PSA test and Crohn's Disease

Posted , 4 users are following.

This discussion has been locked due to a period of inactivity. Start a new discussion

Does anyone know if having Crohn's disease can elevate PSA durring a flare up? I am having a CD flare and also trouble with an enlarged prostate. My Urologist wants to do a PSA test on me, because she thinks it is elevated. She also said if it is she will want to do a Biopsy. I don't think a Biopsy is a good idea for someone that has CD and is in a state of flare. Maybe ok if it is done through the Parenium instead of rectally. Still don't want to have one if things are enlarged due to my flare up. Just wondering if anyone has had an increased PSA due to a CD flare? Is it possible? My rectum is inflamed due to the CD so is it likely my prostate could be enlarged due to CD?

0 likes, 23 replies

Report

23 Replies

  • Posted

    Hi Craig - sorry to hear about your CD. BPH and CD are both autoimmune inflammatory diseases so it is quite possible that your PSA could be elevated during a CD flareup. A better way to check for prostate cancer than a needle biopsy is to do liquid biopsies. These are readily available and are very sensitive to prostate cancer cells at the molecular. One test is a urine test called the Michigan Prostate Score test ot MiPS which also checks for an additional protein marker called PC3. And there is also a blood serum test called Apifiny which looks for autoantibodies specific to prostate cancer. So even if you are having an inflammatory episode now these tests are not sensitive to that but only prostate cancer molecules. Good luck. Neil
    Report
    • Posted

      Hi Neil,

      Do you know where in the US that offers this service "liquid Biopsy testing"? Just cuious. Thanks.

      Report
    • Posted

      Hi Viet - these tests can be ordered by any doctor in the US as far as I know. Your docotr would just have to contact the main offices and request the kits to be sent to him and then the samples are taken and returned to the labs for analysis. I would give you the web sites here but that is not allowed. So the first test is called the MiPS test which stands for the Michigan Prostate Score test. It is just a urine sample that looks for pieces of mRNA associated with oncogenes specific to prostate cancer. If you google that you should get their home page.

      The other test is called the Apifiny test by Armune. You can google them too. It is a simple blood test that looks for autoantibodies produced by the body in response to certian prostate cancer antigens. So the two tests compliment each other in screening for biomarkers at the molecular level for prostate cancer. It is used to decide whether or not a person should proceed to a needle biopsy (or a 3T MRI as Rich suggests ) if the PSA is elevated. I believe my 3 needle biopsoes over the past 20 years gave me the chronic prostate infection that led to my BPH.

      Take care

      Neil

      Report
    • Posted

      Thanks for the good info. I am suprised to hear about all these tests, when my Urologist just say's we will give you a PSA and if high I am going to recommend a biopsy. Why on earth wouldn't she mention any of these tests?

      Report
    • Posted

      Good question. There may be some difference of opinion on the usefulness of the liquid biopises (Neil,is that a possibility?), but the MRI seems like a total no brainer to me.
      Report
    • Posted

      Hi guys - my urologist here in Canada would not even look at the data on these 2 liquid biopsies - he just dismissed them out of hand as nonsense. So I had to drive to Detroit and pay for them myself. The uros get a lot of money from needless biopsies and they cause a lot of damage and are not really definitive if negative. MRIs are great if you have access to them but here in Canada the 3T MRIs are only used for cancer patients. I think most uros are not aware of these liquid biopsies and in any case will not make money off them. There are a lot of really good research papers on their use and they are the way of the future.

      Also an important point is that these tests look for pre-cancer/cancer indications at the molecular level long before a tumor might form on an  MRI scan. So if these markers show up they can help nix the cancer before it becomes a tumor or worse. But if the scores are high say then probably an MRI would be ordered right away. In the US the trend is to get away from needless biopsies based solely on elevated PSA levels because of the false positives in the 4 to 10 range. Take care. Neil

      Report
    • Posted

      In the US the trend is to get away from needless biopsies based solely on elevated PSA levels because of the false positives in the 4 to 10 range.

      Neil, did you mean "needle" biopsies in this sentence?

       

      Report
    • Posted

      Yes : "... needless needle biopsies.. ". The needle biopsies are needless in many case when the PSA just rises a little. It isn't until the PSA gets above 10 that there may be cause for concern. I had my first "needless" needle biopsy 20 years ago when my PSA rose to 1.2! The procedure gave me a UTI which I believe caused my BPH. The last "needless" needle biopsy was 5 years ago which sent me to ER that evening when a clot blocked my penis and I had to be catherized to remove 1.5L of fluid. In the following years my rpostate grew from 150 to 300gm!. Yet all "needless" 12 -core TRUS guided needle biopsies were always negative. My uro lines up all his victims every Wed. afternoon like lambs sent to slaughter and biopsies at least a dozen every week - good money if you can get it! Take care. Neil

      Report
    • Posted

      Ah, yes needless needles. I too have had some, but escaped the problems that they have caused for you. The first 2 were random and came back negative.The third happened yaers later when my PSA continued to rise, and a 3T MRI returned with one suspected lesion PIRADS 4/5. The targeted biopsy came back negative.
      Report
    • Posted

      That's kinda how I feel. Like I am about to be killed for no good reason. I will get the 3T mri before I have a biopsy done.

      Report
    • Posted

      Good. And then if the mri shows something that warrants a biopsy, be sure to have a targeted biopsy where the needles are not randomly placed but guided by the data from the MRI. The most common way this is done is where the mri data is fused with the ultrab sound machine that guides the needles. Less common I believe is where the biopsy is actually done while an MRI is performed.
      Report
    • Posted

      Neil. Thanks. I had 2 MRIs done & follow up with a biopsy because the MRI report said "one suspicious area". Surprisingly, biopsy report also said " one suspicious area". I wonder where in the us or particular in southern CA that I can pay to have it tested if it does not cost a fortune.

      Report
    • Posted

      Viet,

         Did they give you a Gleason score on the area in the biopsy? I've never heard of a biopsy reporting " a suspicious area", I thought they always grade it with a Glaeson score. A Gleason score will give you info on how dangerous the area is at this point.

      Also, you can always have the biopsy tissue sent to another lab for a second opinion. The Gleason grading is subjective to some degree.There are very highly regarded labs, I think John Hopkins is one of them.

      Report
    • Posted

      Rich,

      That was also my curiosity question. It was only in one of 12 cores. But I didn't ask the uro doctor at that time. I also did not know if the specimen can be requested to send for a second opinion. My uro doc said to me "all good" after seeing the report. Few weeks after, I said to myself that if the doc who examed the biopsy specimen could not define a PCa cell (with no Gleason score), then it meant no PCa. I have never heard any biopsy report states "suspicious".

      Report
    • Posted

      Hi Viet,

          Why not contact the doc to ask for clarification on the suspicious comment? And also to ask about whether the specimen is available for sending out for a second opinion, if you think it might make sense. The office where I had my biopsy done was all set up to send the tissue for second opinion, apparently not an unusual request for them.

      Report
    • Posted

      I would still suggest you try the two liquid biopsies I mentioned above to really clear your mind. The tests are not subjective and detect any suspicious activity at the molecular long before they show up in scans.
      Report
    • Posted

      Neil,

      That is the reason I ask if there is a service somewhere in So. Cali that I can go in with cash payment (if it not expensive). I dont think my uro doctor will do this, so I will do it on a sideline if I can.

      Report
    • Posted

      Rich,

      It has been few months already & I am not sure they keep the remain or the remain is still good for another review. I will ask him & see. Thanks.

      Report
    • Posted

      Neil, that's not true about the PSA needing to be above 10! My PSA was 4.06, I chose to wait 6 months to be retested it went up to 6.1 after which  I had a biopsy done and was diagnosed with prostate cancer. I went on active surveillence for one year before having surgery to remove it. The reason I went a head with the surgery was I was getting frequent UTI and the span between each episode was getting closer and closer together, like every 2 months or less. I have been cancer free now for just under 1 year.

      Report
    • Posted

      Hi coachjq - yes absolutely you are correct. I was referring to the new liquid biopsies that have been available for the past few years that look at urine and blood samples for molecular biomakers for cancer. These liquid biopsies are recommended for PSA values between 4 and 10. The idea behind these liquid biopsies is that if they are negative there is no reason to proceed with the TRUS-guided 12-needle biopsy. But if they show some suspicious cells then an actual physical biopsy is recommended. The FDA is recommending these liquid biopsies to try and cut down on too many needle biopsies when the PSA is in the grey region of 4 to 10.

      Recently I had a virtual biopsy using a 3T MRI following my PAE. But these machines are also used to replace a random 12-needle biopsy since their resolution is so good that they can detect sub-mm lesions.

      So guess what? My report came back and said there was a likely cancerous lesion measuring 7 mm in the peripheral zone near the capsule and that a targeted MRI biopsy of the lesion is recommended!

      So I am some worried now. Can you tell me a little more about your own experience. Why did you wait before doing a targeted biopsy? The radiologist who read my MRI said I should not wait for the biopsy because the lesion is contained now but if it breaks through the capsule then I am in big trouble. A

      And how did you have it removed? Was it FLA?

      Thanks and all the best to you.

      Neil

      Report
    • Posted

      Hi Neil, so sorry to read you are high on the list of having prostate cancer. I am the doctor wanted to wait for two reasons: 1. I was had been having severe UTI and at the time that was more pressing. From the digital rectal exams the prostate wasn't abnormally large. 2. Since my PSA was on the low side we felt it better to deal with the UTI first. I was more concerned with the UTI. As the UTI got more frequent, I knew it was more an immediate concern. I kind of knew I was destined to get the prostate cancer and was in denial for a few years.After I was diagnosed with the cancer I was told it was slow growing and I was not in any immediate danger. I was an excellent candidate for active surveillance. I was told by many friends and my doctors that prostate cancer caught earlier is very safe. But I could have the surgery to remove it then if I wanted and could deal with the idea of having cancer growing in me. I did a lot of reasearch on the matter and everything I initially found made everything look so rosy. For some reason I changed my search question I then came up with the real truth about it from others that had been in my place and the real stastictics which was no more rosy! All the real side effects of a successful surgery and the ones that weren't by no fault if the surgeon. I wanted to wait as long as I could after I realized the cure ( once you have cancer you are never cured of it you are only in remission). I will not get into the side effects and the not so rosy part that you will not be told about at this point. Later, if you are interested in knowing just ask and I will let you know. First, get yourself ready for the biopsy and and any other tests they may have for you. I will keep you in my prayers that your biopsy comes back negative. Oh I had the DaVinci Robotic surgery. There are a few things about the biopsy for me it was really, really uncomfortable/painful. The instrument they use to stick in you is something I don't ever want to go thru it again without something numbing the area. I was told it would only be uncomfortable, BS!

      Report
    • Posted

      Thanks coachjq for your response. Did you have the DaVinci Robotic surgery to remove your prostate? Since this getting off the topic of this thread please send me a private message as I really wish to hear the rest of your story. My radiologist is almost certain it is cancer but the MRI-targeted biopsy will be in 2 weeks. After that he wants to do FLA to remove the lesion as he says it is very small and contained in the capsule and the rest of mt very large prostate is clear. But i don't believe the doctors as you say and would like to hear your whole story if you don't mind. Thanks for helping and your kind wishes. This whole thing is like quicksand.

      Neil

      Report

Join this discussion or start a new one?

New discussion

Report as inappropriate

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up