Biopsy?

Hi.

I'm 51 y/o with history of chronic prostatitis. Just had an increase in
PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
him why not repeat PSA, just in case? He said the labs don't make
mistakes. Should I push him on this or just accept the biopsy?

Larry

"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked him
> why not repeat PSA, just in case? He said the labs don't make mistakes.
> Should I push him on this or just accept the biopsy?
>
> Larry

First off if your doctor thinks labs don't make mistakes he's a fool.

Second, to my knowledge biopsies are not usually considered until PSA is
usually up around 4.

Personally I'd find anohter uro. It sounds more like he just bought a new
BMW and need someone to make payments for him

On Apr 25, 10:02*am, Larry <la...@nospam.net> wrote:
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
> him why not repeat PSA, just in case? He said the labs don't make
> mistakes. Should I push him on this or just accept the biopsy?
>
> Larry

Hi Larry...A PSA increase of 0.75 ng/ml, some say 0.50, in a year
suggests further evaluation. A repeat of the PSA test is a good idea,
IMO. Better yet might be a retest after a 2-3 antibiotic regimen to
see if prostatitis might be the real culprit (unfortunately not all
prostatitis responds to antibiotics)...ron

LOL! Thanks!

I just think he's looking to CYA. BTW, PSA over 4 is not the only
criteria used. The rate at which it increases is also a consideration.

Larry

whoknew wrote:
> "Larry" <larry@nospam.net> wrote in message
> news:4812005d$0$25032$607ed4bc@cv.net...
>
>>Hi.
>>
>>I'm 51 y/o with history of chronic prostatitis. Just had an increase in
>>PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked him
>>why not repeat PSA, just in case? He said the labs don't make mistakes.
>>Should I push him on this or just accept the biopsy?
>>
>>Larry
>
>
> First off if your doctor thinks labs don't make mistakes he's a fool.
>
> Second, to my knowledge biopsies are not usually considered until PSA is
> usually up around 4.
>
> Personally I'd find anohter uro. It sounds more like he just bought a new
> BMW and need someone to make payments for him
>
>

"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an
> increase in PSA from 1 to 1.8 over one year. My uro is ordering
> a biopsy. I asked him why not repeat PSA, just in case? He said
> the labs don't make mistakes. Should I push him on this or just
> accept the biopsy?
>
> Larry

I'm not a doctor but it is my understanding that prostatitis
does elevate PSA levels. Furthermore, I suspect that PSA tracks
flareups. When you're having a bout of prostatitis the PSA may
go up during that period and then come back down if the
inflammation recedes.

Apparently, PSA levels can go up due to a number of different
factors. If you had sex the night before the blood draw, or if
you had a digital rectal exam shortly before the blood draw, that
could elevate PSA levels (again, I'm not a doctor, but those are
the conventionally accepted views.) The theory is that there
should be no stress on the prostate for 48 hours before the blood
draw in order to get an accurate reading.

It is commonly held that people with prostatitis should get a
round of antibiotic treatment to see if it goes down. From my
reading, I think that the majority of prostatitis cases are not
in fact due to bacterial infections and won't respond to
antibiotics. I know that I've suffered from prostatitis and had
no response to antibiotics except a queasy stomach for 28 days.
I personally don't believe in taking antibiotics unless you
really need them, and would ask the uro to do a urine culture to
find out if there are higher than normal levels of bacteria in
the urine - which might indicate that an antibiotic would do some
good and not just wipe out beneficial bacteria in your body and
help breed antibiotic resistant organisms.

As for labs making mistakes, well, I'm sure it's true that
mistakes are pretty rare. But no matter what systems they have
in place to prevent them, there are still human beings running
the labs. I would have liked your doctor's statement better if
he had said that mistakes are rare rather than that they don't
happen. Still, the odds are high that the reading is correct.
The main issue is, is this increase in PSA really due to cancer?

Did the uro feel anything on his digital rectal exam? If he did,
then I think he's right that a biopsy should be done.

If not, then I like your idea of repeating the PSA rather than
getting a biopsy.

I'm a little reluctant to contradict your uro. He's a
credentialed expert and I'm not. However, your PSA is well
within normal limits, you have an alternate explanation for the
recent rise (prostatitis), a biopsy is expensive and invasive, a
PSA test is cheap and non-invasive, and prostate cancer is
normally a very slow growing disease anyway so that waiting a bit
and re-testing is unlikely to put you at much risk. The usual
theory is that anyone with a PSA below 10 and a Gleason score
(which you can't get without a biopsy unfortunately) below 7, has
a very high probability of successful treatment.

So, I'd schedule another PSA test. I'd be sure there is no sex,
no digital rectal exam, maybe even no bike riding, for 48 hours
before, and see what it says. I think there is a good chance it
will be lower than your last reading. If it's higher, then maybe
you should get a biopsy.

Good luck.

Alan

Thanks, Ron. So I wonder why this guy is so anxious to do a biopsy
before trying antibiotics, especially given I have a history of
prostatitis?

Larry

ron wrote:
> On Apr 25, 10:02 am, Larry <la...@nospam.net> wrote:
>
>>Hi.
>>
>>I'm 51 y/o with history of chronic prostatitis. Just had an increase in
>>PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
>>him why not repeat PSA, just in case? He said the labs don't make
>>mistakes. Should I push him on this or just accept the biopsy?
>>
>>Larry
>
>
> Hi Larry...A PSA increase of 0.75 ng/ml, some say 0.50, in a year
> suggests further evaluation. A repeat of the PSA test is a good idea,
> IMO. Better yet might be a retest after a 2-3 antibiotic regimen to
> see if prostatitis might be the real culprit (unfortunately not all
> prostatitis responds to antibiotics)...ron

Thanks, Alan. The only thing he noted upon DRE is the left lobe bigger
than the right. He said sometimes that means something and sometimes
not. And in fact, I am having a bit of dull pain on the left side, so
I'm thinking it could be the prostatitis.

Larry

Alan Meyer wrote:

> "Larry" <larry@nospam.net> wrote in message
> news:4812005d$0$25032$607ed4bc@cv.net...
>
>>Hi.
>>
>>I'm 51 y/o with history of chronic prostatitis. Just had an
>>increase in PSA from 1 to 1.8 over one year. My uro is ordering
>>a biopsy. I asked him why not repeat PSA, just in case? He said
>>the labs don't make mistakes. Should I push him on this or just
>>accept the biopsy?
>>
>>Larry
>
>
> I'm not a doctor but it is my understanding that prostatitis
> does elevate PSA levels. Furthermore, I suspect that PSA tracks
> flareups. When you're having a bout of prostatitis the PSA may
> go up during that period and then come back down if the
> inflammation recedes.
>
> Apparently, PSA levels can go up due to a number of different
> factors. If you had sex the night before the blood draw, or if
> you had a digital rectal exam shortly before the blood draw, that
> could elevate PSA levels (again, I'm not a doctor, but those are
> the conventionally accepted views.) The theory is that there
> should be no stress on the prostate for 48 hours before the blood
> draw in order to get an accurate reading.
>
> It is commonly held that people with prostatitis should get a
> round of antibiotic treatment to see if it goes down. From my
> reading, I think that the majority of prostatitis cases are not
> in fact due to bacterial infections and won't respond to
> antibiotics. I know that I've suffered from prostatitis and had
> no response to antibiotics except a queasy stomach for 28 days.
> I personally don't believe in taking antibiotics unless you
> really need them, and would ask the uro to do a urine culture to
> find out if there are higher than normal levels of bacteria in
> the urine - which might indicate that an antibiotic would do some
> good and not just wipe out beneficial bacteria in your body and
> help breed antibiotic resistant organisms.
>
> As for labs making mistakes, well, I'm sure it's true that
> mistakes are pretty rare. But no matter what systems they have
> in place to prevent them, there are still human beings running
> the labs. I would have liked your doctor's statement better if
> he had said that mistakes are rare rather than that they don't
> happen. Still, the odds are high that the reading is correct.
> The main issue is, is this increase in PSA really due to cancer?
>
> Did the uro feel anything on his digital rectal exam? If he did,
> then I think he's right that a biopsy should be done.
>
> If not, then I like your idea of repeating the PSA rather than
> getting a biopsy.
>
> I'm a little reluctant to contradict your uro. He's a
> credentialed expert and I'm not. However, your PSA is well
> within normal limits, you have an alternate explanation for the
> recent rise (prostatitis), a biopsy is expensive and invasive, a
> PSA test is cheap and non-invasive, and prostate cancer is
> normally a very slow growing disease anyway so that waiting a bit
> and re-testing is unlikely to put you at much risk. The usual
> theory is that anyone with a PSA below 10 and a Gleason score
> (which you can't get without a biopsy unfortunately) below 7, has
> a very high probability of successful treatment.
>
> So, I'd schedule another PSA test. I'd be sure there is no sex,
> no digital rectal exam, maybe even no bike riding, for 48 hours
> before, and see what it says. I think there is a good chance it
> will be lower than your last reading. If it's higher, then maybe
> you should get a biopsy.
>
> Good luck.
>
> Alan
>
>

Don't forget to examine your family history. I found out after my
diagnosis that my grandfather had pCa. If I and my doc knew that before
I probably would have had a biopsy many months earlier when my PSA was
under 4. And I possibly may have had negative margins instead of
positive margins to go along with my aggressive Gleason which can
influence a lower PSA.

FelmerDingle

Larry wrote:
> Thanks, Alan. The only thing he noted upon DRE is the left lobe bigger
> than the right. He said sometimes that means something and sometimes
> not. And in fact, I am having a bit of dull pain on the left side, so
> I'm thinking it could be the prostatitis.
>
> Larry
>
> Alan Meyer wrote:
>
>> "Larry" <larry@nospam.net> wrote in message
>> news:4812005d$0$25032$607ed4bc@cv.net...
>>
>>> Hi.
>>>
>>> I'm 51 y/o with history of chronic prostatitis. Just had an
>>> increase in PSA from 1 to 1.8 over one year. My uro is ordering
>>> a biopsy. I asked him why not repeat PSA, just in case? He said
>>> the labs don't make mistakes. Should I push him on this or just
>>> accept the biopsy?
>>>
>>> Larry
>>
>>
>> I'm not a doctor but it is my understanding that prostatitis
>> does elevate PSA levels. Furthermore, I suspect that PSA tracks
>> flareups. When you're having a bout of prostatitis the PSA may
>> go up during that period and then come back down if the
>> inflammation recedes.
>>
>> Apparently, PSA levels can go up due to a number of different
>> factors. If you had sex the night before the blood draw, or if
>> you had a digital rectal exam shortly before the blood draw, that
>> could elevate PSA levels (again, I'm not a doctor, but those are
>> the conventionally accepted views.) The theory is that there
>> should be no stress on the prostate for 48 hours before the blood
>> draw in order to get an accurate reading.
>>
>> It is commonly held that people with prostatitis should get a
>> round of antibiotic treatment to see if it goes down. From my
>> reading, I think that the majority of prostatitis cases are not
>> in fact due to bacterial infections and won't respond to
>> antibiotics. I know that I've suffered from prostatitis and had
>> no response to antibiotics except a queasy stomach for 28 days.
>> I personally don't believe in taking antibiotics unless you
>> really need them, and would ask the uro to do a urine culture to
>> find out if there are higher than normal levels of bacteria in
>> the urine - which might indicate that an antibiotic would do some
>> good and not just wipe out beneficial bacteria in your body and
>> help breed antibiotic resistant organisms.
>>
>> As for labs making mistakes, well, I'm sure it's true that
>> mistakes are pretty rare. But no matter what systems they have
>> in place to prevent them, there are still human beings running
>> the labs. I would have liked your doctor's statement better if
>> he had said that mistakes are rare rather than that they don't
>> happen. Still, the odds are high that the reading is correct.
>> The main issue is, is this increase in PSA really due to cancer?
>>
>> Did the uro feel anything on his digital rectal exam? If he did,
>> then I think he's right that a biopsy should be done.
>>
>> If not, then I like your idea of repeating the PSA rather than
>> getting a biopsy.
>>
>> I'm a little reluctant to contradict your uro. He's a
>> credentialed expert and I'm not. However, your PSA is well
>> within normal limits, you have an alternate explanation for the
>> recent rise (prostatitis), a biopsy is expensive and invasive, a
>> PSA test is cheap and non-invasive, and prostate cancer is
>> normally a very slow growing disease anyway so that waiting a bit
>> and re-testing is unlikely to put you at much risk. The usual
>> theory is that anyone with a PSA below 10 and a Gleason score
>> (which you can't get without a biopsy unfortunately) below 7, has
>> a very high probability of successful treatment.
>>
>> So, I'd schedule another PSA test. I'd be sure there is no sex,
>> no digital rectal exam, maybe even no bike riding, for 48 hours
>> before, and see what it says. I think there is a good chance it
>> will be lower than your last reading. If it's higher, then maybe
>> you should get a biopsy.
>>
>> Good luck.
>>
>> Alan
>>
>>

"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked him
> why not repeat PSA, just in case? He said the labs don't make mistakes.
> Should I push him on this or just accept the biopsy?
>
> Larry


Hi Larry. Get the biopsy. I'm 45 years old, had a normal PSA, but a lump was
found during my annual physical. I was sent off for a consultation with a
urologist and they repeated the DRE. As a result, I had a biopsy done right
on the spot. My test results came back positive for prostate cancer. My
surgery was on March 20th and I'm recovering slowly.

A PSA test is not the definitive answer as to whether there is a problem or
not. Get a DRE and get a biopsy just to make sure. The biopsy is unpleasant
but releatively painless and it will take about 10 to 15 minutes depending
on how many samples need to be taken. Waiting for the results is actually
worse.

If you have any questions, feel free to ask.

Thanks, I can appreciate your story and why you would recommend it.
Actually, I just verified that my PSA went from 1 to 1.6 to 1.8 over 2
years (not 1 year). I am still going to question him about it again.

Regarding the biopsy, can you provide any sense for what "unpleasant"
means to you re the biopsy? I mean, a biopsy needle goes through the
intestinal wall and about an inch into the prostate. That is only
"unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
would you describe it?

Thanks!

Larry

NB wrote:
> "Larry" <larry@nospam.net> wrote in message
> news:4812005d$0$25032$607ed4bc@cv.net...
>
>> Hi.
>>
>> I'm 51 y/o with history of chronic prostatitis. Just had an increase
>> in PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I
>> asked him why not repeat PSA, just in case? He said the labs don't
>> make mistakes. Should I push him on this or just accept the biopsy?
>>
>> Larry
>
>
>
> Hi Larry. Get the biopsy. I'm 45 years old, had a normal PSA, but a lump
> was found during my annual physical. I was sent off for a consultation
> with a urologist and they repeated the DRE. As a result, I had a biopsy
> done right on the spot. My test results came back positive for prostate
> cancer. My surgery was on March 20th and I'm recovering slowly.
>
> A PSA test is not the definitive answer as to whether there is a problem
> or not. Get a DRE and get a biopsy just to make sure. The biopsy is
> unpleasant but releatively painless and it will take about 10 to 15
> minutes depending on how many samples need to be taken. Waiting for the
> results is actually worse.
>
> If you have any questions, feel free to ask.
>
>

On April 25, Larry wrote:

(snip)

> Regarding the biopsy, can you provide any sense for what "unpleasant"
> means to you re the biopsy? I mean, a biopsy needle goes through the
> intestinal wall and about an inch into the prostate. That is only
> "unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
> would you describe it?

Well, my anecdote is this: I felt almost nothing. Why? Because I
required that I be administered anti-pain drugs.

Some here will claim that it's not so bad; others will claim that it was
horrible without drugs.

I claim that no one knows what will happen and that only a self-styled
macho fool would decline pain prevention.

One thing I have wondered about and has not been answered by anyone is
this: if the patient does not experience pain and tense up, the uro
should have a more convenient task. Hello?

Regards,

Steve J

Larry wrote:

> Regarding the biopsy, can you provide any sense for what "unpleasant"
> means to you re the biopsy? I mean, a biopsy needle goes through the
> intestinal wall and about an inch into the prostate. That is only
> "unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
> would you describe it?

If my doctor hadn't said, "here goes another one" before each needle
jab, I'm not sure I would have realized he was doing anything beyond
jamming hardware where it doesn't belong. Since he did, I noticed a
twinge of "unpleasantry" each time. He said that's about how
the vast majority of his patients perceived it. I'm sure some gay men
have had far rougher experiences which, overall, they enjoyed.

Our intestine wall nerves perceive only stretching, not cutting (I've
watched them snip bumps from my intestine walls during colonoscopies,
and it was as though it was just a video of someone else's intestine.)
All I actually felt during colonoscopies was the introduction of enough
gas to inflate the intestine significantly, and we've all felt that many
times; they're called gas pains.

A few men say their biopsies were very painful. I have no idea whether
that's physiological or psychological.

I.P.

The first biopsy was without pain medication and unbearable to the point
that I passed out after the Uro announced the eleventh probe.
Due to this newsgroups existence and advise from contributors, I told my Uro
at the second biopsy that I wanted to be sedated or whatever. He performed
the procedure whilst I was under a short spell of anastatic.
In response to I.P.'s comment...I am a masochist and know what pain is, but
can assure you that the acute pain I felt at my first biopsy was NOT
psychological!

John

"Larry" <larry@nospam.net> wrote in message
news:481266fe$0$11635$607ed4bc@cv.net...
> Thanks, I can appreciate your story and why you would recommend it.
> Actually, I just verified that my PSA went from 1 to 1.6 to 1.8 over 2
> years (not 1 year). I am still going to question him about it again.
>
> Regarding the biopsy, can you provide any sense for what "unpleasant"
> means to you re the biopsy? I mean, a biopsy needle goes through the
> intestinal wall and about an inch into the prostate. That is only
> "unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
> would you describe it?
>
> Thanks!
>
> Larry


Well..... the biospy was done with the assistance of an ultrasound probe. A
desensitizing gel is applied to the probe and also applied to your anus.
The probe is then inserted. A needle with freezing medication is inserted
and you feel some of the pressure and poke of the injection into the
prostate. If your doctor is gentle and not in a rush, you shouldn't feel
much of anything beyond that once the freezing sets in. You will hear a
"SNAP!" sort of sound as each sample is being taken. I guess everyones
tolerance to pain is different, but trust me, this isn't nearly as bad
as it sounds. The entire procedure takes about 10 to 15 minutes. Side
effects are minimal in most cases. You can expect to bleed for a few
hours or days afterwards and will need to wear a pad so that you don't
stain your underwear or clothing. Also, you will pass blood in your urine
and semen for some time. It can take several weeks for this to stop.
They encourage you to have as much sexual activity as you can handle
afterwards. It helps clean things out. Other than the wait time to get your
results, the second worst thing about this is the first urination or
ejaculation following the biopsy. It is quite shocking to see blood where
there was none before.

If they know what they are doing, they will give you an information sheet
of things to watch out for following the biopsy. You could develop an
infection in which case you will need antibiotics. Signs to watch out for:
fever, heavy bleeding (soaked pad ).

Feel free to discuss this procedure with your doctor. You will probably also
be offered a sedative or pain medication or both. I went with the sedative
but didn't require anything beyond the freezing injection. Also, you will
be given some antibiotics (or you should be given some antibiotics) as a
preventative measure so that you do not develop an infection.
Unfortunately, I did get some prostatitis following the procedure and I
had to go on antibiotics for several weeks thereafter. Not to worry. It
doesn't happen to everyone.

I hope that answers some of your questions. If you have any others, fire
away. Best of luck,

Nick

On Fri, 25 Apr 2008 19:20:11 -0400, Larry <larry@nospam.net> wrote:

>Thanks, I can appreciate your story and why you would recommend it.
>Actually, I just verified that my PSA went from 1 to 1.6 to 1.8 over 2
>years (not 1 year). I am still going to question him about it again.
>
>Regarding the biopsy, can you provide any sense for what "unpleasant"
>means to you re the biopsy? I mean, a biopsy needle goes through the
>intestinal wall and about an inch into the prostate. That is only
>"unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
>would you describe it?
>
I had no pain killing drugs. I didn't know to ask for them and the
doc never mentioned it. Even though it was done over 13 years ago, I
damned well remember it! The probe is well lubed and no problem. The
needle going in was uncomfortable, but, very tolerable. Most of the
samples were taken with a minimal or moderate amount of pain and
discomfort. (Some kind of pain killer would have been nice for
those.) A couple of the "snaps" were accompanied by a lot of pain. I
remember shouting "SHIT" with he pulled the trigger for one. Some
pain killers and some valium would have been good about that time. I
have no idea why some hurt like hell and others were just unpleasant,
but that was my experience

Take the advise that several have given you and ask for drugs!

Even though I was told to expect some blood in my urine, the first
time at a urinal I almost passed out! It looked like pure blood! Rust
colored semen for a while is another joy! It's no fun, but, we all
survived it.

Good luck and best wishes!

Burney

whoknew wrote:
> "Larry" <larry@nospam.net> wrote in message
> news:4812005d$0$25032$607ed4bc@cv.net...
>> Hi.
>>
>> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
>> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked him
>> why not repeat PSA, just in case? He said the labs don't make mistakes.
>> Should I push him on this or just accept the biopsy?
>>
>> Larry
>
> First off if your doctor thinks labs don't make mistakes he's a fool.
>
> Second, to my knowledge biopsies are not usually considered until PSA is
> usually up around 4.

That is way out of date. For a 51 year old man, a much lower threshold
would be appropriate. But it is the rate of change that is important
rather than the actual value., and if the trend shown in the last test
continued, it would be reasonable to go to biopsy.

It is possible, on the other hand, for PSA to vary for a lot of reasons
other than prostate cancer, even assume the labs anever make mistakes.
Many doctors would wait a few months and take another reading to see if
the trend were continued.

Did your doctor suggest any other reason for concern, such as a
suspicious DRE?


If you are really concerned about the matter, you could seek another
opinion,
>
> Personally I'd find anohter uro. It sounds more like he just bought a new
> BMW and need someone to make payments for him
>
>

"Larry" <larry@nospam.net> wrote in message
news:481266fe$0$11635$607ed4bc@cv.net...
> Thanks, I can appreciate your story and why you would recommend it.
> Actually, I just verified that my PSA went from 1 to 1.6 to 1.8 over 2
> years (not 1 year). I am still going to question him about it again.
>
> Regarding the biopsy, can you provide any sense for what "unpleasant"
> means to you re the biopsy? I mean, a biopsy needle goes through the
> intestinal wall and about an inch into the prostate. That is only
> "unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
> would you describe it?
>
> Thanks!
>
> Larry
>
> NB wrote:
>> "Larry" <larry@nospam.net> wrote in message
>> news:4812005d$0$25032$607ed4bc@cv.net...
>>
>>> Hi.
>>>
>>> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
>>> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
>>> him why not repeat PSA, just in case? He said the labs don't make
>>> mistakes. Should I push him on this or just accept the biopsy?
>>>
>>> Larry
>>
>>
>>
>> Hi Larry. Get the biopsy. I'm 45 years old, had a normal PSA, but a lump
>> was found during my annual physical. I was sent off for a consultation
>> with a urologist and they repeated the DRE. As a result, I had a biopsy
>> done right on the spot. My test results came back positive for prostate
>> cancer. My surgery was on March 20th and I'm recovering slowly.
>>
>> A PSA test is not the definitive answer as to whether there is a problem
>> or not. Get a DRE and get a biopsy just to make sure. The biopsy is
>> unpleasant but releatively painless and it will take about 10 to 15
>> minutes depending on how many samples need to be taken. Waiting for the
>> results is actually worse.
>>
>> If you have any questions, feel free to ask.
>>

I can't say it was pleasant, but I've had a number of other medical and
dental procedures that were a lot worse. I had no anesthetic outside of
possibly a numbing material on the the probe (I'm not even sure I had that.)
Before I underwent the procedure, I read someone describe it as feeling like
someone was snapping rubber bands against the inside of the rectum. That
was pretty much descriptive of my experience.

Leonard,

The only "abnormality" from the DRE was the "left lobe was slightly
larger than the right lobe". I'm not sure that really constitutes an
abnormal DRE. And I confirmed the PSA numbers. It did not go from 1 to
1.8 in one year. It went from 1 to 1.6 in one year, and then from 1.6 to
1.8 in the subsequent year. In other words, it took 24 months for it to
go from 1 to 1.8, not 12 months.

Larry

Leonard Evens wrote:
> whoknew wrote:
>
>> "Larry" <larry@nospam.net> wrote in message
>> news:4812005d$0$25032$607ed4bc@cv.net...
>>
>>> Hi.
>>>
>>> I'm 51 y/o with history of chronic prostatitis. Just had an increase
>>> in PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I
>>> asked him why not repeat PSA, just in case? He said the labs don't
>>> make mistakes. Should I push him on this or just accept the biopsy?
>>>
>>> Larry
>>
>>
>> First off if your doctor thinks labs don't make mistakes he's a fool.
>>
>> Second, to my knowledge biopsies are not usually considered until PSA
>> is usually up around 4.
>
>
> That is way out of date. For a 51 year old man, a much lower threshold
> would be appropriate. But it is the rate of change that is important
> rather than the actual value., and if the trend shown in the last test
> continued, it would be reasonable to go to biopsy.
>
> It is possible, on the other hand, for PSA to vary for a lot of reasons
> other than prostate cancer, even assume the labs anever make mistakes.
> Many doctors would wait a few months and take another reading to see if
> the trend were continued.
>
> Did your doctor suggest any other reason for concern, such as a
> suspicious DRE?
>
>
> If you are really concerned about the matter, you could seek another
> opinion,
>
>>
>> Personally I'd find anohter uro. It sounds more like he just bought a
>> new BMW and need someone to make payments for him
>>

On Apr 25, 1:02 pm, Larry <la...@nospam.net> wrote:
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
> him why not repeat PSA, just in case? He said the labs don't make
> mistakes. Should I push him on this or just accept the biopsy?
>
> Larry

Larry:

you don´t need a "permission" from your uro to have another PSA test.
There are good reasons to have several, preferably spaced by time
intervals. PSA may vary within a short time and results are affected
by many activities and conditions. Get the information and learn about
PSA velocity and PSADT (doubling time). Always get a second opinion.
And labs do make mistakes.
best of luck

"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked him
> why not repeat PSA, just in case? He said the labs don't make mistakes.
> Should I push him on this or just accept the biopsy?

Well, it's not exactly true that labs don't make mistakes. But an 80%
increase over 12 months is significant. It's best to rule out cancer.




--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08
Non Illegitimi Carborundum

On 25 abr, 11:02, Larry <la...@nospam.net> wrote:
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
> him why not repeat PSA, just in case? He said the labs don't make
> mistakes. Should I push him on this or just accept the biopsy?
>
> Larry

Hi Larry,

Labs do make mistakes. My PSA went (supposedly) from .5 to 1.8 in
about 18 months, and I freaked out. I went to a uro, who examined me
and told me a biopsy was not necessary, and suggested I monitor my PSA
every six months. The subsequent six month readings were 1.6 and 1.9.
Well, it turns out that when I had my yearly physical last October, my
GP and I looked more closely at my past tests, and, sure enough, there
were other discrepancies on the lab tests in which the PSA was .5. For
instance, my lipid profile was also way off my "usual" results. This
does not, of course, prove the lab screwed up, but it does make it
more plausible.

One thing about PSA velocity. Two readings are not enough, you need at
least three PSA tests done at the same lab on the same equipment over
at least 18 months to get any useful information. The general idea is
that you're trying to distinguish exponential from linear PSA growth,
which can not be done with two readings alone. I'm a mathematician and
can vouch for this. Do some research and you'll see what's going on
here. The .5 ng/yr threshold should be an average of at least three
readings taken at least six minths apart.

You'll get great feedback from this group, Larry. I have learned much
from the posters, and still occasionally lurk here, reporting in with
my PSA numbers. As of yet, I'm not a certified member of the club, and
have no desire to change my status. I get a DRE and a PSA test every
year, without fail.

Good luck.

"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
> Hi.
>
> I'm 51 y/o with history of chronic prostatitis. Just had an increase in
> PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
> him why not repeat PSA, just in case? He said the labs don't make
> mistakes. Should I push him on this or just accept the biopsy?
>
> Larry

Thanks, Alan. The only thing he noted upon DRE is the left lobe bigger
than the right. He said sometimes that means something and sometimes
not. And in fact, I am having a bit of dull pain on the left side, so
I'm thinking it could be the prostatitis

Based on what you said in the first paragraph you should push for more
information and a Second PSA. However, based on the second paragraph which
you added for another poster, you should get the biopsy. It's always good to
give complete information if you want an accurate answer. Getting the biopsy
will give you peace of mind one way or the other.

I suspect the Uro is concerned about the unevenness or lump in the left lobe
as well as pain more than the PSA. He's probably not concerned about the PSA
that's why the dismissive answer.

I got a biopsy after a lump was felt during an DRE and, fortunately the
biopsy was negative. It's no big deal, you don't feel the needle which
usually samples a number of times, not just once. There is no pain. The
biggest issue is the feeling of having to poop with the ultrasound probe
pushing this way and that over about 10 minutes. The Doc is using ultrasound
to view the prostate and find locations to take the biopsy samples. The
needle pops out of the probe very fast taking it's sample and that part
doesn't feel like much of anything. Again the biggest problem is the feeling
of fullness and pushing in the rectum.