Prostate Cancer

sueanne · New User Joined: 19 Jan 2005 Posts: 3

My husband had a blood test on Jan. 10 that showed his PSA at over 2,000. On Jan. 14, he had another blood test that indicated that his PSA was even higher. Everything we have learned about PSA, it's listed at 2.0 to 4.0. What does it mean when it's 2,000 or higher? We know he is in the very dangerous zone, so please do not hold back any info.

Thank you

mycroft · Posted: Wed Jan 19, 2005 12:53 pm Post subject: Re: Prostate Cancer

[quote="sueanne"]
My husband had a blood test on Jan. 10 that showed his PSA at over 2,000. On Jan. 14, he had another blood test that indicated that his PSA was even higher. Everything we have learned about PSA, it's listed at 2.0 to 4.0. What does it mean when it's 2,000 or higher? We know he is in the very dangerous zone, so please do not hold back any info.
[/quote]

Why was the PSA test done?? Were other tests performed? There is insufficient information.

Based upon the PSA alone, I would have to say that it is best to take action without delay.

But what action? One must make sure that there is not some other reason for the extreme PSA reading. For example, was the prostate under stress within the 24-48 hours before the test? Examples include but are not limited to ejaculation, a DRE (digital rectal examination) and/or infection or inflammation.

Is a biopsy scheduled? If so, it absolutely MUST be validated by further examination by a lab that specializes in pathological examination of prostate specimens. The biopsy result would be the foundation for any future course, so its accuracy must be assured. There are about 6-8 specialist labs in the USA.

Is the doctor a urologist, or a cancer specialist (oncologist)?

There is a number of tests that will help to construct a portrait of the biology of this case, but first and foremost the presence or absence of carcinoma must be confirmed.

Please post updated information, including age, general health, symptoms, any other test results.

And see the Prostate Cancer Research Institute website at:
http://prostate-cancer.org/index.html
for essential information and guidance.

Regards,

Steve J

sueanne · New User Joined: 19 Jan 2005 Posts: 3

To answer your questions, my husband just turned 69. He has not had a physical since he retired from the military in 1984. I have seen signs of problems throughout our 14 years of marriage that indicated a problem, but he refused to see a doctor.

We saw an internist on Jan. 10, and the doctor did the first blood test on my husband. There was no stress on the prostate that I know of prior to this blood test. This doctor sent my husband to an urologist immediately upon receiving the results of the blood test (Jan. 14). The urologist scoped the prostate and took another blood test. This blood test showed that his PSA was more than the 2,000 that his first blood test showed. The urologist set up an immediate appointment for him to scope the prostate and do a biopsy on Monday (Jan 17). (The doctor gave up his day off to do this.) The urologist sent my husband for a CT on his stomach and a bone density x-ray. We are to get all of the results from the CT, x-rays and biopsy on Tues. (Jan. 25).

My husband's general health is good. The most he has had through the 14 years is bronchitis once, pnumonia once, and had a basal cell removed. He had skin cancer when he was stationed in Hawaii back in the 70's, so he is very careful about any abnormoral growth on his body.

I hope this gives you the info you need to answer my original question. I would like to know what PSA 2,000 or more compares to the info I've been getting where the PSA is measured as 2.0 to 4.0 nano what have you. I know we have to do something in a hurry, and we are. My feeling is, if there is a cancer, you cut it out and get rid of it and hopefully live a long healthy life after that.

Thank you.

Sue Anne

mycroft · Posted: Thu Jan 20, 2005 7:44 pm Post subject: Re: Prostate Cancer

[quote="sueanne"]To answer your questions, my husband just turned 69. >He has not had a physical since he retired from the military in 1984. I have seen signs of problems throughout our 14 years of marriage that indicated a problem, but he refused to see a doctor.

**Yes, I understand that denial is often the case in these matters. In general, men simply do not want to think about any problems with their "plumbing." This is a potentially deadly error.

The lives of Sue Anne and her husband (what's his name?) have fundamentally changed. No matter what the future holds, PCa in some of its aspects will forever be part of it. There is no choice; it is best to decide to deal with this devil as best one can and not look back.

My response to it is somewhat military: first, I want to know the strength and dispositions of my enemy. Second, I want to attack it with every weapon at my disposal. The patient, a retired military man, may understand this very well.

Those weapons are chosen based upon the intelligence gathered in the testing and staging phase. This is not just important, it is *vital.* I have seen too many cases in just the year or so that I've had to deal with my own PCa where men stampeded into treatments that may not have been appropriate because they did not learn the biology of their disease. And -- this is important -- the disease is as different as there are the men who have it. IOW, what's right for me is not necessarily what's right for Sue Anne's husband.

It will not do to choose a treatment strategy until as much as possible is known about the enemy. So: while moving quickly is important, I believe that moving in the right direction is absolutely essential.

>We saw an internist on Jan. 10, and the doctor did the first blood test on my husband. There was no stress on the prostate that I know of prior to this blood test. This doctor sent my husband to an urologist immediately upon receiving the results of the blood test (Jan. 14). The urologist scoped the prostate and took another blood test.

** What is meant by "scoped?"

This blood test showed that his PSA was more than the 2,000 that his first blood test showed. The urologist set up an immediate appointment for him to scope the prostate

**there's that word again...

and do a biopsy on Monday (Jan 17). (The doctor gave up his day off to do this.) The urologist sent my husband for a CT on his stomach and a bone density x-ray. We are to get all of the results from the CT, x-rays and biopsy on Tues. (Jan. 25).

A CT and nuclear bone scan (it that's what the latter was) are usually too insensitive to be of use in staging the case of a newly-diagnosed man. AIUI, this is something that urologists and naive oncologists resort to as a sort of "mantra." However, considering the extreme PSA level reported, they may in this case provide useful information about possible metastases.

(snip)

I hope this gives you the info you need to answer my original question. I would like to know what PSA 2,000 or more compares to the info I've been getting where the PSA is measured as 2.0 to 4.0 nano what have you.

**The cutpoint for maximum PSA was, until recently, 4.0 ng/dL. Lately, it has been recommended that 2.5 is more likely to produce good results in terms of survival. A PSA in excess of these levels is considered to be good cause for a biopsy. An excessive PSA in and of itself is *not* diagnostic of PCa. Only a biopsy, properly validated as stated in my previous post, will do that.

Moreover, we must not neglect clinical staging, which is dependent upon a DRE (digital rectal examination) that one hopes was performed by a competent medic. This would be expressed as, for example, "T2c." The medic is checking for hard spots on the prostate. What is the patient's stage??

I know we have to do something in a hurry, and we are.

**As above, do something soon, but *do the right thing.* Take the time to learn the biology of the patient's particular disease. Once that is known, the most effective treatment choice can be chosen. Running off in all directions will likely do more harm than good.

My feeling is, if there is a cancer, you cut it out and get rid of it and hopefully live a long healthy life after that.

**One must hope that prostatectomy is the right choice. BUT there may be another, better, treatment choice. I must say again that learning the biology of this particular case is *absolutely essential.*

I am not a medic, just a (so far) survivor. I have studied this devil for many months, and will not stop until either I kill it, or it kills me.

I cannot recommend , nay, beg too strongly that the site of the Prostate Cancer Research Institute be the first resort: http://prostate-cancer.org/index.html
then click on the "Decision Aide" link.

Regards,

Steve J
__
"Never give in--never, never, never, never, in nothing great or small, large or petty, never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.''
--Sir Winston L. S. Churchill

sueanne · New User Joined: 19 Jan 2005 Posts: 3

I give up! I do not understand why no one in America can answer my original question!! I had a call today from a friend of ours that just went through prostate surgery, and he told me that he saw his doctor for his final check-up yesterday and while he was there, he asked his doctor my question. It's a shame that I have to get answers from an Australian doctor!

Thanks for no help.

Sue Anne

mycroft · Posted: Sat Jan 22, 2005 4:01 pm Post subject: Re: Prostate Cancer

On January 21, Sue Anne posted:

[quote="sueanne"]

Thanks for no help.

Sue Anne[/quote]

What a pity....

Steve J

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