From: daave481@yahoo.com (dave481)

My psa was down to a 32.6. The prostate didn't appear as tender as it
was two weeks ago. Psa then was 39.8.

Since my psa had fallen 7 points I took it as a good sign that it
probably is an infection instead of cancer. Is this a fair assumption?

David
============

hi david - it's a good sign that your psa took a big drop.  

but in response to your question about it being infection instead of
cancer, i would have to say, wait and see what the biopsy says.

the explanation that i will offer is that there is no doubt account for
some of the high psa rise and tenderness of the prostate is due to the
infection.

but i will add to this that while my psa was only 6.35, by comparison, i
had reduced urine flow, the prostate had pushed into the floor of my
bladder and i had BPH, so when i had the biopsy done, i was fairly sure
that the rise in psa above the 4.0 cutoff was due to the BPH condition.
plus my prostate was full of prostate stones.  i had explained it all
away logically.  

then, when i got told that both lobes had prostate cancer, it was a
surprise.  my logic didn't work...... i had prostate cancer and i was
going to have to deal with it.

i really want to say that the biopsy won't reveal anything, but instead,
i'll say, hope for the best, prepare for the worst.  this way, it will
keep you on level ground in case the results aren't what you were
expecting.

all the best,

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

On February 17, David wrote:

Every PCa specialist medic I've read or heard of strongly recommends
having the specimens sent to a specialist laboratory for a second
opinion on the Gleason grades and score (x+y=z).

I believe that this is absolutely vital, since everything that is done
from here on will be controlled by the  Gleason score. Its accuracy
cannot be guaranteed unless a specialist has examined and reported on
the specimens. This second opinion is, I understand, covered by
insurance and Medicare. Even if it were not, the ~$350 cost is well
worth the peace of mind of knowing the facts.

There are various labs: Bostwick, Oppenheimer, Uro-Cor. Google prostate
pathology laboratories.

My second opinion on my second biopsy (don't ask) was done by Bostwick
and reported important facts not even mentioned in the local lab's report.

(snip)

I must confess that due to the relatively high PSA I doubt that the
assumption is correct. Wasn't a Cipro regimen used before the biopsy? If
so, it should have killed off any infection.

But wait for the path reports....

Regards,

Steve J

"The thing is to expect nothing in particular, but be aware of the lack
of enforceable guarantees or enforceable contracts with
nature/god/entropy as to the condition or durability of our bodies."
-- Brian Brunner, PCa survivor, December 12, 2005 on The Prostate
Problems Mailing List
Thank you, Brian.

nice.

Well, my experience w/PCa has been a roller coaster of emotion.
There's no way to not hope for good news.  So true, you won't know what
the biopsy shows until you get it back.  Still, I found this and it was
the only thing that showed what amount of effect on PSA.  Apparently it
is technically possible that your PSA is due to prostatitis.  It's just
that you would be in the minority (3%) with a PSA > 20 that wasn't
cancer.  I hope you are.  You have enough to deal with anyway.  Seems
like you're getting lots of good medical help quickly.  Good job on
that.

http://www.cancer.prostate-help.org/capsaif.htm

Condition                  Manipulation Increase    Effect on PSA Level
Persists Up To

Acute bacterial prostatitis           5-7 fold        6 weeks
Acute urinary retention               5-7 fold        6 weeks
Digital Rectal Exam (DRE)         Variable       3 days
Exercise - bicycle                     0-3 fold        1 week
Prostate biopsy                   Very Variable     6 weeks
Prostate massage                    Variable        6 weeks
Ejaculation                              Variable        3 days
TURP Very                              Variable        6 weeks

Best wishes!

It is certainly something to hang your hat on, as they say.  But, with all
that is, or possibly is, going on in your colon, bladder and prostate
region, I suspect wild variations of PSA are possible regardless of your
diagnosis.

However, cancer without Cipro or something, usually does not produce
significant drops in PSA.  And 7 points is significant.

David,
What did you learn?
laurel