Concerned Daughter - Update on Father
Posted , 12 users are following.
Hi. I posted earlier this month about my father's PSA results after he went for a yearly physical. The results were:
2011 - PSA 1.83
2013 - PSA 2.92
2017 - PSA 4.24
My father does have symptoms of BPH, and has for a couple years, but he was never definitely diagnosed with anything. I would hate to jump to the assumption that he has cancer, but it is definitely a worry of mine. He was placed on Flomax earlier this month from his GP and his symptoms have gotten better.
Anyways, he went to the urologist two days ago. The urologist was concerned with the rise in the PSA numbers. He placed him on three weeks of levofloxacin in case it is an infection or inflammation of some sort. If the numbers don't come down, he was considering doing a biopsy. The urologist also did a DRE and didn't notice anything remarkable.
I'm just nervous and was looking for input on this latest news. Thanks.
0 likes, 26 replies
karlee13
Posted
rocketman42 karlee13
Posted
Good luck.
karlee13 rocketman42
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Pepasan karlee13
Posted
Those numbers are very low compared to many. My PSA has been around 8 for 10 years but has just come down to 6.7. I'm 66 now. Living with higher PSA scores is perfectly feasible. I have cancer but it isn't apparently growing or spreading. No treatment required. We are all individual cases, but I hope your mind can rest a bit easier to know your Dad's situation seems good to me!
mosski karlee13
Posted
If at a later date his urologist recommends biopsy then it would be time to talk about the MRI.
Good luck.
barney34567 karlee13
Posted
You say the urologist is concerned with the rising PSA. If the only figures he has are the three you mention then I don't see the PSA worrying anyone.
It is understood that a doubling of the PSA in a year may indicate a problem. The figures you offered don't indicate that.
But if in doubt, I suggest you follow scotth's recommendation of a MRI. Ideally 3T and ideally reported on by a radiologist that specialises in prostate images. You don't want a regular radiologist. If you can't find a facility with a 3T scanner, a 1.5 T, which is what I had reported on by a skilled prostate radiologist is good enough.
I live in Australia and can't say if such MRIs are covered by your insurance. What I can say is that a biopsy is an invasive procedure which is never 100% safe and if possible, a non invasive procedure like a MRI should initially be used instead. After the MRI is performed and a biopsy is recommended, the biopsy can be guided by the MRI to obtain far greater accuracy than an unguided biopsy, which is really a hit 'n miss procedure.
karlee13 barney34567
Posted
He mentioned to my dad that it doubled, which obviously worried my father, but I did explain to him that it doubled over 6 years. My dad hasn't looked into this stuff and it's really only been me researching options, so now hearing the concern of his urologist has him worried. I've read about the complications of a biopsy and I do believe that it may be too soon. I've mentioned the PCA3 test, free PSA test, and MRIs to my father as options he can ask about before a biopsy. His concern is more so the cost of these procedures at the moment.
rocketman42 karlee13
Posted
I am not at my computer so difficult to type answers. Depends on your insurance as to whether it will be covered. Most do cover it now. If the doctor requests it then have them put in for a precertification to insure it is covered.
Depending on where you live I would suggest a major teaching institution for the 3T MRI so that a top notch radiologist familiar with prostate MRI's can read it. I would only have a 3T which has much higher resolution than a 1.5 T. Even the 3T can miss things so why risk it with anything else.
A 4K test is a much more specific blood test that measures four Prostate protein markers. It predicts the likelihood of finding a significant cancer if a biopsy were to be done. Many "local urologists" are not even aware the test exists so ask for it. If the test suggests a high likelihood of finding cancer then at least you go into it with peace of mind that it is needed.
If a lesion shows up on the MRI then a fusion guided biopsy is in order. They will typically take 4 cores from the lesion and then do 12 random biopsies along with it.
Prostate cancer is typically slow growing so have your father take his time and do plenty of research. This will arm him with the knowledge of the right questions to ask and how to proceed.
Light1 karlee13
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Karlee, I would request a PCA 3 test before agreeing to a biopsy
karlee13 Light1
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Light1 karlee13
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The PCA 3 is extremely specific to prostate cancer. I'm not sure about the sensitivity, would suggest reading up on it. I'm on Medicare with a Blue Shield supplement, and they have paid for two PCA 3 tests, 18 months apart
craig84609 karlee13
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BPH can and will increase PSA, so before going through a painful biopsy get a PCA3 test done. He may have to ask for it, in my case I had to demand it. PCA3 is only sensative to prostate cancer, so it can be used to see if there is a problem. Now if that came back high I would then get a 3T MRI done as this alows the doctor to find the tumor and do a guided biopsy with less needle pokes. Don't let them fool you into traditional means. My urologist was all set to do a biopsy on me and I said no way. I will have a PCA3 done first to at least see if there is a need for a biopsy. If I hadn't said that I may have been biopsied for no reason as I have BPH and BPH runs in my family, but PC doesn't. So try not to worry and don't asume it is PC yet.
karlee13 craig84609
Posted
This makes me feel a little better for now. My grandfather (his dad) has also been diagnosed with an enlarged prostate with 4 negative biopsies for prostate cancer, so I'm hoping enlarged prostate is the reason for my dad's numbers as well. I will definitely try and convince my dad to ask more about the PCA3 test, before jumping into a biopsy. Did you have a similar rise in numbers?
craig84609 karlee13
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Whiteplume karlee13
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I would think you must check your plan I was only in the US long time ago, you may not get what they say in U.K. that's why the NHS is broke!
If his PSA keeps going up some form of further investigation is a MUST I had a biopsy at 5.5 and 4 weeks after Thad had the prostate removed I am fine now 3 years on Zero!
Don't mess around take action it's to late when it escapes and much more difficult to deal with, but I do hope it's all Neg!