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PSA Total was 12

Darkdancer333's picture
Darkdancer333
Posts: 98
Joined: Feb 2018

Just had a blood test for PSA and it was 12. My PSA free was 9. I have an enlarge prostrate and have had the Joe Theisman sympton for years. On the morning of my lab test I just finished colonoscopy prep and had my colonoscopy after the test. I also had sex two days prior to the PSA test. 

In 4 weeks I go back for another blood test. And two weeks after I see an Urinologist. I am almost one year rwemoved from HPV Cancer and my latest PET scan was last August. If prostrate was cancerous would this have not shown up on the PET scan. The has been no sign of mestasis anywhere. Since 2010 my PSA has ranged from 4-6. MY primary care did a rectum check for lumps and all seemed normal. My colonoscopy results were also negative. In short could the high PSA be caused by the constant bowel movement, and hemmroid issues that arose the week prior.

 

hewhositsoncushions
Posts: 356
Joined: Mar 2017

DD333

Scans do not show small nodules so are not definitive. The best way of checking is a biopsy. In your shoes I would ask for an MRI (others can advise on the best kind) and said biopsy.

I am really surprised that your PSA numbers did not prompt at the least a biopsy over that period.

H

VascodaGama's picture
VascodaGama
Posts: 3224
Joined: Nov 2010

I agree with Cushions comments. Try being cleanthe day before drawing blood for your next PSA test (out of sex, no riding a bike or or activities that could massage the prostate gland). Most probably, the PSA will be high again (above 6) and the urologist will recommend a biopsy. The PSA alone cannot diagnose cancer but a low percentage (<15%) free-PSA is much linked to cancer cases (is your 9 a percentage?). Image exams (PET, MRI, CT, BS) are also required to provide you with a clinical stage. You can do it before the biopsy (better) or after but you should try getting the one most appropriate to your case. CT is the worse as it cannot identify small size tumors providing frequently false negatives. DRE are important elements in diagnosing but it examines only one side of the gland.

BPH also causes the PSA to increase in a sort of sudden increases followed by decreases (seesaw style). I wonder if you have any symptom that could be related to an infection or any increase regarding the glands size. Do you have urination issues?

Let's hope that the high PSA relates to BPH, however, only the biopsy can certify if cancer exists.

Best

VG

Darkdancer333's picture
Darkdancer333
Posts: 98
Joined: Feb 2018

 I am 64 and thin lol

 

 

Not sure what the 4 stands for 

 

03/22/2019 8:03
PSA - Total
((H))
12.02 ng/mL
( - <=4.00)
03/22/2019 8:03
PSA - Free
   
9.00 ng/mL
   

 

Darkdancer333's picture
Darkdancer333
Posts: 98
Joined: Feb 2018

at night i use to go every two hours but after my radiation and chemo I only get up once in the night. During day i drink lot of water and two cups of coffee and i urinate more often

Doctor thought colonoscopy prep also could affect the PSA test.............

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3469
Joined: May 2012

Like all other replies thus far, let me say that you need a biopsy. This is a complete no-brainer.  A PET absolutely will not find tiny PCa tumors.  Neither will a CT.  T-3 MRI, a little bit better.  And I will add that tiny tumors not yet visible via scanning can also be aggressive.  This is not ensured, but a real possibility.   "This" or "that" can skew a PSA result a little, but a 12 is reason to schedule a biopsy.  My G.P. and later my Urologic Oncology Surgeon (> 1,000 Da Vinci surgeries) told me to my face that he regards sex or exercise irrelevant to PSA results (my surgeon did his Residency at M.D. Anderson).  I know there are other studies that suggest that it is relevant.   But focusing on pre-test sex, coffee, etc. at this point is a distraction, not science. You might as well be studying the phases of the moon.  Any urologist that dragged his feet in rcommending a biopsy at this point would instantly become my "former urolgist."

Darkdancer333's picture
Darkdancer333
Posts: 98
Joined: Feb 2018

Here is some documentation from my last PET Scan

Not sure what SUV and Metobolic activity mean

 

Abdomen/Pelvis: Generous size of the prostate gland. There is a focal area of increased radiotracer activity in the center of the gland with maximal SUV 7.2.

Physiologic activity is seen in the kidneys, ureters, bladder, and bowel. There is atherosclerotic calcification in the aorta and iliac arteries. There is minor distal aortic ectasia measuring approximately 2.2 cm on series 3 image 124.

Skeleton: No abnormal FDG activity is seen in the skeletal structures. Noncontrast CT images demonstrate no suspicious bony lesion.

IMPRESSION-

1. There is misregistration between the PET and CT images in the head/neck secondary to patient motion which limits evaluation. 
2. Activity in the region of the previously noted base of tongue tumor appears to be decreased from prior. 
3. The previously noted hypermetabolic right level II cervical lymph node has also decreased in size and metabolic activity from prior. 
4. There is prominent metabolic activity in the right greater than left neck musculature and in the anterior tongue which is presumably either physiologic or inflammatory. 
5. No finding suspicious for new FDG avid metastatic disease. 
6. There is a focal area of increased metabolic activity in the middle of the prostate gland which is new from prior. This may represent activity in the prostatic portion of the ureter. Inflammation or neoplasm might appear similarly.

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3469
Joined: May 2012

Dancer,

PET scans place a short half-life glucose isotope (minimally radioactive) in the bloodstream. Cancer cells respond to this glucose, and the degree to which they react is the amount of metabolic activity engendered. Less metabolic response is better, more is worse.  Some non-cancerous physiological activities, like healing from an injury, or infection, will increase metabolic response.  Because of how the computer program involved is designed, the amount of response is usually mostly read by the colororation of th tissues, with red and orange indicating possible cancer.

SUV, Standard Uptake Valuation, is another computer-generated estimation of cancer liklihood.  For reasons that are too technical to enter here, SUV is regarded as less authoratative than coloration by radiologists, but both factors (SUV and color) matter. With SUV, a higher number is worse, a lower number less worrisome.

You would do best to have your oncologist review for you what the results suggest; a PET, by itself, never "proves" anything, except for a worsening or improving situation.

max

Darkdancer333's picture
Darkdancer333
Posts: 98
Joined: Feb 2018

thx for the help I think the oncologist was concerned with enlarged prostrate

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