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psa 3.9 retest/3.2/ but free psa 13%
  1. #1
    Ed Kratz Guest

    Default psa 3.9 retest/3.2/ but free psa 13%

    I had posted earlier about a PSA of 3.9.
    My internist called today with the results of the re-test, after about two
    weeks on Levaquin. The re-test was 3.2.
    (Based on a rising PSA, I had a biopsy last March.)
    He also said he had received the second opinion from Epstein at John
    Hopkins, and Epstein agreed with the March biopsy. No cancer, one focus of
    chronic prostatitis.
    My internist did not mention the complexed PSA, but he did say the free psa
    was 13.9 %, which I know is a bit low.
    I have an appointment with a uro in February, so I'll see what he says.
    (From now on I'll be followed by a uro.)
    Just thought I'd let the group know the results (though I'll be happier when
    I get the actual reports.)
    I would prefer a higher free psa, but at least the psa has come down from
    November.
    Comments/etc. are appreciated.

    Thanks,
    Ed




  2. #2
    CW89134 Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    Hi Ed:

    I saw your post yesterday but was waiting for the results of my
    husband's PSA and free PSA tests before I posted back. Congratulations
    on your PSA decrease!

    My husband's PSA (done yesterday, 1/17/07) was 3.5 and his free PSA was
    11.4%. His PSA in June 2006 was 2.6. We're a bit concerned about a .9
    increase in less than a year after a .8 increase between November 2005
    and June 2006. His free PSA in June 2006 was 11.5, which is very close
    to yesterday's number. I should add this he (Paul) will be 65 in May.

    He had a negative biopsy on 8/24/06 which said, in part, "no evidence
    of atypia, high grade PIN or malignancy in any of the levels". This was
    an 18 core biopsy.

    He has an appointment with the uro who did the biopsy on 1/29/07 and
    we'll see then how he wants to proceed.

    Does anyone know the guidelines for repeat biopsy? How soon after a
    negative biopsy is a repeat biopsy generally done?

    Thanks, in advance, for any replies.

    CW89134
    __________________________________________________ _______________________________


    Ed Kratz wrote:
    > I had posted earlier about a PSA of 3.9.
    > My internist called today with the results of the re-test, after about two
    > weeks on Levaquin. The re-test was 3.2.
    > (Based on a rising PSA, I had a biopsy last March.)
    > He also said he had received the second opinion from Epstein at John
    > Hopkins, and Epstein agreed with the March biopsy. No cancer, one focus of
    > chronic prostatitis.
    > My internist did not mention the complexed PSA, but he did say the free psa
    > was 13.9 %, which I know is a bit low.
    > I have an appointment with a uro in February, so I'll see what he says.
    > (From now on I'll be followed by a uro.)
    > Just thought I'd let the group know the results (though I'll be happier when
    > I get the actual reports.)
    > I would prefer a higher free psa, but at least the psa has come down from
    > November.
    > Comments/etc. are appreciated.
    >
    > Thanks,
    > Ed



  3. #3
    Alan Meyer Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    Ed,

    I'm glad the PSA is lower. Remember that MOST prostatitis cases
    are NOT caused by bacterial infections. And those that are aren't
    always cured by antibiotics. So the fact that your PSA did not
    drop further doesn't mean that you have cancer. All in all, the
    drop is a good sign.

    If you want to try something else, you might try a course of
    ibuprofen therapy. Assuming you have no stomach problems
    and have not had trouble with ibuprofen in the past, you might
    try the maximum daily non-prescription dose for a month.
    Prostatitis is an inflammatory condition, so anti-inflammatories
    might bring it down. Then you could try another PSA test at
    the end.

    CAVEAT: I'm no doctor. Check with your doctor to see if he
    or she thinks this is worth trying.

    CW89134,

    I don't know the guidelines for repeat biopsies. I had a friend who
    had three biopsies in three years after PSA readings in the 6-10
    range. All came back negative.

    I believe that my brother-in-law, who is a doctor, has had similar
    treatment. I don't know what his PSA was. He sought help
    because of prostate pain. In his case too, no cancer has yet
    been found.

    An 18 needle biopsy is pretty thorough. I would hope that if there
    was any cancer to find it would have been found.

    In both your husband's and Ed's case, rather than go through
    the pain and invasiveness of a repeat biopsy, maybe you should
    ask for frequent PSA tests, e.g., every 6 months, or 4 months,
    or even 3 months. That way you should get some indication
    if things are changing and have plenty of time to decide whether
    another biopsy is warranted.

    Incidentally, I was told by my urologist when I had my first
    biopsy that my initial PSA of 6.3 only meant I had a 15%
    chance of having cancer. Unfortunately, I was in the 15%
    group. However, while your husband's PSA is certainly cause
    for concern, the odds are good that he doesn't have cancer,
    and the 18 needle biopsy appears to confirm it.

    Good luck to both of you.

    Alan


  4. #4
    ron Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    Alan Meyer wrote...snip...
    > An 18 needle biopsy is pretty thorough. I would hope that if there
    > was any cancer to find it would have been found.


    Hi Alan...Around 20% of all primary PCa tumors are located in areas
    (transition zone and central zone) that a standard TRUS biopsy cannot
    access. These tumors will not be found by TRUS biopsy until they grow
    large enough to generate secondary tumors in the peripheral zone of the
    prostate. Color Doppler ultrasound can examine the entire prostate and
    it is often a reasonable way to proceed in the face of rising PSA and
    negative TRUS biopsy...Best wishes and good health, ron


  5. #5
    CW89134 Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    According to the 8/24/06 pathology report, six specimens were taken
    from the transition zone (6 right, 6 left, 6 transition) "varying in
    length from 3 to 13 mm".

    CW89134
    __________________________________________________ _____________________
    ron wrote:
    > Alan Meyer wrote...snip...
    > > An 18 needle biopsy is pretty thorough. I would hope that if there
    > > was any cancer to find it would have been found.

    >
    > Hi Alan...Around 20% of all primary PCa tumors are located in areas
    > (transition zone and central zone) that a standard TRUS biopsy cannot
    > access. These tumors will not be found by TRUS biopsy until they grow
    > large enough to generate secondary tumors in the peripheral zone of the
    > prostate. Color Doppler ultrasound can examine the entire prostate and
    > it is often a reasonable way to proceed in the face of rising PSA and
    > negative TRUS biopsy...Best wishes and good health, ron



  6. #6
    Steve Kramer Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%


    "CW89134" <[email protected]> wrote in message
    news:[email protected] ups.com...
    > Hi Ed:
    >
    > I saw your post yesterday but was waiting for the results of my
    > husband's PSA and free PSA tests before I posted back. Congratulations
    > on your PSA decrease!
    >
    > My husband's PSA (done yesterday, 1/17/07) was 3.5 and his free PSA was
    > 11.4%. His PSA in June 2006 was 2.6. We're a bit concerned about a .9
    > increase in less than a year after a .8 increase between November 2005
    > and June 2006. His free PSA in June 2006 was 11.5, which is very close
    > to yesterday's number. I should add this he (Paul) will be 65 in May.
    >
    > He had a negative biopsy on 8/24/06 which said, in part, "no evidence
    > of atypia, high grade PIN or malignancy in any of the levels". This was
    > an 18 core biopsy.
    >
    > He has an appointment with the uro who did the biopsy on 1/29/07 and
    > we'll see then how he wants to proceed.
    >
    > Does anyone know the guidelines for repeat biopsy? How soon after a
    > negative biopsy is a repeat biopsy generally done?
    >
    > Thanks, in advance, for any replies.


    Those are numbers to be concerned about. And, as I recall, didn't cancer
    indicators show up in his urine test?

    I think biopsies are usually done 6 months apart. And, there are 20 and >20
    needle biopsies.



    --
    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
    EBRT 05-07/2002 @ 47
    PSA .34 .22 .15 .21 .32
    Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
    2/06, 6/06
    PSA .07 .05 .06 .09 .08 .132 .145
    Casodex added daily 07/06
    PSA <0.04
    Non Illegitimi Carborundum



  7. #7
    Ed Kratz Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    I thought I had replied to this, but might not have, since I didn't see it.
    Bascially, I wish you good luck. I believe there might be other reasons
    for increasing PSA, but I can see why you are concerened.
    I don't know if it's a big deal, but I wondered if you had a second opinion
    of the biopsy slides.
    I'm sure the group will have more comments.
    I wish you and your husband good luck.
    Ed
    "CW89134" <[email protected]> wrote in message
    news:[email protected] ups.com...
    > Hi Ed:
    >
    > I saw your post yesterday but was waiting for the results of my
    > husband's PSA and free PSA tests before I posted back. Congratulations
    > on your PSA decrease!
    >
    > My husband's PSA (done yesterday, 1/17/07) was 3.5 and his free PSA was
    > 11.4%. His PSA in June 2006 was 2.6. We're a bit concerned about a .9
    > increase in less than a year after a .8 increase between November 2005
    > and June 2006. His free PSA in June 2006 was 11.5, which is very close
    > to yesterday's number. I should add this he (Paul) will be 65 in May.
    >
    > He had a negative biopsy on 8/24/06 which said, in part, "no evidence
    > of atypia, high grade PIN or malignancy in any of the levels". This was
    > an 18 core biopsy.
    >
    > He has an appointment with the uro who did the biopsy on 1/29/07 and
    > we'll see then how he wants to proceed.
    >
    > Does anyone know the guidelines for repeat biopsy? How soon after a
    > negative biopsy is a repeat biopsy generally done?
    >
    > Thanks, in advance, for any replies.
    >
    > CW89134
    > __________________________________________________ _______________________________
    >
    >
    > Ed Kratz wrote:
    >> I had posted earlier about a PSA of 3.9.
    >> My internist called today with the results of the re-test, after about
    >> two
    >> weeks on Levaquin. The re-test was 3.2.
    >> (Based on a rising PSA, I had a biopsy last March.)
    >> He also said he had received the second opinion from Epstein at John
    >> Hopkins, and Epstein agreed with the March biopsy. No cancer, one focus
    >> of
    >> chronic prostatitis.
    >> My internist did not mention the complexed PSA, but he did say the free
    >> psa
    >> was 13.9 %, which I know is a bit low.
    >> I have an appointment with a uro in February, so I'll see what he says.
    >> (From now on I'll be followed by a uro.)
    >> Just thought I'd let the group know the results (though I'll be happier
    >> when
    >> I get the actual reports.)
    >> I would prefer a higher free psa, but at least the psa has come down from
    >> November.
    >> Comments/etc. are appreciated.
    >>
    >> Thanks,
    >> Ed

    >




  8. #8
    Ed Kratz Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    Alan,
    Thanks for the comments. For now I'm going to hold off on anything until I
    see the urologist in February. I hope I like him because I think I'd be
    wiser to be followed by a uro, whatever time frame he suggests. I only saw
    a uro once, in November, for consultation. Now I think regular folllow-up
    wouldn't hurt.
    Thanks again.
    Ed
    "Alan Meyer" <[email protected]> wrote in message
    news:[email protected] oups.com...
    > Ed,
    >
    > I'm glad the PSA is lower. Remember that MOST prostatitis cases
    > are NOT caused by bacterial infections. And those that are aren't
    > always cured by antibiotics. So the fact that your PSA did not
    > drop further doesn't mean that you have cancer. All in all, the
    > drop is a good sign.
    >
    > If you want to try something else, you might try a course of
    > ibuprofen therapy. Assuming you have no stomach problems
    > and have not had trouble with ibuprofen in the past, you might
    > try the maximum daily non-prescription dose for a month.
    > Prostatitis is an inflammatory condition, so anti-inflammatories
    > might bring it down. Then you could try another PSA test at
    > the end.
    >
    > CAVEAT: I'm no doctor. Check with your doctor to see if he
    > or she thinks this is worth trying.
    >
    > CW89134,
    >
    > I don't know the guidelines for repeat biopsies. I had a friend who
    > had three biopsies in three years after PSA readings in the 6-10
    > range. All came back negative.
    >
    > I believe that my brother-in-law, who is a doctor, has had similar
    > treatment. I don't know what his PSA was. He sought help
    > because of prostate pain. In his case too, no cancer has yet
    > been found.
    >
    > An 18 needle biopsy is pretty thorough. I would hope that if there
    > was any cancer to find it would have been found.
    >
    > In both your husband's and Ed's case, rather than go through
    > the pain and invasiveness of a repeat biopsy, maybe you should
    > ask for frequent PSA tests, e.g., every 6 months, or 4 months,
    > or even 3 months. That way you should get some indication
    > if things are changing and have plenty of time to decide whether
    > another biopsy is warranted.
    >
    > Incidentally, I was told by my urologist when I had my first
    > biopsy that my initial PSA of 6.3 only meant I had a 15%
    > chance of having cancer. Unfortunately, I was in the 15%
    > group. However, while your husband's PSA is certainly cause
    > for concern, the odds are good that he doesn't have cancer,
    > and the 18 needle biopsy appears to confirm it.
    >
    > Good luck to both of you.
    >
    > Alan
    >




  9. #9
    CW89134 Guest

    Default Re: psa 3.9 retest/3.2/ but free psa 13%

    His PCA3Plus score was 27.2 last August. At that time, Bostwick's
    threshold for positive was > 10. They've changed their threshold. Now
    it is > 35.

    http://www.bostwicklaboratories.com/about/PCA3.pdf

    Thanks for your comments.
    __________________________________________________ ________________
    Steve Kramer wrote:
    > "CW89134" <[email protected]> wrote in message
    > news:[email protected] ups.com...
    > > Hi Ed:
    > >
    > > I saw your post yesterday but was waiting for the results of my
    > > husband's PSA and free PSA tests before I posted back. Congratulations
    > > on your PSA decrease!
    > >
    > > My husband's PSA (done yesterday, 1/17/07) was 3.5 and his free PSA was
    > > 11.4%. His PSA in June 2006 was 2.6. We're a bit concerned about a .9
    > > increase in less than a year after a .8 increase between November 2005
    > > and June 2006. His free PSA in June 2006 was 11.5, which is very close
    > > to yesterday's number. I should add this he (Paul) will be 65 in May.
    > >
    > > He had a negative biopsy on 8/24/06 which said, in part, "no evidence
    > > of atypia, high grade PIN or malignancy in any of the levels". This was
    > > an 18 core biopsy.
    > >
    > > He has an appointment with the uro who did the biopsy on 1/29/07 and
    > > we'll see then how he wants to proceed.
    > >
    > > Does anyone know the guidelines for repeat biopsy? How soon after a
    > > negative biopsy is a repeat biopsy generally done?
    > >
    > > Thanks, in advance, for any replies.

    >
    > Those are numbers to be concerned about. And, as I recall, didn't cancer
    > indicators show up in his urine test?
    >
    > I think biopsies are usually done 6 months apart. And, there are 20 and >20
    > needle biopsies.
    >
    >
    >
    > --
    > 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
    > EBRT 05-07/2002 @ 47
    > PSA .34 .22 .15 .21 .32
    > Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
    > 2/06, 6/06
    > PSA .07 .05 .06 .09 .08 .132 .145
    > Casodex added daily 07/06
    > PSA <0.04
    > Non Illegitimi Carborundum



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