Dave, I am sorry to tell you that 39.8 is very high.  Of the 408 people that
have reported their PSA in this NG in the last four years, only 26 have
reported higher PSAs.

If it is not cancer, it's certainly a serious prostate problem.  I would, if
I were you, start reading up on prostate problems.  Dr. Patrick Walsh wrote
a very good book.  It's titles something like "The Prostate" and subtitled
something about men and the women who love them.

If it turns out to be cancer, switch to his other book, Gude to Surviving
Prostate Cancer.

It is a very good reason to have a biopsy.  I don't think it is possible
to say much definitive beyond that until you know the results of the
biopsy.  You may or may not have prostate cancer.  If you do, then the
biopsy will provide a lot more information, and at that point you can
decide what to do next.  Take it one step at a time.  There is no point
assuming the worst, since you would have wasted lots of nervous energy
if it turns out to be a false alarm.   Note however, that with prostate
cancer, the worst is seldom as bad as you might imagine.

Good luck.

Dave, there is no point in getting worried yet, but make sure you follow up
and get that biopsy. That will determine where you go from there. My own psa
was 55 over five years ago and yes, it was cancer in my case. But I am still
here today,  and I like it here, and I am doing whatever I can to try and
stay here for as long as I can. You have something to deal with here, cancer
or not, and a biopsy is the first step. Best wishes for you. Many of us will
be watching for news from you.

Dave...That is a high PSA reading and it could be caused by cancer or
urinary tract infection.  How old are you?  Have you had previous PSA
tests?  Do you have a history of prostatitis?  If you had a PSA run,
say a year ago, and it was 2 or 3, then it is unlikely that cancer
could cause your PSA to jump to near 40 in a year.  If you do have a
history of more "normal" PSAs or if you have a history of prostatitis,
then taking an antibiotic, like Cipro, for a few weeks and having your
PSA remeasured, might be a reasonable alternative to immediate biopsy.
The information gleaned from that step would comment further on the
need for a biopsy...Ron

 Dave when is the last time you had it done, and at what age?

Yes - it is VERY alarming - mine was 4.65 when I was sent to bio

Dave,

We (I am the wife) had a PSA of 26.7 in December, and we are basically
new to this like you.   There is too much to learn, too fast.  But
actually it will all work out.  All the responses are good.  I am
writing to tell you some things we learned the hard way.  1. Get the
free PSA test BEFORE the biopsy.  If done after the biopsy the results
mean nothing (until 6-8 weeks).  2.  Get the next PSA test BEFORE the
biopsy.  Same thing about the results.  3.  The Cipro is a good idea,
you need to take it a couple of weeks before the biopsy so you can get
another PSA BEFORE the biopsy to see if it had an affect.  You may not
want to wait on that, probably not. 4.  If anyone recommended other
tests, find out if the biopsy will affect the results, and if so, get
the test BEFORE the biopsy.

We are getting an endorectal MRI with spectroscopy on the 20th.  That
is the ONLY MRI that is really useful, and your would probably do well
to put all posted tests on this group for info before you do them.
Because if you have, say, a regular MRI then your insurance isn't going
to do one with spectroscopy also.  I don't think an MRI is indicated
before a positive biopsy, so that's why I didn't put it in my numbered
list.  They guys will have to correct me if I'm wrong.

There is some prioritizing necessary here.  It sucks to have none of
the appropriate tests done and have to wait 6 weeks to get information
you should have had before the biopsy.  Basically, you should get right
on it but if possible without compromising your timing, get more
bloodwork before the PSA.  For one thing, PSAs can vary as much as 30%
in a day.  For another, you can see if it is going up or down.  In a
week that probably wouldn't say much.  But it might.  Also, get your
PSA done at the same lab every time.  Labs use different processes and
the results aren't that comparable.

About the biopsy, they should put each sample in its own petri dish.
Basically, my husband had 10 cores but they put them into a Right and a
Left dish, so it was only two samples.  You are going to want as much
information as possible because it is all so inexact anyway.  Also, if
it is positive (and maybe if it isn't), you will want a 2nd opinion
from one of the specialist pathologists in the country. You should
probably tell them during the biopsy.  Mayo did our biopsy and the
first results we got were 4+3=7.  After I asked for the samples sent to
another lab, apparently they redid it because the next copy of the path
report said 3+4=7. (That's what the 2nd opinion found also.)  There is
a difference between those two numbers, that could be significant.

Do you know that a biopsy may come back negative even if you do have
cancer?  A biopsy samples only a tiny fraction of the prostate.  So
even if you get negative results, you should probably keep on this
until you get a clear diagnosis of whatever.  That is a very high PSA
even though you hear of #s in the hundreds and thousands.

My husband Steve has a huge history of colon cancer in his family, in
addition to prostate cancer.  I hope that is not what you have, but it
sounds like they are checking that out.  Please keep posting what you
learn, because it will help us.  (Everyone is so full of disclaimers, I
will make one of my own: I know your experience won't be the same as
ours.  Still, the human experience is valuable to other humans.  Trust
me to have good judgement.)

Dave, good luck and best wishes.  It's a big, shocking deal to have
something like this happen, whether or not it is cancer.  I am sort of
embarassed by it, but I have basically lived out the first 6 weeks
since the PSA on this NG.  You can search by author (at least in Google
groups) if you want to read my travels/travails.  Boring probably.  But
it may be helpful to see someone's posts in the same part of the
process as yourself.

Regards,
laurel

http://www.phoenix5.org/menuvideos.html
http://www.prostateforum.org/videos.cfm - I ordered from these guys and
it was here in 2 days.  We got this one: 302. - "The Challenge for a
Newly Diagnosed Prostate Cancer Patient to Choose His Initial
Treatment" by Mark Scholz, M.D. and Medical Oncologist from Healing
Touch Oncology in Marina del Rey, California at the East San Gabriel
Valley Prostate Forum on 11/19/02. 98 minutes. This is probably the
best video for newly diagnosed men.

Might be something till you get the books.  My husband likes "A Primer
on Prostate Cancer: An Empowered Patient's Guide" for its completeness.

Mine was 39.6 on MArch 29, 2001.  Cancer found in all 12 samples of
biopsy.  Had spread to seminal vesicles.  I have a had a lot of
treatment and now PSA as of Sept 7, 2005 was .25.

Get ready for a real challenge.  Best of luck.
Allan