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Medical Forum / Diseases and Disorders / Prostate Cancer / June 2006Prostate Biopsy
My husband recently applied for a life insurance policy and was denied based on his psa reading of 5.08. Last year his reading was 3.5 and the Dr. did not seem concerned. He went back to his primary Dr. after getting life insurance results and we thought he would do another PSA as we don't know much about the lab used for life insurance. The IM Dr. sent him to a UR. He said he automatically sends with anything outside of normal range. Husband went to UR yesterday. UR was in surgery so the PA did the DRE exam and reviewed the life insurance results....still no repeat PSA. I thought was strange. One thing before life insurance test we did not know sex could cause a higher reading. I read one should abstain for 48 hours. We do not recall if this was the case before the 5.08 reading. PA felt of prostate and it felt normal....he scheduled him for a biopsy in 2 weeks. Husband's dad was diagnosed with prostate cancer at the age of 68. I called the Dr. as I could not go with hubby and asked why they did not repeat the psa. PA told me he did not see a need and I ask about free psa but he went on and I could not understand. I am okay with a biopsy if it is necessary but bothered by neither Dr. doing another psa test. I would have also felt better if the Dr. was to make the plan to do biopsy and not PA. I like PA's but this is important and serious to us. I have another UR # and have thought about going to him. I worry about seeding if there is cancer. We are going to go through with it but wanted some feedback. I read a site earlier that I hope i saved in the event I can not find it. It was great informatino from men who have had this procedure and I would like my husband to read it. Note to doctors: the patient is the consumer; the patient is the BOSS; if the patient wants a PSA and is willing to pay for it if health ins. won't, you run the damn PSA. I did not know that life ins. cos. required PSA tests. Perhaps before one gets a definitive Dx of PCa he should run out and buy term or whatever he can get. Once you get that Dx it's a different ballgame. Bill Denton RP 2/12/02 PSA .93 Memphis > Note to doctors: the patient is the consumer; the patient is the BOSS; > if the patient wants a PSA and is willing to pay for it if health ins. [quoted text clipped - 8 lines] > PSA .93 > Memphis The life insurance was to take him to 71 years old and I think a fairly large one. The previous life insurance policies we now have did not require this test. He is 51 years old perhaps they test psa after a certain age. But, yes this changes everything in regards to life insurance. I am glad we have a couple of policies but I am not sure when the run out. I fear how this will effect other areas of our life too. I am with you I do not understand why they hestiate running another test. I think for peace of mind we are going to have to insist. > The life insurance was to take him to 71 years old and I think a fairly > large one. The previous life insurance policies we now have did not [quoted text clipped - 6 lines] > I am with you I do not understand why they hestiate running another > test. I think for peace of mind we are going to have to insist. I agree with Bill (usually do), but it just may be that the doc is basing his decision for biopsy on the DRE as well as the PSA as well as his age. Which he should.  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 >>Note to doctors: the patient is the consumer; the patient is the BOSS; >>if the patient wants a PSA and is willing to pay for it if health ins. [quoted text clipped - 19 lines] > I am with you I do not understand why they hestiate running another > test. I think for peace of mind we are going to have to insist. You can certainly insist, but the likelihood that it will be enough different so as to avoid the PSA test is not too high. A PSA of 3.5 is already a bit high for a man of age 51. My feeling is that at this point a biopsy is indicated. The chances are still that your husband doesn't have prostate cancer. A more likely explanation for a sudden increase in PSA would be prostatitis, which often has no other symptoms. But a biopsy, done properly, is safe and not particularly painful, and it would go far toward clarifying the matter. The only other reason for another PSA test at present would be to help establish a baseline if it turns out he has prostate cancer, which might help in deciding appropriate treatment. It could, for example, affect which part of the Partin tables to use. You might want to discuss this with your husband's urologist. As to the insurance, it is my impression that insurance underwriters are often irrational. They often express bias rather than hard statistics. I would guess that the number of men age 51 who die of prostate cancer within a 20 years is so small that it isn't worth their while, actuarily, to do the testing. Even if your husband does end up with a diagnosis of prostate cancer, the chances of his actually dying of it in the next 20 years may be pretty small, depending on the specifics of the diagnosis. But it is their policy, and they can do what they want, whether it makes sense or not. Good luck! RocSam wrote...snip... The life insurance was to take him to 71 years old and I think a fairly large one. The previous life insurance policies we now have did not require this test. He is 51 years old perhaps they test psa after a certain age. But, yes this changes everything in regards to life insurance. I am glad we have a couple of policies but I am not sure when the run out. --------------------------------------------------------------------------------------------------------------------------- Follow this link to some relevant information on PCa and life insurance posted by Tom Cular a couple of months ago...ron http://tinyurl.com/ou29x Oh, my, does your post bring back memories. I'm not a doctor and I don't want to worry you, but knowing what I know now I would have been screaming for a urology doctor visit with the PSA of 3.5 at age 50. But 6 years ago we didn't know what a PSA was or what a 4.9 meant so we sat on it for a year. Fortunately everything has turned out well. Bev > My husband recently applied for a life insurance policy and was denied > based on his psa reading of 5.08. Last year his reading was 3.5 and [quoted text clipped - 21 lines] > not find it. It was great informatino from men who have had this > procedure and I would like my husband to read it. Bev, The first thing I read when I found this group today was about your husband. I just put the two together. You stated everything turned out well. What do you mean by that? What was the outcome of your husband's biopsy? Oh, my, does your post bring back memories. I'm not a doctor and I don't > want to worry you, but knowing what I know now I would have been screaming > for a urology doctor visit with the PSA of 3.5 at age 50. But 6 years ago we > didn't know what a PSA was or what a 4.9 meant so we sat on it for a year. > Fortunately everything has turned out well. > Bev Saying things have turned out well just means that 4 years after treatment my husband's PSA is undetectable, his radiation oncologist said he no longer needs to see him, he needs a PSA test yearly for life (done by his PCP) and so I guess that means my husband cleared that hurdle in life. Bev (hubby had 5 weeks of external beam radiation followed by brachytherapy) > Bev, The first thing I read when I found this group today was about > your husband. I just put the two together. You stated everything [quoted text clipped - 8 lines] > > Fortunately everything has turned out well. > > Bev Candidly, with your husband's PSA numbers and family history, I would say that a biopsy is a very good idea. Suppose you have another PSA and it comes back 4.5, then what - he would still need a biopsy. Expecting it to go all the way back down to 3.5 is wishful thinking, and 3.5 is too high anyway. SignaturePeter Headland > Candidly, with your husband's PSA numbers and family history, I would > say that a biopsy is a very good idea. Suppose you have another PSA and [quoted text clipped - 4 lines] > -- > Peter Headland I agree with you....I guess it is hard to accept this is happening so I am grasping at straws hoping a new test would show a more favorable light. I realize we still have to get the biopsy and I am trying not to worry or be too negative but I am worried. Something is causing the number to go up. This has come out of left field and shocked us. Lisa > My husband recently applied for a life insurance policy and was denied > based on his psa reading of 5.08. Last year his reading was 3.5 and > the Dr. did not seem concerned. He went back to his primary Dr. after > getting life insurance results and we thought he would do another PSA > as we don't know much about the lab used for life insurance. The IM Your life insurance company required a PSA, or you coincidentally had one at the same time? I never heard of a required PSA test. All his medical records will be picked up when you submit the paperwork. They usually look for high BP, Diabetes, obesity, smoker, history of cancer, etc. My wife had a rare kidney desease, and they gave us the policy at a higher rate. After a year or 2, we requested and recieved a reduction in premium to normal rates, since she was doing fine. SignatureJK Sinrod www.sinrodstudios.com www.MyConeyIslandMemories.com The life insurance required a psa. It is strange how it happend. He was planning on going skydiving....accelerated free fall....against my wishes but I would not stand in his way. He wanted to add another life insurance policy before he skydived because they ask you about this in the application. It was a high amount and it was to take him through the age of 71 years old. The did the PSA test. We have other policies and they have never done a psa. So, I guess in some instances they do run the test. I guess it might be a blessing I don't know . He would have been scheduled for his routine exam in July but many times he puts this off by letting business get in the way. The skydiving which scared the devil out me prompted the life insurance which dropped the elevated psa at our doorstep. > > My husband recently applied for a life insurance policy and was denied > > based on his psa reading of 5.08. Last year his reading was 3.5 and [quoted text clipped - 15 lines] > www.sinrodstudios.com > www.MyConeyIslandMemories.com > I never heard of a required PSA test. Family history plus high $ amount? Maybe they also saw that 3.5 PSA from the previous year and are smart enough to know that needs checking? SignaturePeter Headland > > I never heard of a required PSA test. > > Family history plus high $ amount? Maybe they also saw that 3.5 PSA > from the previous year and are smart enough to know that needs > checking? The thing is Peter is that they WANT to sell you insurance. More than you need is even better. They could easily adjust the premiums to reflect increased risk, and still sell the policy. I'm just puzzled that they could reject someone based on a non conclusive PSA test? Even if he had PCa the chances are that he'd still outlive any loss that they would incurr by collecting 10-20 years of inflated premiums. SignatureJK Sinrod www.sinrodstudios.com www.MyConeyIslandMemories.com The Insurance company did say they would reconsider after a complete urological evaluation...but at present it is denied based on elevated PSA. > > > I never heard of a required PSA test. > > [quoted text clipped - 17 lines] > www.sinrodstudios.com > www.MyConeyIslandMemories.com > My husband recently applied for a life insurance policy and was denied > based on his psa reading of 5.08. [[Bulk redacted]] > if there is cancer. We are going to go through with it but wanted some > feedback. I read a site earlier that I hope i saved in the event I can > not find it. It was great informatino from men who have had this > procedure and I would like my husband to read it. You don't give his age, which may be important. If he's 70+, 5.08 may not be unusual. However, a rise in one year of 60% is significant. Having sex before PSA testing can raise it 10%. Also, you didn't discuss the DRE. Did the doc say something about a lump or hard spot on the prostate? That might indicate cancer. Or was it enlarged? That might indicate it is not cancer. In any case, I think a biopsy is a good idea. 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 Hi Elizabeth, Hi 51 and the DRE appeared normal. The PA did the exam and not the Dr. PA told me it might be slightly enlarged but he felt no nodules. They are going to do the sonogram before biopsy. > > My husband recently applied for a life insurance policy and was denied > > based on his psa reading of 5.08. [quoted text clipped - 25 lines] > PSA .07 .05 .06 .09 .08 .132 > Non Illegitimi Carborundum Okay. I think the advice is good, but it's time to get a better urologist. 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 > Hi 51 and the DRE appeared normal. The PA did the exam and not the Dr. > PA told me it might be slightly enlarged but he felt no nodules. They [quoted text clipped - 34 lines] >> PSA .07 .05 .06 .09 .08 .132 >> Non Illegitimi Carborundum Hi Elizabeth, Sorry to hear your husband may have prostate cancer. It's always possible that it may be something else but with his father having it and his elavated PSA there is good chance that he may have early localized cancer. If so, he has a very good chance for a cure by catching it early. The insurance requirement for a PSA test may have been a blessing in disquise. If it is cancer, then you will have a big decision to make about what course to take in treating it. My suggestion if you have the time and money is to go to one of the major cancer research medical facilities such as; John Hopkins, Memorial Sloan Kettering, Cleveland Clinic or Mayo Clinic and have them do a workup and consult with professionals who have seen it all and who are on the cutting edge of the latest technology used for prostate cancer treatment. All these facilities can do all the treatment options that are available and you can rest assured you will be getting the best advise available. Each persons situation is unique and one shouldn't try and make a decision based upon anothers situation and the treatment choice they chose. One should also not make a decision based upon side effect alone. There is a lot of hipe on the internet embelishing different treatment options and the side effects associated with it. You can read all you want but in the end you will probably be overwhelmed with the information. Yes, it will be your decision in the end but you will feel better about it if you go to the experts and not rely on the internet or even forums to make a decision. Ron S. We recall very well the panic when confronted with a possible cancer diagnosis. While not retesting the PSA is a concern, you are better off with a biopsy at this point as mentioned. It will tell you alot more. Two things I didn't know - my Dad had prostate cnacer at 71 and that put me at risk to get it younger and more seriously. So in March I was diangosed with advanced prostate cancer at 60. I had a normal PSA a year ealrlier so you r odds of catdching early are enhanced by doing a biopsy at this point. Don't be afraid to seek a differendt doctor - differnedt opioinosn may be confusing but give you options. Ask where the biopsyresults will be read adn you can ask to have a second reading of them at a recognized expert center if they don't typically use one. My UR had mine read by the foemost pathoologist. Good luck, pray and keep in mind there are options regardless. Duke > Husband's dad > was diagnosed with prostate cancer at the age of 68. Let me add that it is my impression that this may not mean too much. Usually, they say that a family history of prostate cancer before age 65 will increase the risk. But once he has the biopsy, all that will probably become moot. Although it is possible your husband has prostate cancer, don't assume the worst right now. The people responding to you all had prostate cancer. Needless to say, men with high PSA who end up with negative bisopsies, usually don't end frequenting this news group, so you won't hear from them. I'm a person who tends to try to prepare for the worst, but I've found it's always a big mistake. It is impossible to do, you don't feel any better either before or after, and you spend all sorts of time looking for signs of one sort or another rather than actual facts. At this point, although a biopsy is warranted, the chances are that he doesn't have prostate cancer, and even if he does the chances are good that it is treatable. At his age, there is even an excellent chance, with a good doctor, of avoiding serious side effects of treatment. Even if side effects develop, they are often treatable and need not impact on one's life. At this point you have nothing to lose by being optimistic, and the chances are that optimism is justified. So, although it is hard, try to be upbeat and wait for results. I want to thank you all for your feedback. I had no idea this kind of support existed. I so appreciate you taking time out of your lifes to reach out. I take away from this encouragment regardless of what our future holds. Thank you, Thank you, Thank you Lisa > My husband recently applied for a life insurance policy and was denied > based on his psa reading of 5.08. Last year his reading was 3.5 and > the Dr. did not seem concerned. > I want to thank you all for your feedback. I had no idea this kind of > support existed. I so appreciate you taking time out of your lifes to [quoted text clipped - 5 lines] > > based on his psa reading of 5.08. Last year his reading was 3.5 and > > the Dr. did not seem concerned. Here's the sad, frustrating and often maddening truth. Life Insurnace companies are in business to make mpney. In reality (they won;t say it to your face) that means they don't want to pay out on ANY policy if possible. They want to take your money, period.. They'll tell you they want you to live long and prosper. That's bull. I a promoter that all life and health insurance companies should be forced to be NOT FOR PROFIT. That would get them out of the money making business. Right now most have to respond to their shareholders - who like money. A PCa patient is a high death risk in insurance company terms - therefore no insurance. They have to grandfather it when pre-existing, but it really hurts.... to the point where they my try to "buy you out" for a lesser amount now. I know! The health insurance fiasco is worse. Same motivation. Sick-o's. I can't upgrade my health insurance because of my PCa. They can downgrade it! Nice, ain't it! I fugured out what I have paid into life and health insurance over my lifetime. It's approaching six figures! Until PCa I had "taken out" less than 5 figures. Now I'm close to if not more than breaking even, ONLY IF I CONSIDER THE INTIAL INVESTMENT. If I'd had that money and invested it independently, I'd be on the French Riviera now (along with all the Insurance company CEO's), and my PCa surgeon would have used a golden robot! Insurance is a LOUSY investment, but it's something ya gotta have. There are lots and lots of people out there who make a living making money on your money. From insurance to investment, just realize what their basic motivation is (usually). Use Federal Credit Unions for your banking and financing. You are an owner. Eventually they should come up with similar organizations for insurance. They already exist for investing. Don't get me going (guess I already am)! I wanted to add update here. As you know hubby is scheduled for July 5th for biopsy. He had to go back to his IM today for another reason. He told the Dr. how the PA had done his DRE and recommended biopsy. The PA did not discuss why he was doing a PSA or FreePSA...I realize that it would not change need for biopsy but I would think the Dr. would want to run his own test...the paper work we are bringing is from a Life Insurance app. Our IM told him that he did not think it sounded right....that the Dr. should be the one doing the DRE and talking to him he has every right to ask questions about freePSA and and another. Hubby knew nothing about what the procedure entailed. I have done my research but he has not... I ask him if they did not go over with him what would take place....No, they just told him to show up on the 5th. I even called the UR yesterday and ask for an appt. for him to meet the UR and ask questions before the procedure seeing how he was out of the office in surgery the day of husbands visit. She had nothing available that would fit both their schedules. We talked today and think that before he gets the biopsy it is important for him to at least meet his Dr. and see if he likes him....I don't know I am just not very happy with his office at this point. I told the nurse yesterday that this might be routine for them but it was not for us. I am not saying he is a bad guy but I just don't feel good about the PA calling the shots...hubby said he was in his late 20's...I called and talked to the PA after visit and he was not very helpful. Any thoughts? > My husband recently applied for a life insurance policy and was denied > based on his psa reading of 5.08. Last year his reading was 3.5 and [quoted text clipped - 21 lines] > not find it. It was great informatino from men who have had this > procedure and I would like my husband to read it. Correction....why PA was not ordering another PSA or free PSA > I wanted to add update here. As you know hubby is scheduled for July > 5th for biopsy. He had to go back to his IM today for another reason. [quoted text clipped - 44 lines] > > not find it. It was great informatino from men who have had this > > procedure and I would like my husband to read it. On June 21, RocSam wrote after reciting her husband's problem with the urologist's employee aka PA: I have to confess that I'm unsure just what an "IM" is. Is that the same as a PCP (Primary Care Physician)? > I wanted to add update here. As you know hubby is scheduled for July > 5th for biopsy. He had to go back to his IM today for another reason. > He told the Dr. how the PA had done his DRE and recommended biopsy. > The PA did not discuss why he was doing a PSA or FreePSA...I realize > that it would not change need for biopsy but I would think the Dr. > would want to run his own test What have I missed? A biopsy is commonly performed when the PSA is too high and the DRE discloses a hard spot on the gland. The medic (a urologist?) depends upon his/her PA and it is unlikely that (s)he will perform another test. > I ask him who? > if they did not go over with him > what would take place....No, they just told him to show up on the 5th. [quoted text clipped - 5 lines] > Dr. and see if he likes him....I don't know I am just not very happy > with his office at this point. Judging from what is reported, I cannot fault this instinct. > I told the nurse yesterday that this > might be routine for them but it was not for us. I am not saying he is > a bad guy but I just don't feel good about the PA calling the > shots...hubby said he was in his late 20's...I called and talked to the > PA after visit and he was not very helpful. Any thoughts? > Yes. Fire the uro and shop around for one who is more attuned to the needs of his patients. Please refer to the website of the Prostate Cancer Research Institute at: http://prostate-cancer.org/index.html Also: please see that the patient himself posts inquiries. I realize that the female relatives of PCa patients all too often carry the burden of education but it is best when the patient himself participates -- best for him. Lastly, do NOT make a treatment (tx) decision based upon what is found on support sites such as this. We are PCa patients, NOT doctors. This is war unto death, act accordingly. Regards, Steve J "If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle." -- Sun Tzu, "The Art of War" > >> My husband recently applied for a life insurance policy and was denied [quoted text clipped - 25 lines] > > |
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