I had routine blood work done about a month ago and got the results today with my yearly physical. About a year and a half ago my PSA was around 3.2. It is now 5.3. The doctor didn't bother with the digital exam. We already know that my prostate is slightly enlarged so she wants me to see a urologist and they would do a digital exam. She said that they might also want a biopsy. My father had prostate cancer and it had finally spread to his pelvic bones by the time he died at age 84. I am now 66.

If any of you folks (and I'm sure that a few of you have) been down this road, please chime in. How bad is a biopsy? Do they put you out for that or numb you up at least? If there is cancer, are there any good treatments? I guess I wasn't expecting this news today and I'm a little upset about it.

Thanks for any input.

I believe that they will knock you out for the biopsy if you desire. They are no fun, but at least they are now numbing with novacane. I did not have that luxury the first time.

My cancer was caught, I had surgery and have been cancer free for 11 years. Are you a Vietnam vet? If so, file for disability.

quote:

Originally posted by wbw:


If any of you folks (and I'm sure that a few of you have) been down this road, please chime in. How bad is a biopsy? Do they put you out for that or numb you up at least? If there is cancer, are there any good treatments? I guess I wasn't expecting this news today and I'm a little upset about it.

Thanks for any input.

A 'little upset' is probably the right place to be. I'm skirting the thing with some elevations and we're waiting to see if some meds worked for me until Nov.

I have two close relatives that have been the whole route though and it might not be thrilling it isn't curtains either. I wish you well, you have a lot of ground to cover to figure it out though, so stay positive.

One step at a time. The referral makes sense. PSA is only ONE marker and it is often elevated. The second part is the digital rectal exam performed by the urologist and perhaps a repeat of the PSA.

There are many steps before even considering biopsy. Ultrasound etc.

I had the biopsy a few weeks ago, in office, local anesthetic. Not that bad.

Twelve core samples were taken, cancer showed up in one. A following CT scan looked good, no metastasis. Just now back from the urologist, not what I was hoping. The one cancer showed a Gleason score of 7 (on a scale of 2-10). Aggressive.

Due to a TURP procedure a decade or more back, most options are unavailable to me. I'm in line for a radical prostatectomy Nov. 1. I should retain the vast majority of function, cancer hopefully gone but still, fuck.

Follow up, wbw, follow up and good luck.

I just had my fourth biopsy a couple of months ago because I also run a high PSA due to enlargement.

I'll be honest, they aren't any fun but at least you will know one way or another. I choose to get conscious sedation because of my first biopsy experience with another doc and yes the do numb you.

As far as treatments you will have to wait until the results come back and then the doc will tell you all about them. Your high PSA could very well be due to enlargement.

I see your location is Washington. State? Dr. Porter at Swedish in Seattle is the top guy to go see. He is a prostate cancer survivor too so he knows what you are going through.

I had several co-workers and a relative die from Prostate cancer, so I get the semi annual PSA and Urology check ups.

That said...

My Urologist told me that PSA numbers can be skewed by a body infection or by recent sexual activity prior to the PSA test.

So, keeping that in mind, maybe another blood workup and PSA reading might be in order to confirm the prior reading?

I have had an elevated PSA for years. Digital exam yielded a finding of "moderate enlargement" of the prostate. Fast forward a couple of years with an increase in the PSA each time it was checked...

Dr ordered a 12 needle biopsy, which was very uncomfortable, and poorly performed (my biased opinion) by the first urologist. Came back completely negative.

Fast forward another two years: PSA still climbing, digital was same as before, had a second 12 needle biopsy performed, this one by a competent urologist who acted as though he actually cared... actually give the local anesthetic time to act before beginning the procedure. Results once again came back completely negative.

The statistical probability that any cancer could have been missed in 24 needle attempts is very slim.

I am a cancer survivor, three times over: Metastatic melanoma right flank at the age of 26; Lung cancer at the age of 72, requiring removal of upper rt lobe of lung; metastasis of original lung cancer two years later to the left clavicle, which was treated with both Chemo and Radiation, then the smoking remains excised by the same Doc who had done the earlier lung excision.

Just had my semi-annual CT scan done this past Monday, and was told yesterday by my Radiologist Oncologist that I "have no observable cancer activity" at this time!!!

Based on all of the above, and the fact that I will continue to have my condition carefully monitored, I have quit worrying about any potential prostate cancer. My Primary Care Doc and I agree that it is probably just from the enlargement, and not necessarily malignant.

So after all that, my recommendation is to remain alert to the possibilities, but consider the tests to be your friend!

Stay alert, and I wish you Good Luck!
Don

FYI, my last physical, I had a high PSA and what my GP thought was an enlarged prostate. I saw a urologist. Got interesting info from him. He said if I'd had a recent ejaculation, that will both enlarge the prostate and the PSA. After another blood test....after having abstained from sex, my PSA was normally low as it had been the year before.

Advice, abstain from sex for a couple of days prior to a physical.

Had one done a couple years back. If I remember correctly, they took 14 samples. Not bad at all, I liken the feeling of each sample taken as a little shock, not as bad as a push button lighter for a grill.

You have lots of time and lots of things to be checked. An elevated PSA can be the result of an infection, or or could be a bad test.

You can get tested again to be sure, and the Dr. may suggest something to treat the infection and test again.

Biopsy can be done with a local (I refer to those as a "backyard biopsy"). I was much happier being sedated. No pain, no big deal.

Once you get the results (if you have the biopsy) they stage it with a Gleason score to express how aggressive the cancer is. And even from there, you have multiple decisions on the road to take, from simple active surveillance where you simply continue to test more frequently, to one of several other choices.

So hopefully, you got incorrect results the first time, or you have a slight infection that increased the PSA.

No need to worry at this point, see what the Urologist has to say and go from there.

If your PSA is elevated, you caught it at the best possible time for it to be treated successfully.

I caught mine early and ended up having surgery in 2011, and I'm still cancer free today.

quote:

Originally posted by wbw:
If any of you folks (and I'm sure that a few of you have) been down this road, please chime in. How bad is a biopsy? Do they put you out for that or numb you up at least? If there is cancer, are there any good treatments? I guess I wasn't expecting this news today and I'm a little upset about it.

Get thee to thine urologist. 5.3 is somewhat high, not outrageous. My PSA was 27 (not a typo, that's twenty-seven) when we found the cancer.

As far as the biopsy, I've been there twice. I declined the sedative that was offered, since I don't do well with that drugs. Bad aftereffects of me.

Without the sedative, the discomfort was not bad. Maybe on the level of a mild insect sting each time. They take twelve samples. It's over in a few minutes, and I would much rather take a dozen quick stings than deal with many hours of drug aftereffects.

As for treatment, there are many options. Surgery was ruled out in my case because of age. We went with radiation -- about 40 radiation zaps, one a day for close to two months. That was in 2010. We have been monitoring PSA since then, and it has slowly climbed from 0.30 up to 1.20 a few months ago.

The 1.20 level was not really bad, but my primary care doc was concerned about the fact that there was an increase each six months, so he told me to have a conversation with the urologist, who ordered the second of the two biopsies that I mentioned (the first was back in 2010). First time around, there was cancer in eleven of the twelve samples. This time, it is showing in four of the twelve.

Radiation is not an option now, I understand that it's a once in a lifetime deal. Surgery is not being considered. The urologist is setting me up for a conference with one of his partners to discuss cryotherapy, to kill it by freezing. I haven't had that meeting yet. I'll probably post here, when I know more.

quote:

Originally posted by maxwayne:
I believe that they will knock you out for the biopsy if you desire.

I'm not all that brave, but I did it (the biopsy) twice with no sedation. It's mildly uncomfortable, but it's over in a few minutes. Twelve samples, each one is instantaneous, like a moderate insect sting with no lingering aftereffect. Just sort of a really quick "zap," and done. Twelve times. Not worth sedation, in my opinion.

Thanks for all the responses and the well wishes.

To oldfireguy - you might be confusing me with one of the respondents. I'm in York Pa. Not exactly the cutting edge of medicine.

First off, don't panic!! Get to the Urologist for a good exam. The digital exam will throw much more weight than the PSA. I have been there, and done that with (1) elevated PSA (2) three different biopsies(they aren't fun, but less than a trip to the dentist). (3) A digital exam that changed to bad....Gleason 6-7 (4) radical prostatectomy via a DaVinci procedure. (5) PSA every 6 months for the next 5 years.....all were negative!!! I am 6 years post-op next month.

Women get breast and uterine cancer, and men get prostate cancer....that is the way things go. Look for it, and treat it if/when found, and get on with life.

My buddy had his removed this morning. Pretty much the same scenario. He had general anesthesia for the biopsy. He had to be there at 0545 this am. I got up at 5 to text him good luck. He wil be in patient until sunday if all goes well. I just heard from him, aparently they didnt remove his sense of humor!

I had four biopsies due to elevated PSAs until they located the cancer with an 18-sample one. Then active surveillance for three years until the PSA spiked of a sudden. Then robotic surgery last December. PSA at < 0.01 now.

The biopsies aren't as bad as waiting for the results. They aren't fun, and the first was the worst as I had no idea what I was in store for.

The hardest part was telling the wife I had cancer.

Now I tell young guys I'm their ghost of Christmas future so I can help answer questions. (I wish I had somebody for that role when this started for me. It was all uncharted territory.)

Best wishes,

Been down that road!

About 8-9 years ago my PSA was around 6-7 (AIR) and the doc said it was OK. Did some digging, talked to a different doc who said to get the biopsy done!!!!!

Did so. 12 samples (no chemicals) and 8 of the 12 showed cancer.

Got a recommendation from the urologist for treatment. He recommended IMRT (Intensity Modulated Radiation Therapy).

Checked into it with the doc recommended by my urologist. Went through the whole series (39 treatments). No hard radiation, as it involved Xray radiation.

Finished up with a clean prostate. No after effects from the treatments other than being a little tired.

Did PSA testing every 3 months for a while, then 6 months, then once a year.

Last test, PSA was Zero point Three which was down slightly from the previous several readings of 0.4.

Best not to wait!!!!

My son in law's brother waited, his prostate cancer spread to his bones. He died pretty quickly. And not pleasantly.

Well. been there, done that. WBW you didn't give your age, and that is something that affects how you proceed. If you find that you have prostate cancer, and you are older 60's+ you don't have to panic since it is slow moving. If you are in your 40's, you need to move faster. The biopsy is no big deal. I've had quite a number of them since I was diagnosed with prostate cancer about 9 years ago, and my doctor and I decided to proceed with active surveillance. My PSA has remained below 2 (It spiked to 5 causing the biopsy, but the last doc figured that the spike was caused by the flu I had when I had the PSA done, not the cancer) I had the local anesthesia each time, and it was easy. Don't forget that the people in the medical field are now saying that millions of prostate operations that were performed were unnecessary. Surgeons like to operate ($) and radiologists love to do their thing ($). Success rates for both treatments are about the same. Luckily, there is great information on the internet so you can really learn what you need to know quite easily.

well, Been there, done that. problem is will probably have to do it again.

there I was, practically, buck ass nekid, doctor and nurse in the room for the "procedure".

every so often the Nurse would put her hand on my side and ask, "are you doing OK" "yes" was my standard answer.

she asked once too often, and it hit me. Here I am, buck ass Nekid, ass hanging off the edge of the table, exposed to everyone, with a Probe up my ass!

then I Laughed, "yup, doing great!"

what else can you say.

next time they gave me valium prior to the "procedure"

ya'll have fun

john