Strange PSA resulted in detection of cancer

gbwd123

I went to do an annual physical this year which resulted in a PSA of 12.1
Previous year it was 2.3
Urologiest went straight to Biopsy. 2 of 12 cores tested positive for cancer. (1 at 15% and 1 at 35%) Took the antibiotics post biopsy.
At 4 weeks after biopsy and 4 weeks before my scheduled prostatectomy, I asked the urologist if I could have another PSA test. He said WHY? we know you have cancer!!! I said I was curious if it was a bad test, is it remaining elevated, etc, etc!
He agreed, so I tested again, the next day and my PSA went down to 2.7. He was excited! He said WOW! that's great! the antibotics probably killed any infection that was present that was not detected in blood work, DRE, or biopsy pathology. He said, now! that changes everything as he was pretty sure my cancer was in the margin since one of my positive cores had cancer near the margin.
He basically said, I was very lucky that the PSA was elevated due to infection, otherwise I would have never recieved a biopsy at 2.7 at that stage. Greatfull that I found out early, but was wondering if others have experienced this. And the biggest issue for others is: Just because you have a low PSA doesn't mean you don't have prostate cancer. Maybe every male over the age of 50 should just opt for a biopsy regardless!
_________________
50 yrs old - PSA 2.7, Gleason 3+3=6
2 of 12 cores tested positive for cancer
Prostatectomy August 26, 2008

Hawk · Experienced user Joined: 22 Nov 2006 Posts: 82

Having had 3 biopsies, one of which was a story to make all men cringe, I cannot imagine men either volunteering for or doctors performing a prostate biopsies for random screening of PCa.

You are lucky.

Tests more indicative of PCa are being developed but routine biopsies will never fly.

PS: You did not mention your grade of cancer. Did you consider a reexam of your biopsy by another lab?
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2 - 8.1 - 8.7 Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06 - May .09 - Jun .10 - Aug .10 - Nov .15 SRT

chrisz · Regular Joined: 09 Apr 2007 Posts: 44

Many Prostate cancers are detected with DRE/Biopsy. The PSA may be
normal. You may have a high PSA and not have cancer. You may have
cancer and your PSA is normal. You may have cancer and multiple biospy's don't pick it up.

My PSA has been from 2 to 8 and back down to 2 over the past 6 years.
Two Biospys, one 21 core, one 28 core. No cancer found, but that does
not mean I don't have cancer. I guess if I let them keep poking holes
in my ass they will eventually cause PC to develop..... who knows ?

I'm thinking about NEVER having a PSA test again.

Chrisz

Otago · Regular Joined: 20 Jan 2008 Posts: 28

[quote="chrisz"]Many Prostate cancers are detected with DRE/Biopsy. The PSA may be
normal. You may have a high PSA and not have cancer. You may have
cancer and your PSA is normal. You may have cancer and multiple biospy's don't pick it up.

My PSA has been from 2 to 8 and back down to 2 over the past 6 years.
Two Biospys, one 21 core, one 28 core. No cancer found, but that does
not mean I don't have cancer. I guess if I let them keep poking holes
in my ass they will eventually cause PC to develop..... who knows ?

I'm thinking about NEVER having a PSA test again.
[/quote]

Well you might be right. If you go down Main Street USA and randomly grab the first 100 guys between the ages of 50 and 65......then do repeated biopsies on them......say three in 9 months, you are going to end up finding lots of prostate cancer eventually..
However much of it would be better undiscovered since for most of those men it would never affect their longevity or health.

In our original poster, its still questionable as to whether it would have been better for the urologist to give the antibiotics first, then allow some time, finally taking another PSA test.......all before doing a biopsy.
Now in his case it would have come back 2.7 and he probably would not have had the biopsy.
Would this have shortened his life? Would his PCa have grown and endangered his life?
No one knows. Do many men want to take that chance? Some do, some don't.

What we do know is there are heaps of guys ages, 40 to 80 walking around with prostate cancer. Some have PSA's under 2.5 and some are over 7.0. Gleasons probably range from 3+2 (5) to common 3+3(6) to 7+

Should we keep doing biopsies on every man around. NO, or else you could be doing surgery/radiation on about 70% of all men before they reach 90.

BTW, I've read more than one study showing that follow up biopsies using more than 25+ cores don't have much superior detection rates versus the normal 12.
I don't think you should keep looking for PCa every time your PSA fluctuates if that is your pattern. Perhaps you should allow for a proven upper range over several tests before you do another biopsy.

Inflamation either from unknown causes or sometimes from infection can cause large spikes in PSA scores.
Perhaps a diet and possibly anti-inflammatory meds (ibuprofen etc) might help. This area has a bit of recent discussion...pros and cons....
Some eating patterns can help reduce inflammation and perhaps lower your score. Remember, a good portion of prostatitis is non-bacterial.

Nice medical condition...... one where NO ONE is a perfect expert and everyone is usually playing it overly on the safe side just to be sure. Hopefully in a few years they'll have a new test to be able to tell which PCa needs treatment and which to leave alone.

chrisz · Regular Joined: 09 Apr 2007 Posts: 44

Yes Otago, my research has indicated that everything you have said is
true.

I was thinking of setting a PSA level of 10 as the point that I would go
for a third biopsy. But there are many people with a higher PSA that
still have negative biopsy's. Like Otago above, he had a PSA of 16.6
and still had a negative biopsy.

I ask one of my urologists was it possible that during biopsy, the needle
could carry cancer cells outside of the prostate. His answer was "YES".
Now that's scary to me !!

Like you said, many men are walking around today with PC. But many of
them will not die from it. I fear that aggravating the prostate with that
damn needle, even with someone that has PC, could aggravate it to the
point that it's growth is escalated.

Oh well, what's a man to do ? I wish I never had a PSA test and
like I said, I may never have one again.

Boy this type of cancer diagnosing is really making alot of money for those Udocs ! I think they love it !

Sometimes I wonder, what would happen to the medical community it
they found a cure for all cancers ? How many people would be out of
a job. I don't think they really want to find a cure, it would devastate the
economy. But then again, those crooks on Capital Hill, due to their lack
of over-site, did it anyway. That money went somewhere you know !!!!

Chrisz

Hawk · Experienced user Joined: 22 Nov 2006 Posts: 82

Chrisz,

You said you had a concern, "I fear that aggravating the prostate with that
damn needle, even with someone that has PC, could aggravate it to the
point that it's growth is escalated. "

Biopsies clearly are not without risk but I think the evidence clearly supports the statement a biopsy is not going to make prostate cancer more aggressive or up its Gleason score.

You also share a thought that medical community does not want to find a cure for cancer. I have heard this and thought about it at length. No one in the medical community is untouched by immediate family members falling victim to cancer. Not to mention the members themselves. To imagine they would stonewall against a cure means you would have to reject universal human nature to do all you can to fight against that which has harmed your love ones.

Just food for thought.
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2 - 8.1 - 8.7 Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06 - May .09 - Jun .10 - Aug .10 - Nov .15 SRT

sanjis · Regular Joined: 12 Oct 2007 Posts: 35

When my husbands PSA level was high the first thing the doctor said was they were putting him on antibiotics first for 4 weeks and then he went back for another PSA level to see if it had changed. He said that is what they normally do to make sure it is not an infection causing the PSA level to be high. Of course it brought it down 1 point but that was all and he was sent on to the urologist.

chrisz · Regular Joined: 09 Apr 2007 Posts: 44

Exactly the same thing happened to me. Except the Udoc took a semen
sample and SAW the infection. Took the antibotics, dropped on 1 point
to 6. Went and had a saturation biospy, no cancer found, psa dropped to
2.6. I should have had that Udoc check my semen for infection before I agreed to that second biopsy. Tell your husband to ask the doctor to take
a semen sample and look at it under the microscope.

Chrisz

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