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Got another PSA yesterday, 5.0. I decided to go ahead and schedule a biopsy in October even though my urologist is still comfortable with just watching the PSA over the next few months. The MRI report indicates the possibility of low-grade cancer but I am concerned about the subjectivity of these reports. What if it's the beginning of aggressive cancer? My uro says aggressive cancer will have a high Gleason early on, but the MRI images should reflect this aggressive nature.
Your thoughts would be appreciated.
Got another PSA yesterday, 5.0. I decided to go ahead and schedule a biopsy in October even though my urologist is still comfortable with just watching the PSA over the next few months. The MRI report indicates the possibility of low-grade cancer but I am concerned about the subjectivity of these reports. What if it's the beginning of aggressive cancer? My uro says aggressive cancer will have a high Gleason early on, but the MRI images should reflect this aggressive nature.
Your thoughts would be appreciated.
Jerry
Hi Jerry,
I would consider finding another urologist. Any uro that has a patient with a PSA of 5.0, and advises to wait a few more months, is someone to run away from.
While it does not fall into the normal category, it IS VERY possible for such a PSA number to be associated with more aggressive prostate cancer. In fact, I've seen at least one other person who turned up with prostate cancer even with a PSA of UNDER 1.0.
I don't recall if this case involved a higher Gleason score or not, but that is also possible.
I don't recall from the earlier part of this thread, but do you have BPH? If so, that could also be an explanation for your 5.0. But that still does not rule out the possibility of having a tumor at the same time. Two uros urged me to have a biopsy with a PSA similar to yours, and I refused -- until my number went up a couple notches.
Turned out that I DID have prostate cancer all along. Fortunately, it was Gleason 6.
I would suggest that you do need to have a biopsy. If you do, best to make sure the uro has a lot of experience and a good track record/reputation.
Good luck!
Chuck
esident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain painlessly removed morning after surgery.
Catheter painlessly out in 7 days. No incontinence, occasional minor dripping. 100% continent after 3 weeks.
Post-op exams 2/13/12, 9/10/12, 9/9/13, 9/30/14 PSA <0.1. PSA tests now annual.
Semi-firm erections from time to time 3+ years post-op.
Sexual function affected, pre-op, from significant BPH.
MRI Fusion Biopsy results were negative for cancer. 16 cores were taken with 4 cores targeting the small spot noticed on the MRI. Will get PSA's every three months for now. If PSA continues to rise a second MRI will be done followed by biopsy.
Thanks again for all your comments. I read many of the stories which were a tremendous help in calming my nerves.
Jerry
You are correct about the bicycling, masturbating, etc., prior to the PSA blood draw.
Basically, the preparation for a PSA test includes the following:
IN THE 48-72 HOURS BEFORE THE TEST:
* Do NOT have any kind of sex
* Do NOT ride a bike
* Do NOT perform any strenuous exercise
* Do NOT have a digital rectal exam performed
All of the above activities can put stress/excitement on the prostate and, as a result, trigger a falsely high PSA reading.
