Two brothers w/ PCa and I have 9.4 PSA

rikoshaprl · New User Joined: 18 Jun 2009 Posts: 5

I know it sounds bad. One brother passed away from the cancer even though he had his prostate removed. The other brother is doing well after removal.
I am 55 and have been checking my PSA for 12 years. My PSA back then was 3.0. It has gradually increased to the 9.4 it is now. I had a biopsy two years ago when PSA hit 8. It was negative. My urologist wants to do biopsies over and over until he finds cancer...even if it takes 5 or 6 more biopsies. This sounds crazy to me. That can't be good for any body part. I had one urologist that wanted to remove my prostate 10 years ago at PSA 4.2.
Digitals have always been smooth and soft, slightly enlarged. Very minor symptoms,ie. I don't wake up at night to urinate. Should I continue to watch and wait. Or should I become a human pin cushion.

johnT · Senior User Joined: 27 Apr 2009 Posts: 163

I had 12 biopsies, about 160 core samples over the last 10 years and my urologists (5 of them) kept saying BPH, but get a biopsy every year, as my psa rose from 4 to 40. . I finally went to a prostate oncologist and he did some calculations on my PSA history and said I had a very high probably of PC, they just haven't found it yet. He did a color doppler and sent me to an expert color doppler dr. He found a large tumor that 12 biopsies and an MRIS had missed.
Don't waste your time on another biopsy unless it is a targeted color doppler biopsy. Biopsies miss transition zone tumors and they are 25% of all PC tumors.
JohnT
_________________
psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

I agree with John. I had 2 biopsies (total 22 needles) that were negative even though my PSA was 7 and 16 respectively. My PSA dropped back to around 8.2 and a 3rd 12 needle biopsy hit with 2 core samples on the edge of the prostate.

I then went to Sloan-Kettering Cancer Center where they did an MRI with an endo-rectal coil and could see the tumor. I wished I had that prior to goofing around with negative biopsies for years. It may well have cost me my life in the long run since I have now had a recurrence since surgery and it remains to be seen if radiation is likely to stop it.

Get some more sophisticated test like color Doppler - MRI with Endo-rectal coil, Prostascint etc. Then they will know the area of the prostate to target.
_________________
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

Jean222 · Senior User Joined: 14 Dec 2008 Posts: 245

Please get yourself to a Prostate Cancer Specialist as soon as possible.

My Hubby had NO symptoms whatsoever, yet has advanced PCa with positive margins and lymph nodes.

He's now fighting for his life with hormone therapy and about to start IMRT radiation. (SRT)

You def need to have more sophisticated testing, as stated already.

Best wishes,

Jean

johnw100

[quote="rikoshaprl"]
It has gradually increased to the 9.4 it is now. My urologist wants to do biopsies over and over until he finds cancer. Should I continue to watch and wait. Or should I become a human pin cushion.[/quote]

There is no "normal" PSA number.

What has your urologist calculated your "PSA Density" as, and what is your "free PSA" reading ?

rikoshaprl · New User Joined: 18 Jun 2009 Posts: 5

Thanks all for the replies.

John W.
I'm not sure if I'm answering your question properly but
my TSH is 3.80, T4 is 8.5, T3 is 32.3

My urologist did not mention these numbers. He was so angry that I was not jumping into doing the biopsies that he was short with me.

I've been trying to find current info on the color MRI to assist in a biopsy. Most of the info is dated and not particularly upbeat on the method.

Does anyone try low fat, low carb diets and all the suppliments, ie beta - sistosterol, zinc et al. to reduce the size of the tumor?

Replicant · Moderator Joined: 01 Nov 2006 Posts: 720

My uro had me on zinc, lycopene, E....didn't do a thing as far as I could tell. But I probably already had cancer, and that's a genie that won't go back in the bottle by living right and eating well.

Care should be taken with zinc. A little supplementation may help, but a large study found that men who took 100 mg/day over 10 years doubled their risk. Researchers at Oregon State U. did a good job of explaining this, IMHO:

"The efficacy of zinc supplements in preventing prostate cancer is controversial. Although several studies have shown that high cellular zinc levels inhibit prostate cancer cell growth, a recent epidemiological study showed an increased risk for prostate cancer in men who took high-dose zinc supplements. Increased cancer risk was seen with very high dose (over 100 mg/day) or long-term (more than 10 years) zinc supplement use. The current tolerable upper intake level for zinc is 40 mg/day, established by the U.S. Institute of Medicine. Thus, it is possible that the subjects in the epidemiological study could have been in the toxic range of zinc intake. As with most therapeutics, higher doses do not always equate with an increase in efficacy. "
http://lpi.oregonstate.edu/ss05/zinc.html

also see:
http://www.ncbi.nlm.nih.gov/pubmed/12837837

You should also take care with selenium supplements, which are sometimes recommended. Recently the FDA recommended consumers throw out certain brands of vitamins because of selenium toxicity. The same institute as above did a good job of explaining the situation: that some studies have shown men with higher selenium levels had lower rates of prostate cancer BUT another study showed that men who were taking multivitamins and selenium together were more likely to develop advanced prostate cancer and die from it.
http://lpi.oregonstate.edu/infocenter/minerals/selenium/
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 (and thereafter) <0.1
http://pcabefore50.blogspot.com

johnw100

I agree with the previous suggestions to consult a medical oncologist expert in prostate cancer for an objective view on how to proceed.

Various things will affect PSA readings, including prostate size which needs to be taken into account when looking at PSA numbers (PSA Density). The larger a prostate is, the more PSA is produced which can account for a gradual PSA rise over time.
A "freePSA" test will show the % of PSA being produced by normal means which will show the probability of cancer.

Dr Scardino in his publication advocates use of additional transition zone biopsies and the use of imaging "if a patient has a high PSA level given the size of his prostate (PSA density over 0.15) or a low free PSA level (less than 10%) in combination with an elevated PSA, both of which point to a higher likelihood that a cancer exists".

rikoshaprl · New User Joined: 18 Jun 2009 Posts: 5

Thanks.
I found a medical oncologist in my neighborhood covered by my health insurance. I am going to try to get a consultation with him. I'll keep you posted on what happens.

johnT · Senior User Joined: 27 Apr 2009 Posts: 163

Rikoshaprl,
Make sure that the oncologist specializes in prostate cancer. A regular oncologist may not be that much better than a urologist. The Prostate Cancer Research Institute website has a list of prostate cancer specialists including oncologists. There are only a very few oncologists in the US specializing in PC, less than 30. Where do you live?
JohnT
_________________
psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT

rikoshaprl · New User Joined: 18 Jun 2009 Posts: 5

I live in Nassau County, NY

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

As close as you are, I think I would strongly consider zipping over to Sloan-Kettering Cancer Center in Manhattan. They are about the #2 rated cancer center in the U.S. and you are so close.
_________________
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

rikoshaprl · New User Joined: 18 Jun 2009 Posts: 5

Hawk
Do you think your reoccurence is because the PCa had escaped beyond the prostate before surgury? Or could it have escaped from the biopsies or during surgury?
My brother passed away had the radical surgury. The Dr. said the outer wall was not broken. But the PSA #'s started to climb about two years after the surgury. My brother suspected the biopsies as the cause. He did live eleven years after surgury. He did on and off harmonal therapy. Prayers helped extend his life.

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

rikoshaprl, I appreciate the vote of confidence but the truth is that it would not matter much what I think. No one lower than God could have anything but a guess at this point. That is especially true at this point since no one can even tell if it is completely local of if I have some distant metastasis.

No one can tell at what point a cancer is going to metastasize. Unlike Pearl Harbor which was called a day of infamy. that day and moment will remain forever unknown.

If you want a bit of wild guessing, I would say the chances are that it was NOT due to biopsy since only 2 needles ever hit cancer. I am somewhat confident that spreading prostate cancer by biopsy is uncommon and a needle certainly cannot spread what it does not hit.
_________________
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

Replicant · Moderator Joined: 01 Nov 2006 Posts: 720

I agree with Hawk on multiple points, including the part about Memorial Sloan Kettering. If it's not too far and insurance covers it, why not go with some of the best in the world?
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 (and thereafter) <0.1
http://pcabefore50.blogspot.com

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