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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2004supportive info
Thanks to everyone who replied to my inquiries last week. The answers were extremely helpful in deciding how to respond to the fact that my PSA was at 4.25 and my doctor was recommending a biopsy, which *was* scheduled for next Wednesday. After it was mentioned here that sex prior to a blood draw can result in an elevated PSA, I scheduled a second test. As the nurse was preparing the draw, I asked if they could also count free PSA -- which I also learned about here. She replied that the in-house lab didn't do that and sent me across town to the hospital lab where it could be done. I spoke with my doctor today who said his recommendation for a biopsy was withdrawn, based on the reduced PSA of 3.3. I'll return in six months for another test, and again be mindful of potentially elevating activities prior to the test. No sex, water-skiing, or strenuous dumps, to be sure. Thanks again! t A 3.3 is still not low but let's see how the fPSA returns. If it is above 25% then you are probably fine. But if it comes in at 8, 10 or 13% you've got to get that biopsy! Bev > Thanks to everyone who replied to my inquiries last week. The answers were > extremely helpful in deciding how to respond to the fact that my PSA was at [quoted text clipped - 15 lines] > > t > A 3.3 is still not low but let's see how the fPSA returns. If it is > above 25% then you are probably fine. But if it comes in at 8, 10 or > 13% you've got to get that biopsy! I'll try to get a copy of the lab report tomorrow and tell you exactly what it says. However, what the doctor said to me on the phone was that with a PSA below 4, the fPSA doesn't have any significance and is only calculated by the lab if the total PSA is above 4. What he said, I believe, was that research doesn't support giving any weight to fPSA if the total is below 4. I didn't ask for references. With 3.3, he said he was no longer recommending the biopsy and I should come back in six months. Concur. Get the report!  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > > A 3.3 is still not low but let's see how the fPSA returns. If it is > > above 25% then you are probably fine. But if it comes in at 8, 10 or [quoted text clipped - 10 lines] > With 3.3, he said he was no longer recommending the biopsy and I should > come back in six months. > > A 3.3 is still not low but let's see how the fPSA returns. If it is > > above 25% then you are probably fine. But if it comes in at 8, 10 or [quoted text clipped - 10 lines] > With 3.3, he said he was no longer recommending the biopsy and I should > come back in six months. If I remember correctly, there have been a few guys here over the past 18 months who had a lower PSA but were positive. I hope that you *DON'T* have PCa, of course.... but *do* keep an eye on it! Doctors have been known to be wrong... and one thing I've learned from this list is that you have to be your own advocate! If they didn't do a fPSA.... I'd have blood drawn again and be sure they *did* one. Hope it all turns out as well as it seems at the moment, guy! Take care.. MikeH > If I remember correctly, there have been a few guys here over the past > 18 months who had a lower PSA but were positive. I hope that you [quoted text clipped - 3 lines] > If they didn't do a fPSA.... I'd have blood drawn again and be sure > they *did* one. Thanks. I will. For the last couple of days I've been unusually busy at work and haven't yet found time to stop by the urology office to pick up a copy of the lab report. I did ask for fPSA to be run and I believe that it was. However, in reviewing the results with me on the phone my urologist said to me that with a PSA below 4 the fPSA isn't a useful measure. There seems to be disagreement on that point here. When I do pick up the report, I'll post the fPSA result here for the informed advice of group members. > > A 3.3 is still not low but let's see how the fPSA returns. If it is > > above 25% then you are probably fine. But if it comes in at 8, 10 or [quoted text clipped - 10 lines] > With 3.3, he said he was no longer recommending the biopsy and I should > come back in six months. Hi t. When you refer to your doctor, is he an internist or a urologist? If the former, go to a urologist. My *former* internist kept telling me my PSA was "normal" for someone my age with bph. He apparently was ignoring the velocity. He used to refer to some chart he kept in the office. When I demanded a free PSA test, he ordered it. Called me up over the phone and told me it was completely "normal". When I asked him for the percent, he said no per cent was given. I went in for another PSA test 4 months later, happened to glance at the free PSA report, and saw that it was 15%. Since I knew anything below 25% was bad, I almost yelped when I saw the score. I pointed it out to him, and he said "Don't worry. Look how *low* it is." I went to a urologist. He ordered a biopsy. It came back 3+3. Had an RP on 5/2/02. Post op biopsy was 3+4, and the margins were not clear. So far I have been "undetectable", and I'm now sweating out results of the latest draw taken yesterday. Had my internist understood the importance of the "slowly" rising PSA; had my internist understood the free PSA test results, might I have been operated on earlier, had clear margins and a better surgical result? I'll never know. Our local Man to Man group recommends all PSA testing be done by a urologist. * * * > Hi t. When you refer to your doctor, is he an internist or a > urologist? * * * A urologist. I also discussed the results with an internist friend who was dismissive of the earlier 4.51 PSA result. Despite the friendship, with regard to prostate issues I put more confidence in my urologis. So, what was your free PSA? SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > Thanks to everyone who replied to my inquiries last week. The answers were > extremely helpful in deciding how to respond to the fact that my PSA was at [quoted text clipped - 15 lines] > > t |
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