Elevated PSA

I meant to add that my PSA was 2.4 to 3.5 over a decade. I would not rely on PSA or even a digital rectal examination. These  showed nothing in my case.

 

Hello Roger2Dodger... I know the stress you are going through. My PSA went from 4.0 to 5.2. My urologist prescribed an antibiotic to make sure the raise in PSA was not an infection. After the antibiotic, the PSA went to 5.1 which I thought was good. He said no and suggested the biopsy which he scheduled for the next week. This was last October. I was told to arrive 30 minutes earlier than the scheduled biopsy procedure. This was because they would give me some kind of numbing agent prior. Honestly, what ever numbing agent they gave me was not effective at all. The biopsy was not pleasant - but tollerable. I have heard from other people that the biopsy was not painful, so I still wonder if what the assistant used was not the right thing... I would ask your urologist what they would use to numb the area for the biopsy. I was given antibiotics to take before the biopsy and to continue a few days after to help prevent any infection. I think this is a very good idea too. Follow the directions from your urologist - including an enema the morning of the biopsy... this also helps prevent infection. The procedure takes roughly 20 minutes or so and you go home. That day you are a bit sore - but take some ibuprofen and it helps greatly. I developed prostatitis from the biopsy - which my urologist said was probably already there, the biopsy just brought it forward. I was also given Avodate due to a slightly enlarged prostate. At first I wasn't sure if the discomfort I was feeling (sort of like I had a golf ball up my back side) was from the Avodate, or the biopsy. The doc told me it was the prostatitis and gave me another regimen of antibiotic which cleared everthing up. The biopsy came back 3 days later - it indicated 2 out of the 12 core samples had some cancer cells. 1 sample was 10%, the other was only 2%. My urologist said that put me the the 'low risk' group. After the antibiotic for the prostatiis, my PSA went down to 2.0 which he said was very good. The biopsy is important because it will give you your Gleason score. That number will help determine a good treatment option. 6 or less is good. Mine turned out to be 6. And with the lower PSA of 2.0. he said I could even do the 'active survailence' option which lets you monitor the situation every 3 months or so. Then he said if the PSA rises againi, another biopsy - ouch! I just felt like I should deal with it now and get it over with. I am in reasonably good health otherwise, and I thought it I wait longer it would be harder to deal. I researched many treatment options and I think for me the Brachytherapy (low dose radiation seed implants) was a good choice. I had that done 3 weeks ago... and I am doing pretty good. It is a one time treatment done as an outpatient procedure. It takes about an hour. The ibuprofen helps with discomfort after - and it was not any more painful than the biopsy - but at least you are asleep during this one.The first few days it is a bit painful urinating - sort of buring sensation. Not terrible, just uncomfortable. The doc also put me on Tamulosin (generic Flomax) even though I did not have a problem with urination he said this was a precaution. And probably a good idea to keep everytihing working. I have my follow up with the urilogist and the radiation oncologist next Monday. In the first 2 weeks, All treatment options have side effects, but most all will go away from what I've read and been told. I think the Brachytherapy has the fewest side effects, and after a few months, all the radiation is gone. My urologist told me that the side effects will peak at about 3 to 4 months - then be less and less. As I go into the 3rd week after treatment, I feel pretty good. If I start feeling a little discomfort, the ibuprofen seems to knock it out. If I can tell you anything further, please ask. I know this is a tough time. The biopsy should be done to see what options are available for you. Also, what ever you consider, just make sure your doctors have performed that procedure successfully many times. Also, ask you doctor what treatment he would do if it were him or a relative with the same diagnosis as you. Good luck to you.

Charles

Hi Roger ,my PSA was 4.1 two years ago and last December went up to 8. I went to few urologists and all said I shoulg go for biopsy. I didn't. I ran few tests for biomarkers for cancer ( any test related to PSA is not in my favor, and any test which does not include the psa in the algorithm shows less probability of finding cancer in a biopsy ). My point is that psa is not specific, and many reasons other than cancer can cause the psa numbers to go up.

The more important thing is to check if anybody from your immediate family died from prostate cancer ( if immediate relatives had BPH, it is not cause for alarm ).

I am 68 years old and I feel and research shows that i will live same length of time without treatment, as with treatment that will ruin my quality of life.

Don't make decisions under stress or anxiety. Prostate cancer is most likely indolent and grows very slowly, so you have time. Family might put pressure on you ( but you are the one to read and research and you should be the most informative one ), so don't rush into a decision.

 

You are worrying needlessly.  The change in PSA could easily be mere differences in test samples and is in no way significant even were it accurate.  Plus the rise in PSA is very slow (look up doubling time).  You can get on the diagnostic treadmill if you like, but I would suggest you read the US Preventative Services Task Force Recommendations on Prostate Cancer regarding both diagnosis and treatment. If you can't simply let go of this, then look up the recent article in Science Daily on predicting aggressiveness of prostate cancer before surgery with a blood test.  You would be suprised to learn that testosterone levels (too low) predict Gleason score (too high).  The authors of the article suggest the possibility that if your testosterone is too low you might supplement testosterone.

Realistically, you have nothing to be concerned about.  Carl 

 

You have to do what you think is right, but if it were me I would not have a biopsy. I would keep getting PSA tests to see if it rapidly goes up. Biopsy can be harmful and even deadly do to infection. Slow growing cancer can take many years to be a problem. Many men will have pc at your age but do nothing because it isn't causing symptoms. Most likely you will not die from it. But again you have to do what you think is right for you. I am 47 and having trouble but I would pass even at my age. I figure I will die of something else.