Jack has come to the right place. Wish I had done so a year ago when I
began this battle.

Why a biopsy? Did a DRE (digital rectal examination) discover a hard spot?

What is the PSA number?

What is Jack's age? General state of health?

A rise in PSA could be for reasons other than PCa, such as benign
prostate hyperplasia (BHP), infection, something else causing stress on
the prostate such as ejaculation, a DRE, some say bike riding, etc.

Lacking something more specific, I'd recommend consideration of having a
series of PSA tests to discover the trend. Or is that the "more blood
test(s)" to which Jack refers?

And there are other tests that help to complete the clinical picture.

If Jack proceeds with the biopsy, I cannot recommend too strongly that
he have a second pathological examination of the slides done by a
specialist. There are several around the country. If/when the time
comes, I'll be glad to name them for Jack.

Here are three of the many informative websites:

Prostate Cancer Research Institute http://prostate-cancer.org
Us Too! http://ustoo.com
Patients Helping Patients http://prostate-help.org

Above all, don't be rushed into a decision, as I was. Even if it is PCa,
there is time to study and make an *informed* decision.

And please keep us informed.

Regards,

Steve J
__
"Never give in--never, never, never, never, in nothing great or small,
large or petty, never give in except to convictions of honour and good
sense. Never yield to force; never yield to the apparently overwhelming
might of the enemy.''
--Sir Winston L. S. Churchill

The minute my doc said it's time for a biopsy, I bought my first prostate
cancer book. Had I bought one 30 months earlier and caught my doctor's
errors sooner, I might have added 20 years to my life span. I highly
recommend that approach, because a BIG decision may be in the works, and it
may be big enough to require weeks of research, later if not now. I strongly
believe in being very involved in our health care, and until we've studied a
couple of books on PCa, we aren't of much use to ourselves in this issue.
It's $15-40 very well spent, IMO. Start by reading the chapter on PSA right
there in the bookstore; that alone may hook you on the topic. Walsh's "Guide
to Surviving Prostate Cancer" is particularly easy to skim, just by reading
the shaded "Read this first" section at the beginning of each chapter. And
"PC for Dummies" is not a lightweight book; it's excellent.

I.P.

Well, you've come to the right place.

Without further data, it may be that you have benign prostate problems which
are treatable with Cipro, et al.  Or, depending on the rate of the rise in
PSA, your doc might send you for a "Free PSA" test.  Then, if it still looks
like cancer is the more likely, it's off to the doctor's office for a
biopsy.

Then, there is a flurry of activity that is best left to after you've seen
your biopsy results.

We wish you well.

These weren't SUGGESTIONS; they were 2x4s. Hope they didn't leave a lump on
your noggin! ;-)
The lump belongs on that quack doctor.
The moment I realized my doc had ignored my alarming PSA for 30 months, I
quizzed him on a couple of other very basic medical issues in my life and
treated (or non-treated) by him. The idiot failed three such tests out of
three in three minutes, and will never see my face again unless I'm
testifying against him in a medical competency hearing.

I.P.

Dave,

You seem to have been caught in the middle of a scientific dispute.
Some physicians believe that routine PSA testing is not merited.  They
will argue that no suitably randomized test has yet shown that routine
PSA screening for prostate cancer, on the average, saves many lives.
They will also argue that PSA can rise for a variety of reason, so there
are lots of false positives.  Also, you can have prostate cancer without
having an abnormal PSA.  (The non-specificity of the test is really
irrelevant since it is the ensuing biopsy that really tells you if you
have prostate cancer.)  They will also argue that while any man in the
US has about a one in six chance of being diagnosed with prostate cancer
in his lifetime,  only about one in six of those men actually die of it.

Urologists, who specialize in diseases of the prostate among other
things, almost all would recommend the use of PSA screening and the
treatment of many, but not all, cases of prostate cancer that are
detected thereby.  They also have very strong arguments for their
position, which I won't go into at this point.

So, what are you to do as a layman?   First, I agree with the others
that you should get another doctor.  At the very least, your doctor
should have explained the controversy to you and referred you to other
sources of information which would allow you to understand the issues.
Then he should have left it up to you to decide what to do.  On an issue
as important as this,  he shouldn't have hidden anything from you by
telling you something as if it were universally agreed upon by the
entire medical community.

Now, the next question is whether or not you should have PSA screening.
  If you were over 75, it might not be so clear.  Many prostate cancers
are very slow growing and might never bother you doing your lifetime.
One of the reasons relatively few men diagnosed with prostate cancer
actually die of it is that the great bulk of such men are older and die
of other causes first.  But at your age, my personal opinion is that PSA
testing is a good idea.  Were you to develop prostate cancer in the next
10 or 15 years, there is a strong chance it would metastasize, if
untreated, and you would suffer from advanced prostate cancer.  That is
a very unpleasant disease, and at present, the treatments for it are
somewhat limited and have very serious side effects.  In addition, there
is a good chance you would die of the disease before your time.  The
counter argument is that PSA testing might uncover a relatively benign
cancer which you would feel obligated to have treated.  The treatment
might produce incontinence and impotence.  (Serious incontinence is not
too likely if you are treated by a competent doctor.  Impotence is more
likely but in relatively young men, there is an excellent chance it can
be avoided, and in any event it can be treated.)  So you would have had
treatment you didn't need and you might have to live with some problems
resulting from it.   If someone could tell you in advance just which of
these things would actually happen,  the decision would be easy.
Unfortunately, right now no one can.

Faced with these choices, those of us here, including me, clearly opted
for treating our cancers rather than taking the chance that they might
be innocuous.

I'd charge a hell of a lot more to look at your plumbing.

Maybe that's why he gave up his medical practice and went into plumbing.

Thanks, Steve.  My two year post op PSA is still undetectable with
another 6 month draw coming up in December.  My PSA anxiety is a
little easier to bear than most of you guys, however.  I don't have to
wait to hear the result from my doctor...I log into the hospital
information system and usually know within about 4 hours of my blood
draw.
Happy Thanksgiving to everyone!
CPW