PSA when to Biopsy

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Ed Kratz - 02 Mar 2006 11:04 GMT

As some of you may recall, I've posted a few times before.
As ever, I appreciate the help I"ve gotten from the group
I'm waiiting the results of a 3rd PSA test in the last few months.
Reason is a PSA of 5.4 in September, after a 1.6 in January 2004. (I'm 58)
Repeat in November was 1.9 -- good news -- but a repeat in January 2006 was
2.5
Just finished 4 weeks of levaquin, and am taking a bunch of supplements.
Now, I'm waiting the results of the re-test.
Saw a URO who recommended biopsy if one more PSA was over 2.3
Just wondered if that seemed reasonable to the group.

My internist has also scheduled the free PSA,, but that won't be done unless
my PSA is over 4.0

Any comments, advice woudl be appreciated.

Thanks,

Ed

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ron - 02 Mar 2006 14:41 GMT

Ed...It is thought thst fPSA is meaningful even when the tPSA is less
than 4.0. For example:

The Journal of Urology 2002; 168(3):922-925
Robustness of Free Prostate Specific Antigen Measurements to Reduce
Unnecessary Biopsies in the 2.6 to 4.0 ng./ml. Range
KIMBERLY A. ROEHL; JO ANN V. ANTENOR; WILLIAM J. CATALONA*
Conclusions: Percent free PSA provides risk assessment but does not
eliminate many unnecessary prostatic biopsies while maintaining a high
sensitivity in the narrow total PSA range of 2.6 to 4.0 ng./ml.

...Ron

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Ed Kratz - 02 Mar 2006 21:58 GMT

Ron,
Thanks.
Unfortunately , if my PSA is less than 4.00 the lab the latest went to
probably won't do free psa.
I should have asked first.
Thanks,
Ed

> Ed...It is thought thst fPSA is meaningful even when the tPSA is less
> than 4.0. For example:
[quoted text clipped - 8 lines]
>
> ...Ron

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Steve Kramer - 02 Mar 2006 15:27 GMT

Ed, there are several causes of PSA increase. It is more common to
experience one of them than it is to have cancer. However, assuming you had
some infection and the drugs knocked it out the chafe, your PSA shows a
steady rise of about 1.6, 1.9 and 2.5. That doesn't make it cancer, but if
it were cancer, that is a pattern we'd expect. And, we'd expect another
reading before taking further action.

I think your doc is using appropriate restraint thus far.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06
PSA .07 .05 .06 .09 .08 .132
Non Illegitimi Carborundum

> As some of you may recall, I've posted a few times before.
> As ever, I appreciate the help I"ve gotten from the group
[quoted text clipped - 15 lines]
>
> Ed

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Ed Kratz - 02 Mar 2006 22:00 GMT

Steve,
Thanks.
However, the last jump to 2.5 was before the antibiotics, which I
completed a week or so ago.
We'll see what it is now.
I'm almost hoping I'd stood on the 1.9 and waited six months -- I guess
not really.
If I've learned anything from this list it's that it's best to deal with
this sooner rather than later.

Thanks again, and good luck to you.

Ed

> Ed, there are several causes of PSA increase. It is more common to
> experience one of them than it is to have cancer. However, assuming you
[quoted text clipped - 25 lines]
>>
>> Ed

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JK@work - 02 Mar 2006 18:55 GMT

> As some of you may recall, I've posted a few times before.
> As ever, I appreciate the help I"ve gotten from the group
[quoted text clipped - 12 lines]
>
> Ed

Reasonable would be to listen to your doc. A biopsy is not a big deal,
and worth the effort.

Signature

JK Sinrod
www.sinrodstudios.com
www.MyConeyIslandMemories

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Ed Kratz - 02 Mar 2006 22:01 GMT

Thanks JK

I agree.
Ed

>> As some of you may recall, I've posted a few times before.
>> As ever, I appreciate the help I"ve gotten from the group
[quoted text clipped - 17 lines]
> Reasonable would be to listen to your doc. A biopsy is not a big deal,
> and worth the effort.

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