Free PSA Question

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anonymous@anonymous.net - 29 Apr 2009 07:33 GMT

I have been monitoring my PSA and Free PSA recently as about one and a
half years ago my PSA was about 2.7. I have had a history over the past
couple of years of urgent urination at times that went away with weight
loss. I was also diagnosed as diabetic about two years ago
and symptoms went away and blood sugar to normal with weight loss and no
meds. The beginning of Feb I went to MD for checkup and PSA = 5
and upon retest two weeks later it was 5.7 and % Free PSA was 18. Went
to a urologist and I was put on a course of Cipro and two weeks after
finishing the meds was retested and PSA = 4.7 and % Free PSA = 14.2. MD
tells me to get a biopsy although he keeps saying that it is not
critical and I could wait and retest again or try another course of
antibiotics but thinks it is a waste of time. He also said that I could
get an ultrasound but today said that that was probably not going to
reveal anything. He originally referred me to a radiologist for a biopsy
but I thought I should see a urologist first. Saw a urologist who told
me that I probably would need a biopsy, but said that my prostate was
quite large and that could be causing the problem, but would it cause
the % free psa to drop? The urologist did tell me that perhaps if biopsy
cameback negative I could start proscar but side effects are not
appealing! I have been taking Saw Palmetto, last couple of days Beta
Sistosterol. Have had a split stream at times, but it goes away. Could
this be prostatitis or should I definitely get a biopsy? I am not sure
what level of risk this is. It is of concern that my % Free PSA seems to
have dropped from 18 -14 in about 6 weeks. The lab results say that for
my age 54, it puts me in a 24% risk category ... 10.1 - 15.1 = 24% risk.
Any help, or experience would be appreciated. Thanks. Regards

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Roy Starrin - 29 Apr 2009 14:04 GMT

>I have been monitoring my PSA and Free PSA recently as about one and a
>half years ago my PSA was about 2.7. I have had a history over the past
[quoted text clipped - 5 lines]
>to a urologist and I was put on a course of Cipro and two weeks after
>finishing the meds was retested and PSA = 4.7 and % Free PSA = 14.2.

Regardless, your PSA is still higher than your historical

> MD
>tells me to get a biopsy although he keeps saying that it is not
[quoted text clipped - 5 lines]
>me that I probably would need a biopsy, but said that my prostate was
>quite large and that could be causing the problem,

Is this the result of a DRE? What were his comments after the did
that?

> but would it cause
>the % free psa to drop? The urologist did tell me that perhaps if biopsy
[quoted text clipped - 6 lines]
>my age 54, it puts me in a 24% risk category ... 10.1 - 15.1 = 24% risk.
>Any help, or experience would be appreciated. Thanks. Regards

BOTTOM LINE: My PSA was 1. I was diagnosed with Gleason 9 Pca in 6
0f 12 biopsy cores last December.
The fight is on.
YMMV
starrin

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lmac - 29 Apr 2009 17:14 GMT

>> I have been monitoring my PSA and Free PSA recently as about one and a
>> half years ago my PSA was about 2.7. I have had a history over the past
[quoted text clipped - 32 lines]
> YMMV
> starrin

I started tracking psa 15 years ago (age 59-74)
and have also noted some annual variation with
both weight and Saw Palmetto consumption.
(Usually I run around 1 to 1.25 with less than a
20% variation on a year-to-year basis.)

*Perhaps*... Body fat is aromatizing
Testosterone into E2. And, E2 is suspected as
being a major long-term factor in bph and
perhaps initiation of pCA. Then, maybe there
are some short-term effects of E2 on psa; and
by inference, of weight on psa.

All conjecture. But, I tend to prescribe to Dr.
Shippen's thoughts on body fat, testosterone and
prostate health.

Personal feeling. A annual jump of 20% or more
is a point of concern and reason to pay for a
retest in three months. (My HMO does not fund
psa tests beyond age 74 but, until they
guarantee me that I'm going to croak within 4-5
years from other causes, I plan on monitoring my
psa.)

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Roy Starrin - 30 Apr 2009 13:54 GMT

>I have been monitoring my PSA and Free PSA recently as about one and a
>half years ago my PSA was about 2.7.

Johns Hopkins just dropped this in my inbox:
Using PSA Velocity to Predict Prostate Cancer Risk
http://www.johnshopkinshealthalerts.com/alerts/prostate_disorders/JohnsHopkinsHe
althAlertsProstateDisorders_1425-1.html?ET=johnshopkins_blog:e19590:312986a:&st=
email&st=email&s=EPH_090430_005
or
http://tinyurl.com/dlnkn3

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