Prostate biopsy for hi PSA level
Posted , 20 users are following.
Greetings all
I seem to be having chronic problems with a raised PSA level. I have a urologist but have turned down just about everything he wants to do to me, just because cic seems to be solving my problem. I'm not having any symptoms of prostate cancer - actually I don't think there are any symptoms - but my yearly blood tests for medicare and some other ones I've had lately keep showing a high PSA. It's been 5.7 and now my doc says its 6.4. About a year ago we tried antibiotics to bring down this level. He said normal for me would be between 0 and 4. So he has made another referral to my urologist and I suspect they are going to recommend a biopsy.
I am doing cic on average about 4 times a day depending on how much water I drink. I understand from reading these forums that this can raise PSA levels. My doctor (GP) concurs but apparently doesn't think that can account for that much of a raise??? I know he doesn't really like me doing cic and thinks I should have gone with my urologist's plan for Green Light laser so he is not real helpful with the cic thing. He wanted to give me another round of a/b to see if that brings it down as it did before. I was surprised it brought it down because I did not have a UTI; at least not like the prostatitis I had when all this started. He says I have chronic prostatitis but I corrected him on that; so, anyway, I take this doctor's advice with a grain of salt.
So my question is: should I do a biopsy based on a fluctuating PSA blood level? It mostly has been spiking up. I am using a hydrophilic coude catheter and don't have a problem getting into the bladder with it but I suppose it is nudging the prostate on the way in.
0 likes, 53 replies
jim81578 keith42667
Posted
3-t mri would be my first choice just to settle my mind...
dennis63948 keith42667
Posted
I hope I can help and make this more simple as I went through this last year, with similar readings.
My PSA went from 4 to 6 in a year. I had no symptoms but have a routine blood test. My Doctor recommended an MRI scan. After querying this I went ahead and a small pea sized lump was found. The oncologist said that in his experience there was about a 70% chance of this being cancerous.
I then decided to have a biopsy, which found that is was cancerous, moderate grade. Treatment was recommended and I looked at every option as I wanted to avoid any side effects, if possible. These options included Radiation, surgery and Brachytherapy. Fortunately I was told about pencil beam Proton Beam therapy, which had just been introduced to the UK.
After my first review my PSA had gone down to 0.19. An excellent result. I had no symptoms to start with, no effect from the beam and no side effects.
In my knowledge and now experience if your blood PSA has jumped then you need a scan to see what it is.
I suspect that you are in the USA so I do not know what some of the terms you use, mean. No idea what cic is.
I would have the scan and find out what is there, then you can decide.Good luck.
barney34567 keith42667
Posted
One thing comes to mind: ensure all your PSA tests are done by the same lab as labs differ in their measurements.
frank27027 keith42667
Posted
Hi , Doing CIC will raise your PSA.I have been doing CIC for almost 3 years ,5 to 6 times a day. Do you bleed at times when you do CIC? That seems to be the reason fo bleeding?My PSA was 17.2 and i will not do a biospy. I don't think 6.4 is a high reading when you do CIC?I would ask your urologist if CIC causes bleeding. You should also take a free PSA ,this is more accurate for ones who do CIC.
frank,
frank27027 keith42667
Posted
HI, Can you do a normal void? You said you do CIC 4 times a day. Thats not a lot. I don't think your Psa is high. Doing CIC will make it high.
frank,
keith42667
Posted
No, Frank, I don't have any bleeding. I went to the Urologist about three weeks ago. He did not seem to think my PSA was that alarming. I saw him about two years ago and he wanted to rush me into GL surgery in three weeks. I declined and have been cathing for about 26 months. Now, he tried to talk me into doing a TURP. He's pretty reassuring that I would be glad I did it. He claims that he can tell that I have a large median lobe just by doing the DRE. He's done dozens if not hundreds of these at the Boise Urological Institute. He's probably right that my case is more than likely pretty typical; most things with me are, and thats probably not a bad thing.
I can get a small amount of urine out - maybe 20 to 30 cc typically - right after feeling a strong urge. Sometimes if I keep trying for awhile without the catheter the feeling will just go away, and I get it again in about 20 min. Then I will use the catheter. Sometimes, like right after sleeping for a few hours, I will do it just because I know I SHOULD have to, even though I don't feel it. If I do have a NV, and then do cic, I am retaining around 350 ml or more. I know I don't drink enough water; the last time I saw my GP he said my creatine level was up and I was dehydrated. The urologist didn't seem concerned about that at all. When I drink a lot of water I have to do cic a lot more and my urine is completely clear colored. Hope this helps.
keith42667
Posted
What he wants to do is do a TURP and then use that tissue for a biopsy. That does sound like an attractive option. Unlike JimJames who used to be on these boards; retrograde ejaculation is not a big deal to me although I'd rather avoid it if I can. He also downplayed the recovery time and, as I said, seems to have gone away from recommending the GL for me to doing the TURP. He said its the "gold standard" for this problem.
tom86211 keith42667
Posted
Keith,
Seems like you are going thgourh a LOT of aggravation just to avoid having a treatment - like GL or TURP. I had a bipolar TURP in April - quite easy. Only discomfort was 3 days on Foley. I was home from hospital in 4.5 hours after checking in. No pain. A lot of men on this forum have a fear or TURP and will do just about anything to avoid it. Makes little sense to me since I thought it was not in any way a bad experience and has been quite effective. If retro is the issue then there are ways to perform the operation that bypasses the ducts. After the TURP they send the tissue samples to the lab and you can find out if you have any prostate cancer - so, you get two for one.
Tom
Motto keith42667
Posted
My female Uro demanded I do the needle biopsy. I asked for the free PSA and the MRI. Both done. She repeated her demand for the biopsy saying "her practice would not let her do a TURP without a biopsy." I got a new Uro who said I didn't need the biopsy as I had a very low risk of prostate cancer based on the free PSA and other testing with the first Uro did. She didn't tell me that result, of course.
frank27027 Motto
Posted
Hi, Good info,WHAT WAS THE READING ON YOUR FREE PSA?
THANKS.
FRANK
keith42667
Posted
My Uro seems to have completely changed his story. He hasn't done any other testing on me than he had done over two years ago, but now he's advocating for a TURP other than the GL which he nearly had me set for. I can't remember if I asked him exactly why his recommendation has changed. I'm guessing that it is because I wouldn't go for the GL.
I really don't know what to do at this point except keep doing cic. I don't particularly mistrust Dr. Fredrickson, but, like the Green Light surgery, he acts as if there are no down sides to the operations; that they're standard (he's done hundreds of them, which is probably true) you're in and out of the surgery and its almost always effective. I told him I'd think about it and I still am. It DOES worry me that I'm dependent on these catheters and if I can't get them or they're too expensive, I'm screwed.
On the way out the door, he said "(BTW) How are your erections? I can get you Viagra for $5 a pill" So he tried to sell me a script to Viagra before I left. Just thought that was a little odd. I told him my erections are fine if something turns me on.
dennis63948 keith42667
Posted
I have an idea that I have already commented. Normal Reading for Prostate is up to 4. Your Dr said that. Mine went from 4 to 6 in a year. Like you I was concerned but had an MRI and I had a pea sized lump. Dr said that there is a 70% chance of it being Cancer. Had the biopsy and it was moderate grade.
I had treatment. I am in the UK and did not want surgery or radiation and was able to get the new, for the UK, Proton Therapy treatment.
PSA now down to 0.4.
I think you should have a biopsy. You may have PC and need to find out or not. It;s best to know, in my opinion.
ken19524 dennis63948
Posted
Dennis, I have heard good things about the proton beam therapy. A friend had that done about 10 years ago here in the States. He had to travel to Florida, as there weren't that many places available then. He's been doing great since then.
dennis63948 ken19524
Posted
Hi Ken,
The latest has changed and what I had was called a Pencil Beam machine. It can focus very accurately and after the relevant organ is scanned and mapped in 3D the beam only affects that area. I had no side effects and was treated over 7 months ago now. Here in the UK it is being pioneered by Rutherford Cancer Care.
So glad I chose it!
keith42667 dennis63948
Posted
My PSA has been high ever since I started cic. About a year ago it was a 9 for my yearly medicare blood test. My GP gave me an ultimatum; either I get a biopsy or do a round of antibiotics to see if it would come down. I did the A/b and it took it down to 7.2 or something like that; I don't have copies of my labs. As far as I know, I didn't have any UTI; I didn't have any symptoms. So this year, a 6.4 looks like just another reading. He sent me to the urologist again because I guess he doesn't think the cathing is not all that causing this.
ken19524 keith42667
Posted
Ask for a 'free PSA' test. It is much more definitive about the chance of prostate cancer compared to the standard PSA test.
dennis63948 keith42667
Posted
Keith, My Oncologist was quite clear. Have the MRI and then, with a reading of 7, get a biopsy. Please do not worry about it but do what the suggest. You may be delaying what needs doing and making yourself. You need to know.
I can't add more to that.
Good Luck.
derek76 keith42667
Posted
I'm sure that the cathing is causing it. Which antibiotics were you prescribed for a non UTI without symptoms ?