Just had first raised PSA test. Very raised and a bit worried

Thanks for the advice and speedy response! I should have mentioned, I did have a 30 odd mile cycle 2 days before and an ejaculation the night before the test, is it possible this could account for such a high reading? I know now i shouldn't have done either of these things before the test and that it can affect a result but can it to this extent?? Should I avoid cycling completely now do you think? Thanks again.

Chris, I don't know how much these activities can raise your PSA. I think it is individual,  but probably significant. Yes, I would say abstain from all these activities at least 3 days before a PSA test.

Thank you for sharing your experience Charles and for the advice. I am certainly not going to rush into a biopsy. I will make an appointment with my GP and ask for another test, this time following all of the guidelines and rules prior to the test. Fingers crossed it's just a bit of a rogue result but I fear I'm clutching at straws! Thanks again for taking the time to comment. Chris

Charles,

I am presently doing AS., but I am going for treatment after my scheduled MRI guided biopsy in early Jan. I am interested in the Brachy thearpy. Removing the prostate is not an option. Radiation will probably be my choice.

My question would be,am I a candidate for Brachy thearpy . Are there any stipulations that you may know of,whereas that would disqualify one from this procedure?

Thanks!

Hello Roger. The only thing that would disqualify a person would be the size of the prostate. But they can reduce the size with medication.  It has to be within a certain size.  I have a friend that retired from the Cancer Research Center. She was a director of some sort and was knowledgeable about radiation therapies. She and I talked in detail about my options and radiation was one of them. She also directed me to one of her old co-workers that still works at what is now the START Center where they offer many treatments for many types of cancer. I met with the oncologist and he went over treatment options and explained the pros and cons and their associated side affects. We spoke about radiation beam - which was a nine week process, I believe of about  15 minute sessions. He said the side affects (and all have some side affects) would not happen until late in the treatment. Inflammation and fatigue would be the most notable side affects. Another option was the Cyberknife which is also radiation, but more focused to the area needed. I believe it was 4 fudiciary markers would be implanted into the prostate about 2 weeks prior to the Cyberknife procedure. Those markers help guide the radiation beam in order to cut the risk of radiantion damage to other surrounding tissues like the colon and bladder.. The Cyberknife would be 5 sessions at 45 minutes each. And I believe those would be every other day if I remember correctly.  He told me that prior to each session I would have to drink an amount of water to fill the bladder. And hold the water for the duration of the session. This was to hold the bladder aware from the radiation beam. The last discussion was the Brachytherapy. The only requirement for that was that the prostate had to be within a certain size range. Mine was slightly enlarged in the beginning of all this. I was put on the generic version of Avodart which is Dutasteride. That drug is prescribed for enlarged prostate. After 2 weeks of the Avodart, my prostate was in the correct size range. They have to do a 'volume study' which takes about 10 minutes in the office.They do a sonagram to make images of the prostate as to size and shape. They use that for the seed placement. 2 Weeks after the volume study, I was scheduled for the Brachy. That procedure takes about 45 minutes. After that, you are in recovery for about one hour - and when you pee for them a couple of times, you are released to go home. Ibuprofen helps with the inflammation...  good luck. Let me know how it goes with you. Charles

Thanks Charles for the information. I just wanted some information before I go for my treatment . I appreciate your detailed information, it gives me some knowledge to make a decision that suits me

I like the Brachy therapy, and the Cyberknife, not to keen on 9 weeks of radiation. Taking Ibuprofen is not for me, I am allergic to aspirin products.

If I have to go for the 9 weeks route, I will probably have to delay treatment until spring. Living in the Midwest in the winter time is impossible to make the treatment appointments every day due to winter conditions. Thanks again for your support and knowledge.

Roger

Thanks Craig, I will see if it's available and if not try and go through my PHI. Time for some more research i think! Your comments are much appreciated

Chris

Hi Craig, I'm interested in this PCA3 test. My partner (50) PSA 7.2, now 9.5 has been told by urologist consultant that he highly recommends a biopsy. Why would he not suggest the PCA3 test first?It has never been mentioned. Surely this should be the next step after high pSA if antibiotics don't help as its then unlikely to be BPH or prostatitis. Should he ask for this test before agreeing to biopsy. I think PSA is to be repeated after Christmas prior to biopsy appointment. We are UK based. Thanks

Hi caz,

I hope you don't mind me chiming in. You are correct to request a PCA3 test if the PSA still comes back elevated. However, you might want to just move forward and have an MRI scan done instead.

Here's why...if the PCA3 test comes back high, you will still want an MRI done BEFORE having the biopsy (more on this below). If the PCA3 comes back low or not definitive then you still don't have a solid direction. If you go for the MRI (and insist on a 3T MRI) the MRI will show if there are "areas of concern" or not. If there are no areas of concern you will at least know the size of the prostate and can look for other issues such as BPH. If the MRI does show areas of concern, then you essentially have a roadmap of the areas to do the biopsy. Without the MRI, the biopsy is blind (random) and can come up negative (false negative) even if there is cancer present. There can be "areas of concern" that are not cancerous but the only way to know is from the biopsy.

In my personal case, my PSA came back high both times. He scheduled me for a biopsy but I insisted on an MRI first and an "MRI targeted biopsy". Had the MRI come back clear I was going to cancel the biopsy and do the PCA3 test. Unfortunately, there were 4 areas of concern so I then agreed to move forward with the targeted biopsy. One area had one core 5% cancer, one area was precancerous, and the other two areas were non issues. Because I had such a small area of cancer, a blind/random biopsy might have come back as a false negative.

I hope you find this information helpful.

PCA3 is a newer test and some Urologists don't use it yet. Mine is still in the dark ages as well. You will have to ask for it. As I said it is only sensitive to cancer, so it will likely show if he is at risk or not. Biopsies that are ultasound guided often miss cancer altogether and can cause damage to the organ and infection. A 3T MRI is also fairly new, but has shown that it can discover cancers that were undetected in the past by conventional means. Google 3T MRI and you will find lots of info on it. What I am saying is there are options these days and it seems like the Uro's are living in the past.

Hi ES, that was some really good information you gave me. It is a bit of a minefield and the wrong decision could have far reaching affects. At the moment we have located a few 3T MRI scanning centres in Dublin which is only a short drive away. All being well he will be scanned there early January and see if any areas of concern show up. With the burning I still think it sounds like inflammation/infection but that may be wishful thinking. Lemon barley water is easing the stinging strangely enough. From posts I have read it seems that most feel that 9.5 is a high level for an otherwise fit and healthy 50 year old. I just hope it is BPH or prostatitis. Is the MRI targeted biopsy just using the results of the 3T MRI to know where to take the samples from in biopsy?

Hello Caz.The PSA3,is just another tool for detection of PCa.Different parts of the country have different procedures.A friend of mine is about to have 1 stop appointment,which involves MRI scan first,if any signs of problem with scan,then he will have biopsy on the same day.His PSA reading is 5.7. Caz after my first PSA reading in 2012 was 8.7,then over the next 4 years it reached a peak of 13.7.When i say over the next four years i mean i opted for active surveillance,after being dianosed with PCa,during the summer of 2012.After 3 prostate biopsies and 3 MRI scans over the next 4 years,i eventually opted radical prostatectomy,which i had done august of this year.If your urologist advices a biopsy,i would personally take his advice.9.5 is fairly high but still under 10. If your worried about a biopsy,dont be,ok there is a risk with any procedure.and i have had 3 .You would have a appointment take 3 antibiotics to fight infection.Lay on your side a probe is inserted into your rectom and 12 samples are taken.It is not painful just slightly uncomfortable.Good luck