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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2004PSA Velocity question
I have mild BPH and have had a negative prostate biopsy a year ago. My PSA seems to move quite a bit -- all under 4.0. Is this normal? Should I pursue further testing? Date, Total PSA, Free PSA Nov-94 1.2 Feb-96 1.6 Nov-96 1.1 Dec-98 2.3 Apr-00 1.9 Feb-01 1.9 Feb-02 3.7 May-03 1.6 Oct-03 3.1 0.5 Thanks. hi michael - are you sure the .05 on the free psa? it should be above 25. as far as the psa velocity question. you're bouncing around, but you could have some prostatitis which might be why the psa jumped. however, take your psa in march and see what it shows. if it stays up, you might request a round of antibiotics and another psa test of a couple of weeks. that is how i got started down this road of pca, but they also caught it early. if the psa still stays up after the antibiotics, then you want to look at another biopsy. at that point, you know something is going on, but they haven't put their finger on it yet. you have kept track for a long time which is something to be commended. on a side note. you said you have mild BPH. are you taking S.P? if you are then the estrogen in that will drop your psa level some and you need to know that in order to discontinue it a couple of weeks before your test. hope this helps. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional Actually, that # is probably correct - I think he said ".5" - since free psa is measured as a percentage, .5, or 50%, would be a good #. Mine was 6% - uro told me I had cancer even if the biopsy came back neg - which of course it did not. I thought I read somewhere that 'most' PSA cells are bound. I dont' recal the exact quote, only the impression it made upon me that having a score of say > 40% would be extraordinary. I've never seen an actual score of even 40%. I think all the documentation I've read lists three or four ranges with the highest range being > 25%. It's all fuzzy in my head at this point. I have a few books. I'll see if I can find the answer. But, I'm thinkin' 50% is either not correct or maybe an indication of some reverse problem.  SignatureWishing you a Happy New Year Prostate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .3 .4 .8 EBRT 05-07/2002 @ 47 PSA .3 .2 .2 .2 .3 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .1 Lupron 7/03, 8/03, 12/03 > Actually, that # is probably correct - I think he said ".5" - since free psa is measured as a percentage, .5, or 50%, would be a good #. Mine was 6% - uro told me I had cancer even if the biopsy came back neg - which of course it did not. > ... > if the psa still stays up after the antibiotics, then you want to look > at another biopsy. at that point, you know something is going on, but > they haven't put their finger on it yet. > ... According to Walsh, I don't remember where and don't have the book in front of me, most cases of prostatitis are NOT due to bacterial infection and will not respond to antibiotics. It appears to be a common conception that, if you have prostatitis, you should take antibiotics, and if the prostatitis doesn't go away, then you have some other problem, e.g., cancer. I'm no doctor, so beware of my advice, but it's my understanding that both of these conceptions are wrong. I suffer from pain in the prostate region which, presumably, is included in the non-specific heading of "prostatitis". My doctor did a bunch of blood tests, for example looking for a high white blood cell count, that might indicate infection, and didn't find any. I also had no fever - another common sign of infection. She decided I should not take antibiotics. I concurred with that decision. It seems to me to be a mistake to take antibiotics if there's no evidence of infection. A friend of mine told me that he suffered from prostatitis for a couple of years and took courses of antibiotics without any effect. Eventually it went away by itself. I was given a 10 day course of antibiotics around my brachytherapy procedure, to prevent infection from the procedure - but it had no effect on the prostatitis. If I remember correctly, Walsh thought that less than 10% of prostatitis cases were due to infection and that the true cause in the majority of cases is not yet known to medical science. Alan hi alan - we know that you can not get an antibiotic to the source of the infection through the blood stream when it comes to the prostate. that is why they treat you with an antibiotic that passes through the urine flow. in my case they had me on some heavy doses of levofloxacin 500 mg. the purpose of it is to kill the infection as it passes through the prostate on the way out. after a two week treatment of this, then they had me come back in and run the psa test again. it did drop down from 5.47 to 4.79, but they said that was not good enough. and after coming off the levofloxacin and having to waiting for three weeks, my psa was up to 6.35 by the time i got to see the surgeon at the initial meeting. that is when he set up the appt for the biopsy, but told me at the initial meeting that i had over a 25% chance of having prostate cancer based on what they have done so far. then one third of the cores came back positive and the rest is history. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional Most definitely you should pursue further testing, especially since your total PSA rose from 1.6 to 3.1. First, a "normal" 4.0 doesn't mean squat. You still can have prostate cancer if your PSA is under 4.0. For example, Norman Shwarzkopf, the general, had a PSA of .05 and had prostate cancer. Secondly, a prostate biopsy will miss the cancer about 10-30% of the time, which makes followup biopsies all the more important. For example, I needed to endure 3 biopsies--34 samples in all--before they found my prostate cancer. With you,however, your PSA may be from BPH. But you MUST stay on top of this. Steve >I have mild BPH and have had a negative prostate biopsy a year ago. My PSA >seems to move quite a bit -- all under 4.0. Is this normal? Should I pursue [quoted text clipped - 12 lines] > >Thanks. |
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