Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 (snip) > My PSA came in this month between 3.6 and 4, within two weeks of each other. > If he is so concerned for cancer why schedule me for a biopsy in a > month and wait. Also if you had the biopsy, I'd like to know how > irritating the procedure can be. They said the procedure is an plain > office visit. There are folks who claim that the biopsy was no big deal and others who say that it was agonizing. I say that, unless a guy is some sort of macho idiot, why gamble on pain? I recommend demanding local anesthesia. YOU are in charge. Regards, Steve J Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 Hi Tony, I'm not qualified to advise whether you should have a biopsy, though free PSA of anything less than 25% is usually taken as a sign that there may be cancer. Also you don't give your age which can have a bearing on whether 3.6 can be considered high. However let me put your mind at rest over the actual biopsy procedure. (My stats were 5.5 PSA, 10% free PSA, age 48) I was very worried before I had mine as I'd heard horror stories of how painful it could be. I had heard it compared to a visit to the dentist which did nothing to allay my fears at all. However I found the procedure way less traumatic than I'd feared. It was virtually painless. Out of the 12 samples taken 10 were totally painless, one I felt a slight jolt, and the final one a slight split second sting. Make sure if you go ahead with the biopsy that your Uro will be using a local anaesthetic. I didn't feel the anaesthetic injection at all either - much better than being at the dentist. Also ask your Uro if he can recommend oral pain relief to take after. Aspirin etc are no good as they thin the blood and can cause bleeding. I found that after the anaesthetic wore off (about an hour) I was sore but not unbearably so for the rest of the evening (4pm biopsy). I did make the mistake of going for a coffee and a snack at the clinic immediately after the biopsy and the anaesthetic had worn off before I started the journey home and boy did I feel every bump in the road. So go home ASAP! Finally (and I hope not too personal). If you have never had anything inserted up your back passage before it might be worth asking the wife/girlfriend to try inserting a small lubricated dildo up there just so you know what sort of sensation to expect when the ultrasound device (about 6" long and 3/4" diameter) goes up there! Good luck, Malaga, Spain Opinions on biopsy I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period,with a 15% free PSA. The urologist says this is a no brainer, no moretest, do a biopsy. You have 25% chance of cancer. If we don't findit now we will later. After biopsy if we don't find cancer we willcheck for BPH. I'd like to hear opinions if you have to comment. MyPSA came in this month between 3.6 and 4, within two weeks of each other.If he is so concerned for cancer why schedule me for a biopsy in amonth and wait. Also if you had the biopsy, I'd like to know howirritating the procedure can be. They said the procedure is an plainoffice visit.Thanks for you helpTony No virus found in this incoming message.Checked by AVG. Version: 8.0.169 / Virus Database: 270.9.18/1851 - Release Date: 12/16/2008 8:53 AM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 There's really no hurry in all this. The cancer is a slow growing one and has been in your prostate for a couple years already. The biopsy I had was without any anesthesia (or however it's spelled.) I wouldn't recommend it this way for anyone. Ouch. After the biopsy I waited about six weeks before surgery to let it all heal up. Gives time to really make a decision and to get ready for it if that's the route you take. One thing to be thankful for is that this today is being discovered early. Not the case just a few short years ago. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 sureshot8 wrote: > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr > period, with a 15% free PSA. The urologist says this is a no > brainer, no more test, do a biopsy. You have 25% chance of > cancer. If we don't find it now we will later. After biopsy if > we don't find cancer we will check for BPH. I'd like to hear > opinions if you have to comment. My PSA came in this month > between 3.6 and 4, within two weeks of each other. > > If he is so concerned for cancer why schedule me for a biopsy > in a month and wait. Also if you had the biopsy, I'd like to > know how irritating the procedure can be. They said the > procedure is an plain office visit. Tony, I'm hardly an expert, but I agree with others that you should follow the doctor's advice and get a biopsy. Mine was done without anaesthetic. It was unpleasant but it only lasts a half hour or so and I've had a lot more unpleasant things happen to me than a biopsy. I don't know how " plain " it is, but it is an out patient procedure done in the doctor's office. You can walk in and walk out again afterwards. When I was advised to get a biopsy I thought, " What? I'm perfectly healthy! I feel fine. I have no symptoms of any illness. How could I have cancer? That's ridiculous! " But it turned out that I did have cancer and it was an " intermediate risk " one that would very likely have killed me before I got old enough to die of something else. If you have no sign of cancer, that's great. You will have spent a small amount of time with a minor nasty procedure and you will get some peace of mind, at least until the next PSA test. If you do have cancer, you will have detected it early enough that you will have the most possible treatment options (including the option of no treatment if the cancer is not an aggressive one); the most amount of time to educate yourself about the options (there are many); and the best possible chances for a cure. As for waiting a month, I would guess that with your PSA and rate of PSA increase it is likely to be some years before the cancer escapes from the prostate and becomes untreatable with current methods. So a month delay is not likely to be a significant risk for you. Unfortunately, it is the nature of medicine in every country that medical resources are limited and booked long in advance. Your doctor probably has appointments booked up for quite a long time. Since your case is not an emergency, he can't justify bumping someone else to perform your biopsy. If you switched doctors, you'd probably find yourself in no better position. Best of luck. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 Tony, You are the one that must be convinced. ly, I find this urologist to be arrogant and somewhat assinine, especially to make the statement " If we don't find it now we will later. " Do some research. Find out what your PSA should be for your age. Free PSA is not meaningful when your PSA is below a certain number (can't remember what that is). Did you check to see if your prior PSAs were done using the same immunoassay as the more recent ones? Because that could be responsible for the difference. Do you want to subject yourself to the discomfort of a biopsy and a possible decision about a cancer that could be dormant ... if it turns out not to be necessary? On the other hand, you must be convinced of this one way or the other. I certainly don't want to discourage you if there is a real chance that you have PCa. Lastly, why wouldn't you take your records and lab tests and go to another uro or two for more opinions before you subject yourself to an invasive biopsy? > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > with a 15% free PSA. The urologist says this is a no brainer, no more > test, do a biopsy. You have 25% chance of cancer. If we don't find > it now we will later. After biopsy if we don't find cancer we will > check for BPH. I'd like to hear opinions if you have to comment. My > PSA came in this month between 3.6 and 4, within two weeks of each other. > > If he is so concerned for cancer why schedule me for a biopsy in a > month and wait. Also if you had the biopsy, I'd like to know how > irritating the procedure can be. They said the procedure is an plain > office visit. > > Thanks for you help > Tony > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 He might not have said we will find it later, but he said something that they would have to follow me closely. I'm 50 and I think my PSA is over what it should be for my age. I think it should be 2.5, similar to last year. I even had 2.5 over 10 years ago. The rise is what makes me think I have a problem. I'm surprised he is not checking me for BPH first and he would not do the PCA3 test. He said some test are not available in this area (NJ??). Shouldn't I be getting a bunch of other test first to confirm a better chance then 25% that I have PCa? I've urinated like a race horse my whole life, 1 bottle of beer in and 10 minutes later 1 bottle came right out, now it takes three trips to the bathroom to get 1 bottle back out. My kidney's process liquid faster then Niagara falls. Everyone thanks for your opinion on what I should do. I am leaning very strongly towards a second opinion. > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > > with a 15% free PSA. The urologist says this is a no brainer, no > more > > test, do a biopsy. You have 25% chance of cancer. If we don't > find > > it now we will later. After biopsy if we don't find cancer we will > > check for BPH. I'd like to hear opinions if you have to comment. > My > > PSA came in this month between 3.6 and 4, within two weeks of each > other. > > > > If he is so concerned for cancer why schedule me for a biopsy in a > > month and wait. Also if you had the biopsy, I'd like to know how > > irritating the procedure can be. They said the procedure is an > plain > > office visit. > > > > Thanks for you help > > Tony > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 He might not have said we will find it later, but he said something that they would have to follow me closely. I'm 50 and I think my PSA is over what it should be for my age. I think it should be 2.5, similar to last year. I even had 2.5 over 10 years ago. The rise is what makes me think I have a problem. I'm surprised he is not checking me for BPH first and he would not do the PCA3 test. He said some test are not available in this area (NJ??). Shouldn't I be getting a bunch of other test first to confirm a better chance then 25% that I have PCa? I've urinated like a race horse my whole life, 1 bottle of beer in and 10 minutes later 1 bottle came right out, now it takes three trips to the bathroom to get 1 bottle back out. My kidney's process liquid faster then Niagara falls. Everyone thanks for your opinion on what I should do. I am leaning very strongly towards a second opinion. > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > > with a 15% free PSA. The urologist says this is a no brainer, no > more > > test, do a biopsy. You have 25% chance of cancer. If we don't > find > > it now we will later. After biopsy if we don't find cancer we will > > check for BPH. I'd like to hear opinions if you have to comment. > My > > PSA came in this month between 3.6 and 4, within two weeks of each > other. > > > > If he is so concerned for cancer why schedule me for a biopsy in a > > month and wait. Also if you had the biopsy, I'd like to know how > > irritating the procedure can be. They said the procedure is an > plain > > office visit. > > > > Thanks for you help > > Tony > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2008 Report Share Posted December 16, 2008 He might not have said we will find it later, but he said something that they would have to follow me closely. I'm 50 and I think my PSA is over what it should be for my age. I think it should be 2.5, similar to last year. I even had 2.5 over 10 years ago. The rise is what makes me think I have a problem. I'm surprised he is not checking me for BPH first and he would not do the PCA3 test. He said some test are not available in this area (NJ??). Shouldn't I be getting a bunch of other test first to confirm a better chance then 25% that I have PCa? I've urinated like a race horse my whole life, 1 bottle of beer in and 10 minutes later 1 bottle came right out, now it takes three trips to the bathroom to get 1 bottle back out. My kidney's process liquid faster then Niagara falls. Everyone thanks for your opinion on what I should do. I am leaning very strongly towards a second opinion. > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > > with a 15% free PSA. The urologist says this is a no brainer, no > more > > test, do a biopsy. You have 25% chance of cancer. If we don't > find > > it now we will later. After biopsy if we don't find cancer we will > > check for BPH. I'd like to hear opinions if you have to comment. > My > > PSA came in this month between 3.6 and 4, within two weeks of each > other. > > > > If he is so concerned for cancer why schedule me for a biopsy in a > > month and wait. Also if you had the biopsy, I'd like to know how > > irritating the procedure can be. They said the procedure is an > plain > > office visit. > > > > Thanks for you help > > Tony > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Tony, I think your right; a second opinion seems a very good idea. Reading the other posts I amsurprised at the number of men who had a biopsy without local anaesthetic. There is no justifiable reason for a Urologist not to administer this before the biopsy, I am sure it changes the experience completely! If you do decide you want a biopsy then insist beforehand that an anesthetic will be used. Best of luck, Spain Re: Opinions on biopsy He might not have said we will find it later, but he said somethingthat they would have to follow me closely. I'm 50 and I think my PSAis over what it should be for my age. I think it should be 2.5,similar to last year. I even had 2.5 over 10 years ago. The rise iswhat makes me think I have a problem. I'm surprised he is notchecking me for BPH first and he would not do the PCA3 test. He saidsome test are not available in this area (NJ??). Shouldn't I begetting a bunch of other test first to confirm a better chance then25% that I have PCa? I've urinated like a race horse my whole life, 1bottle of beer in and 10 minutes later 1 bottle came right out, now ittakes three trips to the bathroom to get 1 bottle back out. Mykidney's process liquid faster then Niagara falls.Everyone thanks for your opinion on what I should do. I am leaningvery strongly towards a second opinion.> >> > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period,> > with a 15% free PSA. The urologist says this is a no brainer, no > more> > test, do a biopsy. You have 25% chance of cancer. If we don't > find> > it now we will later. After biopsy if we don't find cancer we will> > check for BPH. I'd like to hear opinions if you have to comment. > My> > PSA came in this month between 3.6 and 4, within two weeks of each > other.> > > > If he is so concerned for cancer why schedule me for a biopsy in a> > month and wait. Also if you had the biopsy, I'd like to know how> > irritating the procedure can be. They said the procedure is an > plain> > office visit.> > > > Thanks for you help> > Tony> >> No virus found in this incoming message.Checked by AVG. Version: 8.0.169 / Virus Database: 270.9.18/1851 - Release Date: 12/16/2008 8:53 AM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Tony, I think your right; a second opinion seems a very good idea. Reading the other posts I amsurprised at the number of men who had a biopsy without local anaesthetic. There is no justifiable reason for a Urologist not to administer this before the biopsy, I am sure it changes the experience completely! If you do decide you want a biopsy then insist beforehand that an anesthetic will be used. Best of luck, Spain Re: Opinions on biopsy He might not have said we will find it later, but he said somethingthat they would have to follow me closely. I'm 50 and I think my PSAis over what it should be for my age. I think it should be 2.5,similar to last year. I even had 2.5 over 10 years ago. The rise iswhat makes me think I have a problem. I'm surprised he is notchecking me for BPH first and he would not do the PCA3 test. He saidsome test are not available in this area (NJ??). Shouldn't I begetting a bunch of other test first to confirm a better chance then25% that I have PCa? I've urinated like a race horse my whole life, 1bottle of beer in and 10 minutes later 1 bottle came right out, now ittakes three trips to the bathroom to get 1 bottle back out. Mykidney's process liquid faster then Niagara falls.Everyone thanks for your opinion on what I should do. I am leaningvery strongly towards a second opinion.> >> > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period,> > with a 15% free PSA. The urologist says this is a no brainer, no > more> > test, do a biopsy. You have 25% chance of cancer. If we don't > find> > it now we will later. After biopsy if we don't find cancer we will> > check for BPH. I'd like to hear opinions if you have to comment. > My> > PSA came in this month between 3.6 and 4, within two weeks of each > other.> > > > If he is so concerned for cancer why schedule me for a biopsy in a> > month and wait. Also if you had the biopsy, I'd like to know how> > irritating the procedure can be. They said the procedure is an > plain> > office visit.> > > > Thanks for you help> > Tony> >> No virus found in this incoming message.Checked by AVG. Version: 8.0.169 / Virus Database: 270.9.18/1851 - Release Date: 12/16/2008 8:53 AM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Tony, I think your right; a second opinion seems a very good idea. Reading the other posts I amsurprised at the number of men who had a biopsy without local anaesthetic. There is no justifiable reason for a Urologist not to administer this before the biopsy, I am sure it changes the experience completely! If you do decide you want a biopsy then insist beforehand that an anesthetic will be used. Best of luck, Spain Re: Opinions on biopsy He might not have said we will find it later, but he said somethingthat they would have to follow me closely. I'm 50 and I think my PSAis over what it should be for my age. I think it should be 2.5,similar to last year. I even had 2.5 over 10 years ago. The rise iswhat makes me think I have a problem. I'm surprised he is notchecking me for BPH first and he would not do the PCA3 test. He saidsome test are not available in this area (NJ??). Shouldn't I begetting a bunch of other test first to confirm a better chance then25% that I have PCa? I've urinated like a race horse my whole life, 1bottle of beer in and 10 minutes later 1 bottle came right out, now ittakes three trips to the bathroom to get 1 bottle back out. Mykidney's process liquid faster then Niagara falls.Everyone thanks for your opinion on what I should do. I am leaningvery strongly towards a second opinion.> >> > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period,> > with a 15% free PSA. The urologist says this is a no brainer, no > more> > test, do a biopsy. You have 25% chance of cancer. If we don't > find> > it now we will later. After biopsy if we don't find cancer we will> > check for BPH. I'd like to hear opinions if you have to comment. > My> > PSA came in this month between 3.6 and 4, within two weeks of each > other.> > > > If he is so concerned for cancer why schedule me for a biopsy in a> > month and wait. Also if you had the biopsy, I'd like to know how> > irritating the procedure can be. They said the procedure is an > plain> > office visit.> > > > Thanks for you help> > Tony> >> No virus found in this incoming message.Checked by AVG. Version: 8.0.169 / Virus Database: 270.9.18/1851 - Release Date: 12/16/2008 8:53 AM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Tony, Those " urination " symptoms could be a sign of PCa, but they also very well could be signs of plain old BPH. After all, you are 50. Yes, the increase in PSA over time CAN be a concern (it is called PSA Velocity). But did you look at your report from last year (around 2.5) and look at your report from recently (3.6) and compare the immunoassays? That could be responsible for part of the difference. Also, I would walk out on any uro that refuses to do a test like PCA3. When I went to my new one for a 2nd opinion, and mentioned PCA3 to him, he didn't even know what it was. When I explained it to him, and had someone from Bostwick Labs contact him to explain it, he was more than willing to do it ... even though they don't use Bostwick normally. All they have to do is get a courier to get it to Bostwick. In my case, they are out on LI. Check out http://www.bostwicklaboratories.com/home/ for locations. And lastly, if you are convinced after all of this that a biopsy is warranted, by all means do it. But be convinced. I went for a 2nd and a 3rd opinion before making my decision. Larry > > > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > > > with a 15% free PSA. The urologist says this is a no brainer, no > > more > > > test, do a biopsy. You have 25% chance of cancer. If we don't > > find > > > it now we will later. After biopsy if we don't find cancer we will > > > check for BPH. I'd like to hear opinions if you have to comment. > > My > > > PSA came in this month between 3.6 and 4, within two weeks of each > > other. > > > > > > If he is so concerned for cancer why schedule me for a biopsy in a > > > month and wait. Also if you had the biopsy, I'd like to know how > > > irritating the procedure can be. They said the procedure is an > > plain > > > office visit. > > > > > > Thanks for you help > > > Tony > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Tony, Those " urination " symptoms could be a sign of PCa, but they also very well could be signs of plain old BPH. After all, you are 50. Yes, the increase in PSA over time CAN be a concern (it is called PSA Velocity). But did you look at your report from last year (around 2.5) and look at your report from recently (3.6) and compare the immunoassays? That could be responsible for part of the difference. Also, I would walk out on any uro that refuses to do a test like PCA3. When I went to my new one for a 2nd opinion, and mentioned PCA3 to him, he didn't even know what it was. When I explained it to him, and had someone from Bostwick Labs contact him to explain it, he was more than willing to do it ... even though they don't use Bostwick normally. All they have to do is get a courier to get it to Bostwick. In my case, they are out on LI. Check out http://www.bostwicklaboratories.com/home/ for locations. And lastly, if you are convinced after all of this that a biopsy is warranted, by all means do it. But be convinced. I went for a 2nd and a 3rd opinion before making my decision. Larry > > > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > > > with a 15% free PSA. The urologist says this is a no brainer, no > > more > > > test, do a biopsy. You have 25% chance of cancer. If we don't > > find > > > it now we will later. After biopsy if we don't find cancer we will > > > check for BPH. I'd like to hear opinions if you have to comment. > > My > > > PSA came in this month between 3.6 and 4, within two weeks of each > > other. > > > > > > If he is so concerned for cancer why schedule me for a biopsy in a > > > month and wait. Also if you had the biopsy, I'd like to know how > > > irritating the procedure can be. They said the procedure is an > > plain > > > office visit. > > > > > > Thanks for you help > > > Tony > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2008 Report Share Posted December 18, 2008 Tony, I have had 3 biopsies. As it relates to how irritating the procedure is, the best advice I can give is to wear some kind of headphone and listen to music of your choice. You will not hear the " clicking " with the associated stress of wondering if this " click " is going to hurt. This helped me big time. No matter what, wishing you the best of luck. > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > with a 15% free PSA. The urologist says this is a no brainer, no more > test, do a biopsy. You have 25% chance of cancer. If we don't find > it now we will later. After biopsy if we don't find cancer we will > check for BPH. I'd like to hear opinions if you have to comment. My > PSA came in this month between 3.6 and 4, within two weeks of each other. > > If he is so concerned for cancer why schedule me for a biopsy in a > month and wait. Also if you had the biopsy, I'd like to know how > irritating the procedure can be. They said the procedure is an plain > office visit. > > Thanks for you help > Tony > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2008 Report Share Posted December 18, 2008 Tony, I have had 3 biopsies. As it relates to how irritating the procedure is, the best advice I can give is to wear some kind of headphone and listen to music of your choice. You will not hear the " clicking " with the associated stress of wondering if this " click " is going to hurt. This helped me big time. No matter what, wishing you the best of luck. > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > with a 15% free PSA. The urologist says this is a no brainer, no more > test, do a biopsy. You have 25% chance of cancer. If we don't find > it now we will later. After biopsy if we don't find cancer we will > check for BPH. I'd like to hear opinions if you have to comment. My > PSA came in this month between 3.6 and 4, within two weeks of each other. > > If he is so concerned for cancer why schedule me for a biopsy in a > month and wait. Also if you had the biopsy, I'd like to know how > irritating the procedure can be. They said the procedure is an plain > office visit. > > Thanks for you help > Tony > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2008 Report Share Posted December 18, 2008 My doctor asked me to make an appointment for one month out too. It was for an ultrasound. During the procedure he found something that brought piqued his concern. He offered to do the biopsy procedure while he was set up and I was there. I believe he used the ultrasound machine to help guide his aiming during the biopsy procedure. They used lydocain gel or something similar for deadening. I recall no physical pain, only concern. In retrospect, I am glad I had the procedure. The results found 1 in 4 of the biopsy samples to be positive for Adenocarcinoma. The time period for all of the above procedure was late March 2006. The results were back by April; I had surgery to remove it in May. I spent the better part of the interm two months reading, learning various exercises and developing a personal support group. Best of luck, Mick -- Abilene, TX > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > with a 15% free PSA. The urologist says this is a no brainer, no more > test, do a biopsy. You have 25% chance of cancer. If we don't find > it now we will later. After biopsy if we don't find cancer we will > check for BPH. I'd like to hear opinions if you have to comment. My > PSA came in this month between 3.6 and 4, within two weeks of each other. > > If he is so concerned for cancer why schedule me for a biopsy in a > month and wait. Also if you had the biopsy, I'd like to know how > irritating the procedure can be. They said the procedure is an plain > office visit. > > Thanks for you help > Tony > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2008 Report Share Posted December 18, 2008 buckeyedan73 wrote: > Last May, my PSA was rising so i went to a urologist. He did > the digital exam and said for safety sake, let's take an > ultrasound. Once in there, or up there (pardon the pun), he > said it would be best to take some samples and 'snipped' 12 > core samples. The result was 1 came back with cancer. At that > time, my psa was 3.7 He started me on avodart and i went back > for a psa test in september and it was 2.1. I have decided to > continue and will be going back on jan 5 for an updated psa. > > Basically, I am 'watchful waiting/acitve surveillance' and > will report back after 1/5. Dan, I'm curious to know why the doctor prescribed Avodart. If he's prescribing Avodart for its principal use, relieving urinary problems caused by an enlarged prostate, then I understand. If he's doing it for the cancer, I'm curious as to why. Avodart will lower the PSA and possibly slow the progression of the cancer, but I can think of pros and cons to both of those outcomes. The possible advantage of slowing the progression of the cancer is obvious. The possible disadvantages are: Reducing PSA could mask further progression. Some say that you should double your PSA numbers when using Avodart in order to see what the untreated number would be. Avodart might suppress some of the hormone sensitive cancer cells, but one theory has it that doing so can leave more biological " room " for the hormone insensitive cancer cells to grow, perhaps making future hormone therapy, if you ever need it, less effective. However that's only speculation. I don't think anyone has any real data on this theory. There are other theories that come to the exact opposite conclusion. In any case, your program of watchful waiting certainly seems justified with only one of 12 samples showing cancer. If you haven't done it yet, I suggest that you get the biopsy Gleason score from the doc. You might also ask him what he thinks about whether it's desirable to get a second opinion on the biopsy slides (which only requires sending the slides to another lab, not getting another biopsy). I got three different scores from three different labs on the exact same samples. The scores were: 3+3, 3+4, 4+3. You also want to keep good records on your PSA values. > I am suprised how many people have surgery so quickly but as > everyone mentions, you have to do what you feel is the best > course of action. I have read that many dr's and people in > the know say that the 'treatment' is worse than the disease. > We will see! Yes, there is no question that prostate cancer is overtreated. Some cases that will probably never beocme life threatening are treated with significant impacts on the patients quality of life. But human emotions are involved. It's not easy for many of us to know that they have a growing cancer inside them and not take action to treat it. At the time that I was diagnosed I knew nothing at all about cancer except that it was a killer. I was in shock and had trouble understanding the doctor's view that I was not facing a medical emergency. Good luck. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2008 Report Share Posted December 18, 2008 buckeyedan73 wrote: > Last May, my PSA was rising so i went to a urologist. He did > the digital exam and said for safety sake, let's take an > ultrasound. Once in there, or up there (pardon the pun), he > said it would be best to take some samples and 'snipped' 12 > core samples. The result was 1 came back with cancer. At that > time, my psa was 3.7 He started me on avodart and i went back > for a psa test in september and it was 2.1. I have decided to > continue and will be going back on jan 5 for an updated psa. > > Basically, I am 'watchful waiting/acitve surveillance' and > will report back after 1/5. Dan, I'm curious to know why the doctor prescribed Avodart. If he's prescribing Avodart for its principal use, relieving urinary problems caused by an enlarged prostate, then I understand. If he's doing it for the cancer, I'm curious as to why. Avodart will lower the PSA and possibly slow the progression of the cancer, but I can think of pros and cons to both of those outcomes. The possible advantage of slowing the progression of the cancer is obvious. The possible disadvantages are: Reducing PSA could mask further progression. Some say that you should double your PSA numbers when using Avodart in order to see what the untreated number would be. Avodart might suppress some of the hormone sensitive cancer cells, but one theory has it that doing so can leave more biological " room " for the hormone insensitive cancer cells to grow, perhaps making future hormone therapy, if you ever need it, less effective. However that's only speculation. I don't think anyone has any real data on this theory. There are other theories that come to the exact opposite conclusion. In any case, your program of watchful waiting certainly seems justified with only one of 12 samples showing cancer. If you haven't done it yet, I suggest that you get the biopsy Gleason score from the doc. You might also ask him what he thinks about whether it's desirable to get a second opinion on the biopsy slides (which only requires sending the slides to another lab, not getting another biopsy). I got three different scores from three different labs on the exact same samples. The scores were: 3+3, 3+4, 4+3. You also want to keep good records on your PSA values. > I am suprised how many people have surgery so quickly but as > everyone mentions, you have to do what you feel is the best > course of action. I have read that many dr's and people in > the know say that the 'treatment' is worse than the disease. > We will see! Yes, there is no question that prostate cancer is overtreated. Some cases that will probably never beocme life threatening are treated with significant impacts on the patients quality of life. But human emotions are involved. It's not easy for many of us to know that they have a growing cancer inside them and not take action to treat it. At the time that I was diagnosed I knew nothing at all about cancer except that it was a killer. I was in shock and had trouble understanding the doctor's view that I was not facing a medical emergency. Good luck. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2008 Report Share Posted December 19, 2008 I like that, Dave, and agree with you about the humour. Hope you agree to my putting it on the site at http://www.yananow.net/troopc.htm#snippets All the best Terry Herbert I have no medical qualifications but I was diagnosed in ‘96: and have learned a bit since then. My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za Dr “Snuffy” Myers : " As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data " From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Dave Machado Sent: Saturday, 20 December 2008 12:48 AM To: ProstateCancerSupport Subject: Re: Opinions on biopsy For me, it is important to try to maintain my sense of humor through these trying times. So, with that in mind: " The biopsy was liking having a 21 gun salute shot up your ass. " Dave > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr period, > with a 15% free PSA. The urologist says this is a no brainer, no more > test, do a biopsy. You have 25% chance of cancer. If we don't find > it now we will later. After biopsy if we don't find cancer we will > check for BPH. I'd like to hear opinions if you have to comment. My > PSA came in this month between 3.6 and 4, within two weeks of each other. > > If he is so concerned for cancer why schedule me for a biopsy in a > month and wait. Also if you had the biopsy, I'd like to know how > irritating the procedure can be. They said the procedure is an plain > office visit. > > Thanks for you help > Tony > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 My PSA has gone up 50% in 6 months and I was advised to have a second biopsy. But since the first one was negative I decided on a PCA3, which I had this morning. I expect the result next week. Ted > > > > > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr > period, > > > > with a 15% free PSA. The urologist says this is a no brainer, > no > > > more > > > > test, do a biopsy. You have 25% chance of cancer. If we > don't > > > find > > > > it now we will later. After biopsy if we don't find cancer we > will > > > > check for BPH. I'd like to hear opinions if you have to > comment. > > > My > > > > PSA came in this month between 3.6 and 4, within two weeks of > each > > > other. > > > > > > > > If he is so concerned for cancer why schedule me for a biopsy > in a > > > > month and wait. Also if you had the biopsy, I'd like to know > how > > > > irritating the procedure can be. They said the procedure is > an > > > plain > > > > office visit. > > > > > > > > Thanks for you help > > > > Tony > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 > My PSA has gone up 50% in 6 months and I was advised to have a second > biopsy. But since the first one was negative I decided on a PCA3, which > I had this morning. From what score to what? Fifty percent in six months is a rather fast velocity. I recommend searching on PSA velocity at the Prostate Cancer Research Institute website: http://prostate-cancer.org/index.html Concerning PCA3Plus (current name), it does sound promising judging by what I've read. However: from the Bostwick website, " A PCA3Plus value of 35 or greater suggests a high likelihood of prostate cancer. Only a prostate biopsy can diagnose prostate cancer. This test's performance has been established by Bostwick Laboratories. It has not been approved by the United States Food and Drug administration and should not be used as the sole evidence for or against the diagnosis of prostate cancer. " Couldn't be plainer. The test is not diagnostic of PCa, nor of the absence of PCa. A word to the wise..... Regards, Steve J " was an optimist. " -- O'Toole's commentary on 's Law Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 Hi Ted: I haven't ever posted in this forum before, so if I'm not doing it correctly, please forgive me. I take it that you are in the UK. I am in the US and have a question for you. Did you have to introduce your doctor to the PCA3 test or how did you get them to do the test? I am going to tell my doctor that before I have another biopsy I want to have the PCA3 test first. It may not be approved by the FDA, but I don't care, at least it's another guideline which might help me decide if I actually need another biopsy or not. But I know that my doctor won't know what I'm talking about. Thanks. > > > > > > > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr > > period, > > > > > with a 15% free PSA. The urologist says this is a no brainer, > > no > > > > more > > > > > test, do a biopsy. You have 25% chance of cancer. If we > > don't > > > > find > > > > > it now we will later. After biopsy if we don't find cancer we > > will > > > > > check for BPH. I'd like to hear opinions if you have to > > comment. > > > > My > > > > > PSA came in this month between 3.6 and 4, within two weeks of > > each > > > > other. > > > > > > > > > > If he is so concerned for cancer why schedule me for a biopsy > > in a > > > > > month and wait. Also if you had the biopsy, I'd like to know > > how > > > > > irritating the procedure can be. They said the procedure is > > an > > > > plain > > > > > office visit. > > > > > > > > > > Thanks for you help > > > > > Tony > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 Hi Ted: I haven't ever posted in this forum before, so if I'm not doing it correctly, please forgive me. I take it that you are in the UK. I am in the US and have a question for you. Did you have to introduce your doctor to the PCA3 test or how did you get them to do the test? I am going to tell my doctor that before I have another biopsy I want to have the PCA3 test first. It may not be approved by the FDA, but I don't care, at least it's another guideline which might help me decide if I actually need another biopsy or not. But I know that my doctor won't know what I'm talking about. Thanks. > > > > > > > > > > I saw my urologist today. I had a 1.5 PSA rise over a 1 yr > > period, > > > > > with a 15% free PSA. The urologist says this is a no brainer, > > no > > > > more > > > > > test, do a biopsy. You have 25% chance of cancer. If we > > don't > > > > find > > > > > it now we will later. After biopsy if we don't find cancer we > > will > > > > > check for BPH. I'd like to hear opinions if you have to > > comment. > > > > My > > > > > PSA came in this month between 3.6 and 4, within two weeks of > > each > > > > other. > > > > > > > > > > If he is so concerned for cancer why schedule me for a biopsy > > in a > > > > > month and wait. Also if you had the biopsy, I'd like to know > > how > > > > > irritating the procedure can be. They said the procedure is > > an > > > > plain > > > > > office visit. > > > > > > > > > > Thanks for you help > > > > > Tony > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 > ... Did you have to introduce your doctor to the PCA3 test or > how did you get them to do the test? ... I haven't tried this, but one thing that I know people sometimes do when they want their doctor to do something that the doc has not done before is print out some information from the most reputable sources they can find, bring it to the doctor at their next visit, and quickly introduce him to the literature. Doctors are so ridiculously busy that if you mail the printouts to them they may not read them, even if they are the kind of doctor who tries to keep up with the literature, and as we all know, not all of them do. But if you bring in printed materials and say, Here's a study by Prestigious University that says this test is 84% predictive of cancer, and another one from Famous Cancer Clinic that claims 87% predictive power, then the doctor may pay attention. It also wouldn't hurt to have a list of names and addresses of one or more labs that can process the test. It might even be good to use yellow highlighter on the key points you want the doctor to see. That's just a suggestion. I don't know if it will work. Best of luck with it. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 > ... Did you have to introduce your doctor to the PCA3 test or > how did you get them to do the test? ... I haven't tried this, but one thing that I know people sometimes do when they want their doctor to do something that the doc has not done before is print out some information from the most reputable sources they can find, bring it to the doctor at their next visit, and quickly introduce him to the literature. Doctors are so ridiculously busy that if you mail the printouts to them they may not read them, even if they are the kind of doctor who tries to keep up with the literature, and as we all know, not all of them do. But if you bring in printed materials and say, Here's a study by Prestigious University that says this test is 84% predictive of cancer, and another one from Famous Cancer Clinic that claims 87% predictive power, then the doctor may pay attention. It also wouldn't hurt to have a list of names and addresses of one or more labs that can process the test. It might even be good to use yellow highlighter on the key points you want the doctor to see. That's just a suggestion. I don't know if it will work. Best of luck with it. Alan Quote Link to comment Share on other sites More sharing options...
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