Slight rise in PSA

[Guest guest]

I have just received my most recent PSA, taken last Thursday, June 2, 2011.  It came back at 0.05 ng/ml.  This is elevated from my previous reading of less than 0.01 ng/ml, which I've had since 2/12/2009, but it is still below my first post-surgical PSA of 0.06 ng/ml on 9/10/2008.  (Conventional radical protastectomy was performed on 6/11/2008). 

 Based on my post surgical pathology, follow-up therapy was not indicated, and I received no radiation, hormones or any chemicals of any type. The nurse from the Urologist's office who called me today (she is very experienced) said they have recently noted fluctuations in PSA's for a lot of their patients.  They suspect that this may be a " lab issue " such as a change in the chemicals used by the lab, or a change in equipment or the operator.  She said my reading is still " fine " . The Uro's practice is at Bixby Medical Center in , Michigan.  His office in is the same building as the Hickman Cancer Center.  This medical office building is attached to the hospital and that is where my surgery, the lab work pre-surgical testing and post surgical pathology was performed (the assay was Hybritech in the past). The Uro and the Oncologist at the Cancer Center both have sterling reputations.  The entire facility and campus is part of Promedica. 

 I have an appointment with the Urologist on the 16th (this was scheduled 6 months ago, as was the PSA), so I will know more at that time.  Still, I want to be well prepared for this meeting, and I plan to talk with him about a consultation with the Oncologist.

 I'm also curious, and I'd like some opinions about other things that could cause a PSA reading to rise.  For example, on May 11, 2012, less than a month ago, I had outpatient surgery to address a chronic nasal infection.  I underwent an outpatient ethmoidectomy.  (I had a much cruder and more painful 5 day inpatient surgery for this same thing some 32 years ago).  This surgery is quite bloody, and there is significant blood loss.  It's just the nature of the procedure.  Prior to the surgery, I was on a course of steroids.   After my second post surgical visit (three weeks after this surgery) I was not healed to ENT's satisfaction and she opined that things looked infected.  As such, I was placed on a ten day course of antibiotics  (Bactin) which I just finished today.  I was also placed on Singulair, which is an asthma medicine that helps with nasal congestion and allergies (although I am not asthmatic). 

 Since this nasal surgery, I have been extremely fatigued.  I also had a pretty constant low-grade headache, until last week (this surgery is cranial surgery, and it can create some swelling of the brain).  Only in the last day or two have I felt better. 

 I felt somewhat okay the day I had  the PSA drawn.  Anticipating a question, I had no sexual activity in the 48 hours prior to the PSA being drawn. I may have also had a slight urinary tract infection going on.  I'm not sure of this by any means, and in any event, if I had such an infection, I have to believe the antibiotic prescribed by the ENT made it go away. 

 Other prescription medications I take are 25 mg of Linsinopril (generic for Zestoric) once a day for high blood pressure (and it controls it well - 116 over 59 this AM - pulse 69) and Omeprazaole (generic for Prilosec) twice a day for acid reflux.  The Linsnopril is new to me about five months ago, a change from Cozaar.

 Over the past three years, the only significant change I made in non-prescription vitamins and herbs (too many to list)  I take is to increase my daily intake of Calcium (Vitamin D) from one to two 650 mg tablets per day (in addition to the multi-vitamin I take daily) and to add a Cranberry capsule to the mix.  I've also had a craving for V-8 Juice, and I've been drinking a lot of that over the past three months.

 I've been under a lot of stress for the past ten months, both personally and professionally.  On the whole, all has been going well, but I've been working a tremendous number of hours. 

In the collective wisdom and experience of this list, might any of these things cause a temporary bump in a PSA reading?  Anecdotal comments are welcome.  I fully understand their limitations. On my part, I'm inclined to think (and I want to believe that) this is PSA increase may not be significant, especially if the next reading is down, but I'd like other opinions from the folks on the list.  I value them greatly.  On my part, I know that I am living with this disease for the rest of my life, and I must be vigilant.

 To summarize my situation: Current age:  58Age at time of diagnosis:  55Cancer detected by DRE by my primary care physician, and confirmed by biopsyPre-surgical diagnostic radiology showed clear.

There was a pre-surgical consultation with an Oncologist.Conventional RPA Performed 6/11/2008Pre surgical Gleason:  3 plus 4

Post surgical Gleason, based on pathology:  3 plus 3No post surgical follow-up therapy of any typeHave family history of PCa. Final diagnosis  Tumor scored as T2B  Lymph nodes clear, No perinueral invasion detected, Metastases not tested for  (T2BNOMX)

No incontinencePotent, with 20 mg Cialis (same as I was pre surgical, but it took a couple of years).  " Willy " is an inch shorter, but my wife of 34 years is a good sport.  All is well.

Height 6' 0 "   Weight 250 pounds ( I'm 50-70 overweight)Was diagnosed as having sleep apnea a few years ago, but I'm too claustrophobic for a CPAP machine.  I also question this diagnosis.  I think the MD

     " Specialist "  that did my sleep study was a quack.Have not been as physically active as I want for the past six months. No excuse. My bad on this. PSA History:

Treated for recurring prostate infection in 1989.  Prostate was enlarged then and remained so.  It was enlarged at the time of the RPA.5/1996     1.02/1998     0.84/1999     2.1  (immediate recheck 0.7)

8/2000     0.710/2001   1.111/2002    1.10  (started Hybritech assays)12/2003     1.0412/2004      1.131/2006       0.912/2007      1.553/2008      1.43  (at time of diagnosis)

9/2010      0.06  (first post-surgical PSA)11/2010     0.032/2009       0.016/2009       0.0112/2009     0.016/2010       0.01  (most recent appointment with Uro)

12/2010     0.01 6/2011      0.05 I know this is probably way more detail than a lot of folks want to read.  For those who have, thank you.  Again, I value the wisdom and opinions of those on this list.  They have been very helpful to me since the time of my diagnosis.

 Thank you again.  Coy, Michigan, USA   

G. Coy

shootingcpa@...

 

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