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Medical Forum / Diseases and Disorders / Prostate Cancer / February 2007diagnosis
Greetings to all Over the past four years my PSA has jumped up and down but recently hit 5.2 up from 4.5 a year ago.... my Gp referred me to a Urologist because of the rising trend..the Uro ordered a Free PSA test, results expected in a few days... Aside from this rise in PSA I am puzzled by the lack of symptoms ...the Uro has indicated I have a 25% chance of PC but I believe he is using biopsy stats rather than my medical data... hopefully someone can place them in context for me.. I do NOT wake at night to urinate, ..a full 8-9 hours of sleep I urinate 5-6 times daily ( normal I believe ) I have no pain during urination or ejac I started taking Saw Palmetto rec by my GP and within 10 days my output of urine doubled DRE reflects a slightly enlarged prostate, nothing unusual according to Uro I do not have brothers or a father with PC I am 61 , the correct age group for BPH to make its appearance If I recall my conversation with my GP, he says likely BPH I understand that PC sometimes shows no symptoms...but can anyone suggest a symptom that I would experience that would point to PC rather than BPH ? Just looking for common sense deductions based on my symptoms or lack of ... TIA Gordie > Greetings to all > [quoted text clipped - 28 lines] > > Gordie Gordie, Unfortunately, PCa rarely exhibits any noticeable symptoms at all until it is fairly advanced. There is probably a very good chance your problem is benign prostatic hyperplasia, but as your Urologist suggests, there is a lesser chance it could be PCa. If the results of your free PSA are suggestive of PCa, your Urologist will probably suggest a biopsy next. I'm sorry, but as far as I know, there is nothing definitive that can be deduced from your lack of sympoms alone. Good luck, and let us know how that free PSA comes out.  SignatureJerryW Please respond to group; email address is not valid 2/11/04 PSA 2.6, Suspicious DRE (age 62) 2/23/04 Biopsy: Gleason 3+4=7, T2a, left lobe 5/18/04 RRP, Path: Gleason 4+3=7, T2c, both lobes Fully continent by 9/04 PSA <0.1 since > Greetings to all > [quoted text clipped - 26 lines] > > Gordie My husband didn't have any symptoms either, although his father did die from PC, but luckily he had a biopsy done (colored dopler test done only by a couple of experts in California and Michigan, I think) and he does have PAC. We are presently educating ourselves in order to choose the treatment we want to pursue. So far, the disease has not spread outside the prostate (he had a bone scan and CT), so we are hopeful that we are looking at a good cure-seeking regimen and he will have a long life ahead of him. Hopefully you won't have the same results, but I wanted to let you know that symptom-free doesn't mean PC free. Norma > > Greetings to all > [quoted text clipped - 46 lines] > > - Show quoted text - Norma: My husband had a negative 18 core biopsy last summer but his PSA is still rising. The uro who did the biopsy wants to do another biopsy (not a surprise) but we feel that if he missed it the first time, what's to say that he'll find it on a repeat biopsy? Therefore, my husband has an appointment with Dr. Bahn, one of the color doppler experts (in Ventura CA. We're about a five hour drive from there), for 2/15. We're hoping that test shows nothing but at least the color doppler is not a "random biopsy" such as the one done last summer. Good luck. CW89134 > > > Greetings to all > > [quoted text clipped - 63 lines] > > CW89134 He is excellent!! There is less pain with that procedure than the usual biopsy procedure, we saw everything as it was happening, and we are very satisfied. This is an excellent physician. Good luck! Norma > > > "john" <ballacal...@shaw.ca> wrote in message > [quoted text clipped - 95 lines] > > - Show quoted text - Norma: You say "we saw everything as it was happening". Were you allowed in the room while the procedure was underway? Thanks. CW89134 ___________________________________________ > > > > "john" <ballacal...@shaw.ca> wrote in message > > [quoted text clipped - 105 lines] > CW89134 > ___________________________________________ Definitely!! They practically insisted on it. He explained everything as it was happening, and I stayed for the whole procedure and the office visit after. Norma <snip> > > > > Norma: > > > [quoted text clipped - 41 lines] > > Norma I forgot to add that we received a lot of educational materials about treatment options, pictures from the Dopler exam were given to us, and all materials and info were sent from the pathologists report, etc. We have had the slides sent to Mayo Clinic, where we will be seeing a specialist in radiation/oncology, who is an expert in doing hundreds of treatment protocols with patient each year. He also discusses any surgery possibilities. We are trying really hard to make the best treatment decision we can. Dr. Bahn also does treatment, of course, but we live in another state. Norma > Greetings to all > [quoted text clipped - 22 lines] > I understand that PC sometimes shows no symptoms...but can anyone suggest > a symptom that I would experience that would point to PC rather than BPH ? Hi, John (or Gordie). I imagine a majority of the people here were diagnosed while they were asymptomatic. I was. That's one of the great things about keeping track of one's PSA after 50 (or 40). The fact that your DRE came back normal, but enlarged, is good news. Doctors often lie about the actual percentages in the early going, but I think in your case 25% is probably fairly accurate. I would advise going through the fPSA testing and biopsy and to not worry about it. If it does end up being cancer, it sounds like you have caught it in time. 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, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum Sorry Gordie, but prostate cancer rarely shows any symptoms until far too late in the game. When you say your PSA has "jumped around" what does that mean? It sounds like 5.2 is a new high and 4.5 was the previous high. What was it before that? Get the Free PSA and report back here. Also, don't swoon if your uro wants to do a biopsy. Your PSA numbers are pointing you in that direction. Just remember, BPH does produce symptoms, none of which you have, and early prostate cancer does not produce symptoms. You gotta follow up on this even though there's "only" a 25% chance of it being PCa. I'm a PCa survivor and I had exactly the same lack of symptoms you have except my PSA topped out at 4.9. Dave Perry > Greetings to all > [quoted text clipped - 26 lines] > > Gordie > Greetings to all > > Over the past four years my PSA has jumped up and down but recently hit > 5.2 up from 4.5 a year ago.... my Gp referred me to a Urologist because of > the rising trend..the Uro ordered a Free PSA test, results expected in a > few days... I hate to tell you this John, but "TAG YOU'RE IT"..... at 61 years old and an escalating PSA, looks like you've aquired the beast. Not to worry, it's not a death sentence if indeed your biopsy turns up positive. We're here to help answer your questions about courses of treatment and returning to a semi-normal life. Keep us posted. SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com > I hate to tell you this John, but "TAG YOU'RE IT"..... at 61 years old and That's a bit premature. This is a real but low probability, not a certainty. Wait until the results of a biopsy. > an escalating PSA, looks like you've aquired the beast. Not to worry, it's > not a death sentence if indeed your biopsy turns up positive. We're here to > help answer your questions about courses of treatment and returning to a > semi-normal life. Keep us posted. Definitely not a death sentence. At this point, more like the doc's saying, "you have hypertension and I don't like your serum cholesterol." The next step, the tests, biopsy, will give you a better picture. The hope is that they say, "everything looks clear". If not, for early detected, lowish PSA disease, the treatments (radical surgery or radiation) are 90% successful. If those fail, there are holding strategies using powerful (and expensive drugs) that frequently buy years of life. There is a cost in side effects. Surgical patients deal with incontinence and use pads for a while; radiation patients have "blockage",take Flomax and grunt while going. Both have major issues with erections and orgasms but most recover some or all of this part of their life. Most times, Vitamin-V helps but some resort to MUSE injections. Neither surgical nor radiation patients ever really know that they are cured. That's how it looks from here. -kh Most of us had no "symptoms" either. I wish the best for you.... Gourd Dancer > Greetings to all > [quoted text clipped - 28 lines] > > Gordie > Greetings to all > [quoted text clipped - 14 lines] > I started taking Saw Palmetto rec by my GP and within 10 days my output of > urine doubled One of the things to be aware of is that Saw Palmetto will lower your PSA some. That means that your actual PSA is probably a bit higher. GP's don't always realise this. My *former* GP prescribed Proscar for what he assured me was just benign enlargement. He had no idea that Proscar can reduce the PSA by half and looked a little befuddled when I mentioned the article I read. I had similar PSA's when I was 64 in 2002, shortly before I was diagnosed with PCa. Had an RP that May. Margins were not clear and my Gleason was 3+4. However, I have been fortunate so far. No recurrence yet and I am basically continent and have decent erectile efficiency for my age. On 01 Feb 2007, you wrote in alt.support.cancer.prostate: (in part) > I understand that PC sometimes shows no symptoms...but can anyone > suggest a symptom that I would experience that would point to PC [quoted text clipped - 4 lines] > > Gordie Gordie, In most cases I don't think that many of us had any symptoms of PCa. I didn't have much, except perhaps chronic lower back pain for a couple of years that might be attributed to prostate cancer. Most PCa is caught because the patient has shown an abnormal spike (or rising treand over time) in the PSA test, or what might be referred to as a velocity (PSAV) change. PSA tends to naturally go up as you age but there are many causes, especially inflammation. It used to be that the family doctor would watch for a spike of 0.75 but now I think most docs should be or are using 0.60. From what I've read, Free PSA (fPSA) is a good indicator about the probability of having PCa. I believe fPSA of 25% or higher is a good indicator that there is no PCa while, I believe, a reading of 15% or less indicates a possibility of having the disease. Neither might be for certain. However, I am just a patient and not a doctor. I do not know that this is absolute. I hope that your result is what you want to hear! Russ >I do NOT wake at night to urinate, ..a full 8-9 hours of sleep >I urinate 5-6 times daily ( normal I believe ) [quoted text clipped - 5 lines] >I am 61 , the correct age group for BPH to make its appearance >If I recall my conversation with my GP, he says likely BPH John I don't want to scare you any more than you are probably already scared, but my history is similar to yours. Over a period of about five years I experienced a steady rise in my PSA. Three consecutive biopsies confirmed I had BPH. The following year my PSA doubled, coincidentally during a time I had been totally symptom free, and the fourth biopsy confirmed the beast had taken hold. I will keep my fingers crossed that things go differently for you. If it is BPH, a series of Bactrim will make it go away. If not, there are many options available and you have plenty of time to choose the one that's right for you. If possible, do not panic and do not get in a hurry. You will get through this, and we will be here to help. Wishing you good health and Aloha from Hawaii Mike Diagnosed with PCa Nov 2006 at age 55 PSA 13.8 Gleason 3+3=6 T1c Asymptomatic No Incontinence or ED da Vinci RLRP planned for Feb 20, 2007 Diagnosed with cardiac ischemia Jan 2007 RLRP postponed pending cardiac eval Feb 7 >If it is BPH, a series of Bactrim will make it go away. Gordie To correct my previous post, if it is *prostatitis* a series of Bactrim will make it go away. BPH is often treated with drugs such as Avodart or Flomax. Sorry for any confusion. Mike Hello, Gordie: When I was going through the process of discovering that I indeed had prostate cancer, there was a point at which the urologist said that I had a 28% chance of having cancer. My PSA was 5.1, high for my age of 50 (at the time), and a DRE showed a very slight bump on the left. My urologist's assessment at that point was that 28% of the time, patients with those numbers eventually are diagnosed with prostate cancer. I'm guessing, but that's the likely basis of the probability you're hearing. And like you, I had no symptoms! For me, that was the most aggravating part of the whole thing. So, I hope it's BPH or prostatitis or something like that in your case. But you should be prepared for all possibilities. Even if it is prostate cancer, you'll have a lot of options. -charlie > Greetings to all > [quoted text clipped - 26 lines] > > Gordie > I understand that PC sometimes shows no symptoms...but can anyone suggest a > symptom that I would experience that would point to PC rather than BPH ? Yes: biopsy results. All your PSA means is that it's probably time for a biopsy. Not to worry . . . they don't hurt for most men because the meat involved has minimal pain sensors. > Just looking for common sense deductions based on my symptoms or lack of ... As others said, symptomatic PC usually portends uncurable cancer. The whole point of PSA and biopsies is to catch it while it's curable. Go read a PC book, at least the first half or so. Given your age and PSA, it's time to bone up on the subject; it may save your life. I.P. > Greetings to all > [quoted text clipped - 26 lines] > > Gordie Gordie, I am 60 (and a half) with ZERO symptoms as you are now and similar family history. However, I have 3 PSA test last year (3 months apart), showing 6.4, 5.9, 7.4, thus my family doctor sent me to a Uro who then performed a biopsy. One of 12 cores showed G(4+3), and a palpable nodule in right side, and volume of 60 cc. So, no symptoms does not mean you don't have PCa. At this time, PSA is the only known and common method for DX-ing of potential PCa. Biopsy may catch it too, if the cores pick up the right samples, but I was told that the typical biopsy, taken from the back of the prostate have no way to determine if the abnormality is toward the front of the prostate. I suggest you get a second, and third opinion, just to be sure. I did, and now and in the midst of RT process. My family doctor did not notice the noudle. The second opinion doctor was to interested in peforming surgery and summarily reccomended one without doing a DRE (just looking at my MRI data), and the third and fourth and fifth doctors found the nodules via DRE (third was another surgeon, 4th and 5th were RT oncologist. |
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