Really scared after first PSA test

sfmcfar · New User Joined: 21 Oct 2007 Posts: 2

Hi,

First time poster here.

I'm 46, and went to see the urologist two weeks ago for what I thought were kidney stone difficulties - I have a history of stones and was having from nagging left flank pain. The doc decided to give me a PSA test as a precaution, since my father's brother died of prostate cancer (although he was in his 70's at the time of his death). My rectal exam, according to the doc, showed some slight enlargement (but nothing else), and since I do have a bit of increased urination at night I thought that it made sense that my prostate was a bit enlarged (and I have a significant family history of enlarged prostate).

Anyway, my PSA level turns out to be at 5.3. The urologist has prescribed a 3 week course of Cipro and a repeat PSA test - if the PSA is still high, he recommends a biopsy. Oh, and the blood was drawn for the PSA test approximately 30 minutes after the rectal exam.

I'm scared to death.

I've got two sons, one starting high school next year and the other starting college, and I'm afraid I won't live to see them finish. If I have to have my prostate removed, I can deal with it, but I'm not ready to die from this. It's really hard to find data on prostate cancer for men as young as I am, so I can't tell if my PSA of 5.3 is much worse for a 46 year old male than a 60 year old.

I'm hoping that my follow-up PSA will be lower (I read that the rectal exam can raise PSA levels, but I couldn't find out by how much), but in the meantime, I'm a basket case. I have a tendency to wear my emotions on my sleeve, and I had to leave church twice this morning to have a good cry.

I sure could use some encouragement.

Thanks and God bless,

Stan

brainman

Hi sfmcfar, I am very sorry about your health concerns right now and I too hope the next PSA is lower. While your PSA is higher that what is considered "normal", it is not off the scale high. An elevated PSA can be caused by several things including enlarged prostate and resent sexual activities. The key is not the specific number but a trend. If it continues to go up, ask your medical team to check your free PSA level, if they have not done so already. It is a much more accurate level. I do not what to frighten you more, but a prostate biopsy does have a higher than other cancers rate of false negatives... especially when no growth is seen on a CAT scan or MRI. Discuss this issue with your medical team.

Good luck and keep us informed.
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sfmcfar · New User Joined: 21 Oct 2007 Posts: 2

Thanks, Brainman. Where in Tennessee are you? I live in Annapolis but was born and raised in Knoxville.

I like the idea of the free PSA test with the biopsy (if I have to have one). I think a negative biopsy plus a good free PSA level would be the best possible outcome. I don't think I'd want to have a repeat biopsy unless the free PSA levels were bad.

-stan

tmadden17 · New User Joined: 02 Nov 2007 Posts: 1

I am with you brother. I am only 40 and have just pretty much conclusively found out I have cancer. Initail PSA was 17.5. Second test was 10 but the free PSA was at 6%. I am scared to death but pissed and fighting like hell to kick this. Good luck to you!

sequoiaranger · Posted: Mon Nov 05, 2007 3:51 am Post subject: Time is of the Essense

I had an elevated PSA (6 range), got a (clear) biopsy one year, and by the next year I had a PSA of 12, and a Gleason 9 tumor that metastasized. I got my prostate yanked and am on hormone therapy to suppress the spread.

GET A BIOPSY NOW! They are unpleasant, but need to be done. In cancer, the earlier the detection the better. I was too late.

Boothby171

I'm 46, and had a slightly elevated PSA initially. But a biopsy showed a small amount of Gleason 3+3 cancer.

A later, second biopsy showed slightly more 3+3 cancer (though whether it is/was growing, or is just attributable to the randiom sampling effect...who knows?!).

If you have a Uro who will knock you out for the biopsy, then it's not painful at all! Wink

My first was like that, my second...was not.

Expect to either urinate or ejaculate blood for a few weeks after (and, perhaps, both, I guess); I suffered from the latter, not the former, both times.

Best of luck.

--Steve

BTW, my PSA keeps REDUCING! It went from 3.40 originally to 2.37 recently! (Two place decimal accuracy is, of course, meaningless) But with the cancer showing in the biopsy, I'm scheduled for robotic surgery with Tewari (one of , if not THE best) on Jan 10, 2008.

Replicant · Moderator Joined: 01 Nov 2006 Posts: 744

It could be the rectal exam that caused the PSA elevation. Or benign enlargement...or an infection. So don't panic. You may not even need a biopsy. Before then next PSA, don't ejaculate for at least a week, or ride a bike. If you're going to have a rectal exam, have it done AFTER the blood draw. Rectal exams, sex and bike riding *can* elevate PSA in the bloodstream.

If you have to get a biopsy, ask for an injection of local anesthetic. Some docs think the lidocaine gel they put on the probe is enough, but by all accounts, having a quick injection before the biopsy makes it a lot more comfortable, and is becoming the norm in urologists offices.

Good luck!

ddooley · Posted: Wed Jan 09, 2008 8:28 am Post subject: PSA

Hi,

it is also my understanding that the blood draw must be done before the

rectal examionation, as this can adversly affect the result by quite a lot.

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