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High PSA should I wait Dr want to keep going with Anti-biotics

grahambda
Posts: 18
Joined: Dec 2017

HI, I have just turned 60, last month had a regular check up/blood test, PSA came back 12.5. Dr put me on a 4 week course of Cypro. Just had another blood test PSA down a bit to 11.8, he wants to keep me on for another month then another PSA test.   I am concerned its not an infection and I may be wasting a month, should I attempt to see a Urologist ASAP and have an MRI?   Thanks for any advice.

Steve1961
Posts: 249
Joined: Dec 2017

No I wouldn’t why i was on mine for 10days only and it went down .9 if it were an infection I think 10 days of antibiotic should knock it out that’s just my opinion

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Instead of a GP, I suggest that you see a specialist and that would be a urologist.

Did the GP do a digital rectal exam(finger wave in anus)? results?

I wonder what your PSA history is?

Have you had any other diagnostic tests, a FREE psa or a PCA3 urine assay test? These tests would be appropriate before a biopsy.

Also there are facilities that do a fusion biopsy, that is first an MRI, then the results are fused into THREE dimensional biopsy machine. This procedure provides more information, and you can have more confidence in the results.....this a a new type of test, some major hospitals offer this............now a days mosts doctors do not have a three dimension biopsy machine, but a two dimensional

grahambda
Posts: 18
Joined: Dec 2017

Last PSA was 5 years ago it was around2.0 , had digit exam at that time all seemed Fine. No digit exam since then. GP informedme the free PSA test was not relevant as my PSA was over 10.0. As you suggest time to see a Urologist. Thanks for recommendation Re the fusion MRI .

Old Salt
Posts: 720
Joined: Aug 2014

Actually three!

1.You have an infection only (prostatitis). Antibiotics (like cipro) often won't help. PSA spikes are typical.

2. You have prostate cancer only; a RISING PSA would be evidence

3. You have both

 

Clearly more data are needed and getting those data may take a while. See the prior comment (from H&O) for suggestions. But the 'good' news is that prostate tumors are typically slow growing and a one month delay won't make a difference in the outcome or therapy.

grahambda
Posts: 18
Joined: Dec 2017

Well good news at least I can enjoy Christmas and start worrying about it in January. Thanks.

ASAdvocate
Posts: 116
Joined: Apr 2017

on prostatitis spikes. They just come and go on their own. Trust me, I have had many over 40 years. Sitz baths do help speed up the healing, but that sound so old school, that I almost hesitate to mention it.

 

I would suggest that you start having PHI tests, which are more accurate than psa alone, and only cost a small amount more.

 

As far as time urgency, that should not be an issue for you. A few more months of diagnosis will not decrease your odds of success if treatment later proves necessary.

 

Grinder
Posts: 441
Joined: Mar 2017

Like hopeful said, you need to have a urine culture sent to a lab to diagnose the infection. Some infections are antibiotic resistant to Cypro. In my case, Cypro only knocks it down. If Cypro works, it can still recur. 

Do you have any other prostatitis symptoms. 

Seriously if the urine culture comes back negative, then you know there is another reason for the high PSA score. If it comes back positive, then you know an infection is the cause. If the infection responds to the antibiotic, then you know it is a treatable infection. And it will help to identify the pathogen to better prescribe a treatment.

And like they said, get a DRE anyway. Yes they are unpleasant, but they will be another diagnostic tool. Often with a prostatitis infection you will have a UTI. Did you have a burning urinary tract infection?

Also like they said, prostate cancer is very slow growing, so you have plenty of time to get this rise in your PSA properly diagnosed as an infection, BPH, or prostate cancer. 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Grinder is correct that a urine culture needs to analyzed. This is currently being done. Also true that some infections are also antibiotic resistant.

The PCA3 urine assay is a different test, that is  an indicator for prostate cancer, and is used to help determine if a biopsy is needed;  another piece in determining prostate cancer:

PCA3 test
This test is a   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 prostate; the patient gives urine and the results are sent to Bostwick Laboratories(the only laboratory that does this) for analysis.

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 should not be used as the sole evidence for or against the diagnosis of prstate cancer. Clinicco-patholological correlation is indicated.

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Increasing Ciprofloxacin Resistance Among Prevalent Urinary Tract Bacterial Isolates

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1224699/

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

Here is a study about increased resistance to ciprofloxacin in biopsies

https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/100717-ciprofloxacin-resistance-a-review-of-patients-in-east-london-undergoing-prostate-biopsy.html

Tom HK's picture
Tom HK
Posts: 2
Joined: Jan 2018

i had the usual symptoms, took urine test (no infection) and blood test on a hunch. 3 days later and my urologlist told me PSA level 24 was six times the normal For 69yr old. Straight to MRI and biopsy. Both positive. 2weeks later radical robo-assisted prostatectomy.

 

Final lab tests showed a much more aggressive cancer than diagnosed. Another month and it probably would no longer "isolated".

Tom HK's picture
Tom HK
Posts: 2
Joined: Jan 2018

I say get the MRI

kidclutch
Posts: 56
Joined: Oct 2017

My dad had two clear biopsies within two years of his diagnosis (October 2017)— he was treated with antibiotics for three months under the impression it was just infection. His spine broke and sent him to ER. Imaging and hip bone biopsy confirmed cancer. Push your doctor for imaging.

1RNFA
Posts: 2
Joined: Jan 2018

My husband is an otherwise healthy white male, age 51.  No family he of Prostate CA.  His PSA was 60.  This is so high I can’t even find any information or data to help give me statistics or possibilities.  DRE appeared normal but urologist was only able to palpate the lower half.  Cancer?  Inflammation of the prostate?  Thoughts?

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Start a new thread, so we can provide input based on the particulars of your husbands case.

My layman's opinion is that  a PSA of 60 can  indicates that cancer exists. 

Did your husband have any onter diagnostic tests, any other psa's done?

Need to see a urologist....needs to retest the PSA..... A biopsy is most likely needed.One cannot be diagnosed without a biopsy. Now there are three dimenisional  targeted biopsies that are available at major centers of excellence that provide greater confidence.

At any rate, please start a new thread, so we can focus on helping your husband make the best decisions.

1RNFA
Posts: 2
Joined: Jan 2018

How do I start a new thread?

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Go to discussion boards that lists all of the cancer sites

click, Upper left corner, that  says "add new Forum topics

 

Hope that this works for you, other wise let us know, and we can try again

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3309
Joined: May 2012

gra,

In the world of Lymphoma, the disease is frequently first detected in the lower jaw/neck. Often patients see an ENT first, thinking infection. ENTs will often treat possible infections for months, when eventually Lymphoma is detected.  We have a saying therefore to "not let an ENT antibiotic you to death."   I guess the same could be said of a GP and PCa.   I would go to a urologist tomorrow.

I had chronic prostititis for decades (nearly 30 years).  Even my biopsy showed inflammed, non-bacterial tissues.

Dr Peter Scardino, director of surgery at Sloan Kettering CC, NYC, writes in his Prostate Book that way over 50% of all prostititis flares are NON-bacterial, and therefore do NOT respond to antibiotics at all.

 

max

js78696
Posts: 2
Joined: Jan 2018

High PSA levels are not always representative of having prostate cancer. Some of the more common reasons for seeing elevated levels of PSA include: infection (Urinary Tract Infection, UTI), inflammation (prostatitis), an enlarged prostate (Benign Prostatic Hyperplasia, BPH) and in some cases recent sexual activity. BPH is also one of the most common prostate problem found in older men. Therefore a PSA test is not always an accurate indicator of prostate cancer.

I work in a research laboratory and we are frequently carrying out this test. There are many different factor to take into account such as family history and how likely you are to get cancer. It is very important to do your own research and I would definitely recommend that you get a second opinion. If your doctor is advising that you have a biopsy, you need to be aware of all the risk factors involved. Please bear in mind that one study revealed that only 25% of men who had a biopsy because of high levels of PSA actually have prostate cancer.

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