A lesson in a PSA and examination false alarm....

At this time last year I was suddenly hit with inability to urinate. My
PSA was around 7, and my urologist said he suspected cancer after an
exam, telling me the prostate was rock-hard.

I underwent a biopsy (I experienced an easy time of it). The samples
were declared "granulomatous prostatitis." My PSA has gone to 8 since
then. I'm nowhere near having cancer.

I'm not sure how reliable prostate cancer detection is these days
overall, but I can say that, in my case, the PSA and examination told my
doctor the wrong story. It wasn't until the biopsy that we really knew
what was going on.

On Sun, 28 Oct 2007 08:58:15 GMT, Christian Williamson
<c.willi@verizon.net> wrote:

>
>At this time last year I was suddenly hit with inability to urinate. My
>PSA was around 7, and my urologist said he suspected cancer after an
>exam, telling me the prostate was rock-hard.
>
>I underwent a biopsy (I experienced an easy time of it). The samples
>were declared "granulomatous prostatitis." My PSA has gone to 8 since
>then. I'm nowhere near having cancer.

You're a lucky chap! Congratulations!
>
>I'm not sure how reliable prostate cancer detection is these days
>overall, but I can say that, in my case, the PSA and examination told my
>doctor the wrong story. It wasn't until the biopsy that we really knew
>what was going on.

Quite, and in your circumstances, a biopsy was probably inevitable.
Unfortunately there's nothing much better these days. Someone might
correct me, but I believe false positives from biopsies are rare. The
far more serious problem is in establishing who amongst those with
early stage cancer need aggressive treatment.

Christian Williamson wrote:
>
> At this time last year I was suddenly hit with inability to urinate. My
> PSA was around 7, and my urologist said he suspected cancer after an
> exam, telling me the prostate was rock-hard.
>
> I underwent a biopsy (I experienced an easy time of it). The samples
> were declared "granulomatous prostatitis." My PSA has gone to 8 since
> then. I'm nowhere near having cancer.
>
> I'm not sure how reliable prostate cancer detection is these days
> overall, but I can say that, in my case, the PSA and examination told my
> doctor the wrong story. It wasn't until the biopsy that we really knew
> what was going on.

I think, and suspect most of us and our doctors agree, that an elevated
PSA and maybe even a hard and/or enlarged prostate is simply an impetus
to get biopsied, rather than an indication of cancer. Your PSA, DRE, and
uro all did their job as proscribed, IMO, and led to a correct (we
presume) diagnosis.

Congratulation on being rejected from our rather snooty club. But don't
feel left out; you have a free pass to join any time your Gleason score
rises and to hang with us in the meantime.

I.P.

<rosbif> wrote in message news:bkl8i311tc3qktder8sg9v6j8t2a126q86@4ax.com...


> Someone might
> correct me, but I believe false positives from biopsies are rare. The
> far more serious problem is in establishing who amongst those with
> early stage cancer need aggressive treatment.

I think that is dead on balls accurate. There are no false positives, but
there are false reports of Gleason.

--
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 10/11/07
Non Illegitimi Carborundum

"Christian Williamson" <c.willi@verizon.net> wrote in message
news:HaYUi.1117$hd1.475@trndny01...

> I'm not sure how reliable prostate cancer detection is these days overall,
> but I can say that, in my case, the PSA and examination told my doctor the
> wrong story. It wasn't until the biopsy that we really knew what was going
> on.

It's pretty damned good depending on the number of needles. When I had
mine, the standard was just then changing from six to twelve because so much
cancer was missed with six. I have heard of some having as many as 24. The
prostate is the size of a walnut (when normal) and 24 needles don't miss
much.



--
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 10/11/07
Non Illegitimi Carborundum

On Sun, 28 Oct 2007 08:58:15 GMT, Christian Williamson
<c.willi@verizon.net> wrote:

>
>At this time last year I was suddenly hit with inability to urinate. My
>PSA was around 7, and my urologist said he suspected cancer after an
>exam, telling me the prostate was rock-hard.
>
>I underwent a biopsy (I experienced an easy time of it). The samples
>were declared "granulomatous prostatitis." My PSA has gone to 8 since
>then. I'm nowhere near having cancer.
>
>I'm not sure how reliable prostate cancer detection is these days
>overall, but I can say that, in my case, the PSA and examination told my
>doctor the wrong story. It wasn't until the biopsy that we really knew
>what was going on.

I'd say your concern lies in future testing. If the PSA and DRE don't
tell you the story, how do you proactively monitor your situation
other than biopsies? I wouldn't want to undergo an annual prostate
biopsy, but then again maybe I would if I didn't have to have mine
removed

--
PSA @ 45 yrs. = 4.7 02/06/2007
Biopsy 03/16/2007 G7(3+4),T1c
RLRP 06/12/2007 G7(3+4),T2cN0M0 Neg margins
PSA 7/16/2007 = <0.1
PSA 9/12/2007 = <0.1

Christian, good news, but please understand that you and your doctor should
continue to monitor. I have a friend who had three biopsies before a cancer
cell was found. All suspected cancer from the get go based on PSA and touch.

What that means is that just because a biopsy was clear it does not mean
that there is not cancer; only that it was not found. So I am sure that a
false positive is not a good description.

BTW, I had 18 sticks because my freePSA indicates a high probabilty of
cancer. Only 4 of the 18 found cancer....

I wish you continued positive results.

Gourd Dancer


"Christian Williamson" <c.willi@verizon.net> wrote in message
news:HaYUi.1117$hd1.475@trndny01...
>
> At this time last year I was suddenly hit with inability to urinate. My
> PSA was around 7, and my urologist said he suspected cancer after an exam,
> telling me the prostate was rock-hard.
>
> I underwent a biopsy (I experienced an easy time of it). The samples were
> declared "granulomatous prostatitis." My PSA has gone to 8 since then. I'm
> nowhere near having cancer.
>
> I'm not sure how reliable prostate cancer detection is these days overall,
> but I can say that, in my case, the PSA and examination told my doctor the
> wrong story. It wasn't until the biopsy that we really knew what was going
> on.

On Wed, 31 Oct 2007 00:20:53 -0500, "MAS"
<!!!msheets!!!@!!!sbcglobal!!!.net> wrote:

>I have a friend who had three biopsies before a cancer
>cell was found. All suspected cancer from the get go based on PSA and touch.
>
>What that means is that just because a biopsy was clear it does not mean
>that there is not cancer; only that it was not found. So I am sure that a
>false positive is not a good description.

What you're describing above is a false negative - there's cancer, but
a needle biopsy didn't find it. As you say, it happens (or it finds
gl3 but misses the gl4, which is a false negative of a kind).

Apologies if I confused the issue; I mentioned biopsies and the very
rare false positives arising from them only to contrast their
diagnostic utility with that of PSA testing.