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I am new to this sight, and have spent the better part of the last week, looking at various websites, forums etc online, for any morsel of information i could find that might lead me to calm down.
Age 62, never had a biopsy, father had PC, i do not know grade, or any other info on his situation.
My PSA readings -
May 2009 - .7
Feb 2011 - 1.1
March 2012 - 1.6
Oct 27 2012 - 2.2
Normal DRE
Urologist recommended Biopsy, but said i could wait 3 months if i wanted to. I did, but changed my mind.
I decided to go to New York Presbyterian and see a doc there, who confirmed that Biopsy is called for.
I am scheduled for this Wednesday, Nov 21st.
Is it possible, if i am diagnosed, with this level of PSA that it could be advanced?
Also, does anyone have any familiarity with a Dr Spencer at Presbyterian? I chose him from his bio, and the fact that he is with NY Presbyterian, rated #5 in the U.S. in Urology.
Thats all i have to go by.
I will say at my first (and only ) visit, he was very patient, answered all of my questions and didnt make me feel rushed in any way. Spent about 45 minutes with me.
I also am crapping in my pants anticipating the biopsy. Doc said it wont be bad with the lydocaine, and yet i have heard horror stories. I don;t know if i am more nervous about the procedure or the potential results.
I had 4 biopsies over a 5-6 year period. Had them at 8 am and was sitting at my desk working by 9--they are no big deal in my opinion. I took no medicines other than the lydocane.
2 days to the biopsy. I am thinking more and more about the day i get the phone call with the results. That thought and the possibilities that go with it are terrifying. I need to just grin and bear it until the results come.
Whoa! Whoa! You seem to have gathered some strange ideas about PSA and prostate cancer, so let me point you to the piece I wrote PSA101 From that you will learn the first basic lesson – that PSA is NOT prostate cancer specific. That is to say, the majority – at least two thirds of men with an elevated PSA – usually regarded as higher than 4.0 ng/ml will NOT be found to have prostate cancer. Whilst it is true that some men with a lower PSA – like those in your range – may be diagnosed with prostate cancer after biopsy, there are fewer than one third of the men with this issue.
I’m assuming that you’ve been scared into biopsy, despite the good advice from your doctor because you think that your PSA is increasing too rapidly? If that is the case, have a look at the PSA EXPERIMENT I ran about ten years ago when I had a daily PSA test for 28 days to see how much variance there was. In one three day period my PSA went from 4.50 to 6.00 and then four days later it was back to 4.60. There are studies to show that the time of day the test is taken might show variance; that the season of the year might affect the result.
You ask Is it possible, if i am diagnosed, with this level of PSA that it could be advanced? Anything is POSSIBLE in the uncertain world of prostate cancer because the Golden Rule is There Are No Rules. If you had asked is it LIKELY that the disease would be advanced with a PSA level of under 3.0 ng/ml I’d so “No.” Generally speaking advanced cancer is associated with PSA levels in the hundreds or even the thousands – the highest I have seen is 12,000 and we have one man who shared his story who was diagnosed with a PSA of 7,000.
I realize that all this information may not be of much help. I say that because I have been corresponding for five years with one man (who is as jittery as you appear to be) who has a PSA test twice a year. Every Fall, the PSA number is up: every Spring it goes down. As I have pointed out to him, if he correlates the Spring numbers only, or the Fall numbers only, they don’t vary much, but every Fall, I have to hold his hand, so to speak and assure him that it is very unlikely that he has cancer.
Good luck with the biopsy. Although I have only had two, I had no anesthesia and did not find the procedure too bad. If you have ever played a contact sport, you’d be likely to have had more pain in that. I hope your doctor has made you aware of the fact that it is likely that your urine will be very bloody after the biopsy as will your semen and that this condition may continue for some time – that was the worst issue for me because no one had mentioned it.
All the best
Terry in Australia – diagnosed in 1996 at 54 and still gong strong
Terry - i really appreciate your response, and the points you have made.
Your comment that i have been "scared into" doing the biopsy, is somewhat accurate. BUT.....
I was told by two Urologists one local, the other at a major teaching hospital, that a biopsy is advisable, based on
1. the slow but steady rise from my initial reading in 2009 to now. (.7 to 2.2, with each test consistently higher) COMBINED WITH.....
2. the fact that my dad had prostate cancer .
With that said, they both told me that if i waited 3 months it would not be the end of the world, and would likely do no harm. But i decided, after giving it some thought, that my anxiety level dictates that i am best served by getting this done. I know that if it is negative, and my PSA continues to rise, i will have to have more biopsies, but at least i will know that for now, things SEEM TO BE clear. (i know about false negatives).
So thats why, as crazed as i am, i decided to get this done on Wednesday. If it turns out that it shows a malignancy, no matter how small or how low grade, i want to know that i have an opportunity to get out in front of it.
BTW - The second Uro that i saw, (at the teaching hospital) indicated that while nothing is for sure, he would be surprised if there was any cancer, based on my numbers (and i guess on my DRE), and also that if there was anything it would be very early in the game and more than manageable.
BUT i can't seem to hear that enough times.
So again, thanks for taking the time to respond. I will post updates as appropriate.
He died at age 77, of congestive heart failure. However the PC had spread. He had many other issues, and was in a nursing home for 3 years, which affected our ability to get him good care for the PC
Well, at least half of men our age will have some form of PC if you look hard enough, and often it is best not to look. You really want to minimise the number of hospital procedures because they do have significant risk of something not going well and that is what your doctor is probably thinking of.
I would be focusing on a heart healthy diet and getting into an exercies program if you are not already. Keep getting your PSA checked and let your doctor decide when it is time for a biopsy. Just make sure your doctor is getting and paying attention to those PSA numbers. In my case my doctor and urologist each thought the other one was keeping track of my PSA so neither one was.
Keep copies of all your medical records. Five years from now a urologist might want to see all the PSA numbers before he decides what to do.
If you are looking at mortality statistics (who doesn't) remember that three new drugs have come out in the last couple of years which is making PC almost a chronic disease, but not fatal, for cases that are caught before full blown metastatic disease has set in.
The more you read about PC the less panic you will feel. Some people should panic but you are not one of them.
Thank you Frank.
I am always leery of unnecessary medical procedures. This is why, when my urologist recommended Biopsy, i went to another urologist for a second opinion, at NY Columbia Presbyterian, a top Uro department in the U.S., and number 1 in my area. So i had 2 Drs, both Uro's and one of them a Urolological Oncologist, recommend that biopsy is recommended.
For anyone reading this that might be in my position - doing a biopsy for the first time, and being terrified ------
I had the procedure done yesterday. it was RELATIVELY SPEAKING, a piece of cake. I had no general anesthesia, i took 2 .5 MG Xanax about 45 minutes before the procedure, and the Dr injected lidocaine into the area. I would call it, annoying discomfort, but really, much to my pleasant surprise, no pain.
Also, he told me that i shouldn't experience much blood in the urine as he tries to stay away from the Urethra. And in fact, my first time urinating, there was a little bit of pink at the very beginning of the stream, but after that, nothing. No blood in stool, other than a little bit on tissue the first time. I did have blood in ejaculate and it burned a bit after my "activity", which i assume is normal. Doc told me i meight get burning when peeing for a few days, but i experienced none of that.
So all in all, i was panicked for nothing. (and i mean i was REALLY panicked. I could not function for days before.
Now the only thing left is the result. A week, possibly a bit more due to the holiday, and i will know where i stand - for now.
Well, i got an email from the nurse yesterday, telling me that my biopsy came back negative, no cancer. So i am off the hook for now. I will be speaking with the doctor next week, he was out of town. I know i will need to keep an eye on my PSA, and if it keeps rising will probably need to do this again, and again, until they find something. But at least i will be out in front of it at an early stage.
I think the biopsy was quite complete (although i realize false negatives are sometimes a reality) because he did 14 cores, and he told me my prostate was not very big for my age, only slightly larger than normal.
Thanks to all for your support and useful information.
