

What dianostic tests does the doc think is appropriate in the event that pCA is found?

.....................................................................

Is the doc able to perform an MRI Guided Biopsy?

...................................................

What meaures will be taken , to limit the chance of infection from the biopsy.

...........................................................

At this meeting can the doc do a PCA3 test so you will have a benchmark

Questions

Thanks, Hopeful.

This is very helpful. I already know the answer to the question about MRI guided biopsy ... he's going to do it with an ultrasound. Being an HMO, and I being on Medicare, I doubt if they would be willing to spend the $$ for an MRI guided biopsy. But I will ask.

Thanks again.

hopeful and optimistic · March 2013

MichaelF1002 said:
Questions
Thanks, Hopeful.

This is very helpful. I already know the answer to the question about MRI guided biopsy ... he's going to do it with an ultrasound. Being an HMO, and I being on Medicare, I doubt if they would be willing to spend the $$ for an MRI guided biopsy. But I will ask.

Thanks again.

Michael

Your right,, doing an MRI Guided Biopsy is cutting edge, the state of the art. The HMO's are more meat and potatoes technology.

Curious; which HMO are you with? Some of the regular posters here can give insights about some of the HMO's.

MichaelF1002 · March 2013

hopeful and optimistic said:
Michael
Your right,, doing an MRI Guided Biopsy is cutting edge, the state of the art. The HMO's are more meat and potatoes technology.

Curious; which HMO are you with? Some of the regular posters here can give insights about some of the HMO's.

HMO

Kaiser Permanente. D.C. area.

Kongo · March 2013

MichaelF1002 said:
HMO
Kaiser Permanente. D.C. area.

Don't Get Too Worried

Hi, Michael and welcome to the forum. While I think that you're savvy to be taking appropriate steps to figure out what is going on, it is perfectly normal for a 66-year old man with an enlarged prostate and other classic symptoms of BPH to see a rise in PSA. Hopefully your doctor is taking steps to rule out a UTI or other potential cause of an "elevated" PSA but PSA naturally rises with age and in my lay opinion from what I have read your PSA readings seem fairly normal for a man living in America eating the "rich man diet" of Western industrialized nations.

Hopefully all will be well with you. That's my guess. Good luck and keep us posted on your progress

Best,

K

MichaelF1002 · March 2013

Kongo said:
Don't Get Too Worried
Hi, Michael and welcome to the forum. While I think that you're savvy to be taking appropriate steps to figure out what is going on, it is perfectly normal for a 66-year old man with an enlarged prostate and other classic symptoms of BPH to see a rise in PSA. Hopefully your doctor is taking steps to rule out a UTI or other potential cause of an "elevated" PSA but PSA naturally rises with age and in my lay opinion from what I have read your PSA readings seem fairly normal for a man living in America eating the "rich man diet" of Western industrialized nations.

Hopefully all will be well with you. That's my guess. Good luck and keep us posted on your progress

Best,

K

What, me worry?

Hi Kongo, thanks for the encouraging words. If it weren't for the two cysts, I don't think I would be overly concerned. But after finally starting to believe that I had a handle on the kidney cancer thing, this prostate problem pops up. I'm beginning to feel like that character in the Lil Abner comic strip from decades ago -- Joe Btfsplk, the guy who walks around with a black rain cloud over his head. A few days ago, my urologist, who did the radical nephrectomy, had me take a blood workup, a urinalysis, and even a bone scan (I had bone pain and was afraid that indicated that the kidney cancer had spread, or maybe that it was prostate cancer that spread!) Blood tests and urinalysis came back normal. Bone test showed osteoarthritis (a big relief!). A have a lot of confidence in my urologist and believe he will do whatever needs to be done (although I do have my doubts about an MRI/biopsy, which might be a problem for my remaining kidney anyway if it involves contrast.

Michael

Newbie Here

Comments

Discussion Boards