Can prolonged use of Combodart for BPH make it difficult to detect cancer in PSA tests?
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Hi, About 5 years ago (aged 49), I was referred for further tests as a result of a routine blood test revealing a PSA level of 9.5 The standard 10 biopsies were clear, so I was referred for a further 25. Of this further 25, one came back as 'A Typical'. The specialist explained that this basically meant that the laboratory could not be sure and that it might indicate a pre-cancerous condition, or perhaps that the biopsy was taken from an area near a cancerous growth. At that point I was introduced to a Macmillan nurse and advised to consider a TURP procedure. I decided to pay privately for the template biopsy procedure, where a further 65 biopsies were taken. To the surprise of the specialist, this came back clear and he advised me that with 99% certainty my diagnosis was BHP. As a result I've been on Combodart ever since. My only follow up is an annual PSA test which has consistently been 3.8 The question I forgot to ask was whether the BPH drug could affect the PSA reading, making it impossible to tell whether there was or is cancer present?
1 like, 16 replies
robert25492 ian1894
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I think this does affect the PSA reading making it read lower but your GP will know this and adjust his interpretation of the reading. However, even without that, PSA readings can be unreliable. Congratulations on taking Combodart, I was unable to take it and stopped in favour of watchful waiting. My PSA level now reads between 1 & 2 (I'm 67)
ian1894 robert25492
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andrew46586 ian1894
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derek76 andrew46586
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andrew46586 derek76
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Emis Moderator comment: I have removed the link as it went to a site requiring a login. If users want this information please use the Private Message service to request the details.
http://patient.uservoice.com/knowledgebase/articles/398331-private-messages
ian1894 andrew46586
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derek76 andrew46586
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From American Society of Clinical Oncology (ASCO)
Background: With the widespread use of PSA testing for prostate cancer screening in population, more prostate biopsy are being performed and seem set to increase in number. The safety of this diagnostic procedure needs to be ascertained. Only one study evaluated the mortality following prostate biopsy and reported an increase of 2 deaths per 1,000 biopsies. Our objective was to re-evaluate the risk of death following prostate biopsy in a large, well-conducted randomised trial ,
We extracted data from the PLCO study on all men participating in the study with a follow-up until 31/12/2009. All biopsies performed since randomisation were included. Cause of death was defined by ICD9 classification. Results: Among 12,300 prostate biopsies, 36 deaths occurred within120 days: 17/8390 in the intervention arm and 19/3910 in the control group. Only 17 deaths had neoplasm listed as the underlying cause of death. Thirty-two deaths out of 9,124 (0.35%) occurred in the positive biopsy group compared to 4 out of 3,176 (0.13%) in the negative biopsy group. In this latest group, this represents 1.3 deaths per 1,000 biopsies. Deaths occurred in all age groups from 55-69 to 70-74, and there was no difference identified in age between study arms (p=0.45) nor between those with a prostate cancer diagnosis and those not (p=0.73). Conclusions: The mortality rate at 120 days following prostate biopsy of 1.3 deaths per 1,000 biopsies, in a population free of cancer, is a serious concern for the computation of benefit risk associated with PSA testing. This figure is in line with the risk reported by Gallina et al (2008) and is now based on a properly monitored population. This prostatic biopsy mortality would occur earlier than any benefit from a screening program and could reverse any potential gain from screening such as recorded in ERSPC study.
robert25492 ian1894
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ian1894 robert25492
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derek76 ian1894
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robert25492 ian1894
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thomas1947 ian1894
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I had a prostate biopsy at age 58 after a test showed a PSA of 9, and it was probably the most unpleasant experience I've ever had. There were no complications, and the test came back negative. I was recovering from a hernia surgery at the time, which means lots of blood, anesthetics, and antibiotics in my lower abdomen. I'm convinced those factors influenced my PSA level or the test itself, because every subsequent test has hovered around 4.
It is not heard of for a prostate biopsy to result in retention so serious that a TURP is required - it happened to a close friend of mine - so be sure you need one before you agree to it.
Guest thomas1947
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osric ian1894
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I had an enlarged prostate,, and the urologist suggested i have a turp surgery
which I did.I had my turp surgery on the 19th Septemper last month..After three days of my surgery I went home..I was experincing a burn sensation which the doctor told me that its normal...Ok Three days latter im having off balance in my walking I went to the emergency unit and I got admitted..Two different doctors came to see me about my swaying here and there..According to them they didnt find anything.One doctor was a ear specialist and the other one was a doctor for stroke patients. I had a ct scan and my urologist doctor says that theres nothing found in my brain to cause my off balance..Iam very worried as this walking problem has coused me to stay indoors and iam not able to do my normal routines.I have a boat and I love fishing. Gardening and lots more work I do around the house..By the way Iam 78years old.My review was last thursday and my doctor i.e. the urologist hav stopped giving me antibiotic but instead told me to drink lots and lots of water. He asked me to come back in three weeks time..If any one could please help me and tell me what is the cause of my walking off balance? Before this turp surgery I was fit and happy..And now Iam a miserable man..
Thank you.This is all
Jack
ian1894 osric
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Ian