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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2006psa concerns/biopsy decisioins
I've gotten a lot of help from this group, and now I'm asking for more. Briefly, I had a PSA of 5.4 in September, 2005. Previous PSA's were 1/14/04 1.6 , 2/17/02 1.5 ging back to 1.1 in 10/11/01. Re-test PSA in November 2005 was 1.9. Saw URO who suggested one more re-test then if PSA was 2.0-2.3 go to six month testing. But re-test in January 2006 was 2.5. Did 4 weeks of levaquin, and urine culture. -- negative . Retest Monday was 2.8 ! I'm concerned about the rapid rise from November --- about .9 in 4 months. Not good. I'm due to travel for work the first week of April. I had wanted to get an appointment with the only doctor in our area who does doppler, targetted biopsies , but his first test would be the week I'd travel. I'm 59 and still working and the trip is kind of important for me. Here are my questions: If my internist can get me in with anyone quickly, should I go for the biopsy sooner rather than later ? Or , should I try to get an appointment with Dr. Lee in Michigan, or a Dr. Halpern here in Philly who does doppler, even if I can't get those appointments until the second week in April ? Basically, is the wait better than going with whoever my doctor can get, with the understanding that I'd then have to wait a bit longer for another biopsy. Also just wondering if anyone's seen a rise like this that might not be PC, and if there are any other tests that could be done prior to biopsy. And , actually, if it is PC, it might be a benefit that I had the 5.4 elevation, which I think was due to bike riding. Without other conditions, once I had the 1.9 in November, I probably wouldn't have had another test for a year. Or, in blackjack terms, maybe I should have stood on the 1.9, not hit it and got a 2.5, and then the 2.8 Once again, any help would be appreciated. I really appreciate it. Ed Ed, i have been on proscar for several years,for bph, so my psa results always need to be doubled to get true value. PSA- 10/7/04- 0.70 PSA-1/10/05-1.06 PSA- 5/2/05-1,20 PSA-8/8/05-1.40 PSA-11/7/05-1.77 Biopsy- 1/9/06 -Gleason of 7, (4 +3 =7) 2 cores in right lobe, (3 +4=7) i core in left lobe) (Adenocarcinoma found in 5% of involved lobes) 2/4/06 - Bone Scan - Neg 2/11/06-Cat Scan- Neg 3/13/06- started casodex-50mg, for 30 days. 3/20/06- 700 cn. rad radiation to chest to prevent gynecomastia. 3//20/06- 30 mg injection of Lupron.- Will last for 4 months. (Contraversey between Urologist & Radiologist ), on necessity for short term HT, i decided to take it because of the gleason of 7. 4/25/06-Scheduled for Palladium Seed. Approx. 45 days after will have 25 RT (IMRT) Age 69, history of Diabetes & heart disease (auricular fibrillation) Note- It is not the absolute value of the PSA, but the velocity change between readings that could indicate pca. Reminder- Never have sex the night before a PSA, as this in itself will give you a false elevated reading. Best of luck to you Ed " The Older we get, the shorter the longevity " :)) Bob, Thanks for your comments. Good luck to you. Ed > Ed, i have been on proscar for several years,for bph, so my psa results > always need to be doubled to get true value. [quoted text clipped - 32 lines] > > " The Older we get, the shorter the longevity " :)) > If my internist can get me in with anyone quickly, should I go for the > biopsy sooner rather than later ? [quoted text clipped - 4 lines] > with the understanding that I'd then have to wait a bit longer for another > biopsy. IMHO, its better to get the best biopsy you can even if you have to wait a month. Getting good data at this stage is critical. The biopsy is the most specific information you can get, if the sample actually intersects with any cancer, if there is any cancer. There is nothing to indicate an emergency here. If you get a second-best biopsy, are you going to trust it? What if it all comes back negative, and comes back with no inflammation? Another biopsy in 6 months or a year, that's what. I'd just do it right the first time. > > If my internist can get me in with anyone quickly, should I go for the > > biopsy sooner rather than later ? [quoted text clipped - 13 lines] > back with no inflammation? Another biopsy in 6 months or a year, > that's what. I'd just do it right the first time. I agree with this 100%. You might find an excellent local doctor who will do a great job on the biopsy, but you might not. If you have an appointment with someone whom you know does excellent biopsies, I'd keep it. As Juniper says, you want as much confidence in the results of the biopsy as you can get. I don't know this at all, but I also wonder if a guy who does lots of biopsies has perfected his technique and has lower rates of infection, pain, and other side effects of the biopsy itself. Alan Ed Kratz wrote: > If my internist can get me in with anyone quickly, should I go for the > biopsy sooner rather than later ? Recent study results show that delays up to 6 months are of no consequence. Have a good trip. I.P. I.P. Alan, Juniper, Thanks for your comments. I spoke to my internist this morning, and feel a little better. Made the decision to have a color doppler with someone who is an expert in this in my area, April 11th. Now I will try to put it out of my mind until then. Thanks, Ed > Ed Kratz wrote: > [quoted text clipped - 5 lines] > > I.P. > I've gotten a lot of help from this group, and now I'm asking for more. > Briefly, I had a PSA of 5.4 in September, 2005. Previous PSA's were [quoted text clipped - 35 lines] > > Ed I understand your concern. I am sure it is really wearing on you. The problem is, as we've discussed before, there are several reasons for PSA rising and compared to these, prostate cancer is less likely. That your PSA results seem to waiver up and down would further lead one to believe it is not cancer. But, those are statistics and stats don't help a human being and his concern for his health. I have not researched color doppler, so I cannot tell you if it will pick up a growth in a prostate that causes 2.5 PSA. However, I can tell you that you have plenty of time to worry about it. Go ahead and take your trip.  SignaturePSA 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 |
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