PSA Velocity?

[Guest ZeroPoint]

OK, so I'm one of the guys who has started seeing guys late in life and i am enjoying this new found passion. The sex has been incredible, better than anything I've experienced in my almost 60 years.

 

Last year, I had an extensive biopsy for an elevated PSA level 6+. All samples negative. Big sigh of relief. Just got my results for the six month check - PSA level doubled - Dr. puzzled.

 

I know that most of the guys on here are over 50 (except for you Jawja), so anybody have experience with what could cause this jump (I've been having a lot more and a lot better sex!) I've read all the normal causes of increase - infection, bicycle riding, sex within 2 days of the test - none of these apply.

 

I don't like where this one is headed.

 

0.

[Steven_Draker]

I know that most of the guys on here are over 50

 

It's reassuring that I'm in the "minority" here.

 

But what a coincidence, we talked about PSA with someone just a few hours ago. I hope all goes well for you, ZeroPoint. Welcome to the Board.

[uwsman2]

PSA can be inscrutable. I've been living with an elevated PSA for decades, as high as 25+. I've been through 2 biopsies, an MRI, and a specialized urine test, none of which has turned up anything of interest. Started taking a medication to shrink my swollen prostate gland about a year ago, and that of course lowers the prostate count, but my urologist assures me that this is an artifact of the shrinkage and has nothing to do with what may or may not be growing within the prostate gland itself. So the word is watchful waiting, and seeing whether there is a dramatic upward change in the count. If so, it's biopsy time again. The problem with biopsies is that they don't tell you whether you have prostate cancer - they just tell you that no cancer was found in the locations where the biopsy samples were taken. It's negative evidence but not conclusive. So you have to keep monitoring the situation. I hate having quarterly PSA tests, but there it is.

[Guest Merlin]

I seem to recall some speculation that masturbation, especially if the dick is not fully hard, can cause a rise in PSA. The theory being that there may be some back pressure or congestion in the prostate. I am not a doctor and am not sure this makes any sense, but viagra etc would help you get harder and have a more full ejaculation.

[KMEM]

ZP-

 

You are too young to do JUST watchful waiting. However, there is no need to panic either. Generally, you have plenty of time to evaluate, assess and choose from among many options when and if cancer is actually discovered during a biopsy. Also, generally speaking,you have plenty of time to do the biopsy when and if you have a sudden, large increase in the PSA. My urologist says he has treated at least one case with a PSA of 900. Like u2 suggests, if is suddenly goes from 6 to 25, time for another biopsy + ultrasound, etc. In the meantime, PSA tests every 6 months or 3 months at your and your physician's choice would be appropriate.

 

Best regards,

KMEM

[Guest ZeroPoint]

ZP-

 

You are too young to do JUST watchful waiting. However, there is no need to panic either. Generally, you have plenty of time to evaluate, assess and choose from among many options when and if cancer is actually discovered during a biopsy. Also, generally speaking,you have plenty of time to do the biopsy when and if you have a sudden, large increase in the PSA. My urologist says he has treated at least one case with a PSA of 900. Like u2 suggests, if is suddenly goes from 6 to 25, time for another biopsy + ultrasound, etc. In the meantime, PSA tests every 6 months or 3 months at your and your physician's choice would be appropriate.

 

Best regards,

KMEM

 

Thanks Memphis,

 

That's kind of the problem as it went from 6 to 13 in six months - following an extensive biopsy. Going to repeat after a course of heavy duty antibiotics and then repeat the PSA and probably have the new PCA3 test. Doc took so many samples six months ago that he doesn't think it worth repeating a biopsy - says he doesn't believe in doing a "prostatectomy by biopsy"

[Guest ZeroPoint]

I seem to recall some speculation that masturbation, especially if the dick is not fully hard, can cause a rise in PSA. The theory being that there may be some back pressure or congestion in the prostate. I am not a doctor and am not sure this makes any sense, but viagra etc would help you get harder and have a more full ejaculation.

 

LOL, not a problem in my case! Hard and a rock and I use the big V for fun anyway! Don't JO much anymore since I found my second wind in life. If I get really horny I just schedule a massage or book one of our escort members.

 

Thanks for the input.

[Phil_musc]

I had a biopsy several years ago - one came back positive and of course it threw me into a tailspin. The doctor said we didn't need to do anything just then. Instead, we moved to quarterly PSA tests which leveled off and actually went down some. He also told me that he had a patient that had a PSA score of over 1000, so my little single digit result was not too alarming. The scary thing, though, was that this runs in my family. My dad had a radical procedure and his life was forever changed. But he is still alive and the operation was long enough ago that it's not clear in my memory when exactly it was. The problem for me was my age - I'm still relatively young. The rate of survivorship with radiation is equivalent to radical surgery for the first ten years. But after that point, the rate of survivorship for radiation goes down markedly. We tend to live a long time in my family so radiation (as it stands now) is probably not the cure that will work in the long run. We are watchfully waiting and hoping for the best. But I've noticed that every three months when it's about time to go for the test, I get kinda anxious and a bit depressed. Is this going to be a bad result? On a related note, I started paying attention to the cost of those PSA's and let me tell you, the lab is not shy about asking for money - each one runs about $800. That's pretty stiff change for a routine test, I think. God bless health insurance.

[Diverdan]

Phil.... something is very wrong if the PSA test is costing you about $800.00. That is a shere ripoff, and you should see about getting your blood sample sent to a different lab. It should be no more than $100.00 or even less, even with insurance coverage.

 

Zeropoint: May I suggest that you subscribe to a wonderful newsletter from Johns Hopkins on Prostate Cancer. It is available on line and on print for a nominal amount, in fact, I don't even remember what it costs. They are one of the leading if not they leading set of experts in this field and offer pros and cons about testing, surgery and other options. I have also found that different labs produce different results and once I had a significant spike... from 2 to 8, my Dr. took another sample and sent to a different lab. It came back 4. When I inquired, he said he has seen a lot of variation in labs, and he watches that very carefully. For the newsletter, just google Johns Hopkins and prostate cancer, and the newsletter should be listed. They publish newsletters on a variety of health topics and are truly the latest science written in layman's terms. Good luck and hope all goes well.

[Guest ZeroPoint]

Phil.... something is very wrong if the PSA test is costing you about $800.00. That is a shere ripoff, and you should see about getting your blood sample sent to a different lab. It should be no more than $100.00 or even less, even with insurance coverage.

 

That's about the price I hear the new PCA3 urinalysis costs, but I agree, no way a STD PSA should cost $800 bucks.

 

Thanks Diver, I will be repeating in 3 weeks after antibiotics. Never heard of a lab being that far off. How are these guys regulated anyway?

 

0.

[+ Shoreboy]

Recently my PSA level was 7 which is not high but not low either...so I scheduled a biopsy and thank God it came back cancer free...so I too am in the "wait and watch" phase of my life.

 

But remember that "wait and watch" does not mean doing nothing....get regular (every four months) PSA tests, start taking fish oil which helped me a lot and keep your doctor visits.

 

Hang in there and pm me if you like

[Guest Merlin]

Philmusc, I am interested in your statement that after 10 years the survivorship for those treated with radiation goes down. I would appreciate any references to sources you can give me. As you know, the side effects of surgery--reduced potency and possible incontinence, have generally not been as good as for radiation. Although,the results have improved for many, since your Dad's operation. And, of course, the surgery itself is awful. Both radiation and surgery have improved a lot in recent years, so the 10 rates necessarily reflect older techniques. For that reason I would not be so quick to make a decision based on long term statistics. Quality of life is too important to be sacrificed without compelling reasons.

[Phil_musc]

Merlin, which is exactly why I am not doing anything except watching and waiting. My information about the rates of survivorship with radiation versus surgery came from my urologist who is also a surgeon. I know, I know, surgeons are always ready to cut. But with prostate issues, this maybe less the case, since the surgeon is well aware of what the side effects of such surgery can be and as a guy himself, he isn't eager to have a patient risk that change in life quality. I plan to watch and wait as long as I possibly can with the hope that science and medicine will improve the options. Actually my last PSA had gone down some and the doctor even raised the idea that perhaps this wasn't the aggressive kind of cancer that kills men in their 50's. He also pointed out that as we mature, most men develop some form of prostate cancer. They live with it and die f something else. It's not an automatic death sentencem and neither does it have to destroy your quality of life.

 

As far as the cost of the PSA goes - maybe I need a cheaper lab. I normally go to a local hospital that has a lab that does this.

[KMEM]

Seemingly, there is never any need to rush into any "cure" or "procedure" or "treatment" for prostate cancer. As with any other statement, there are always exceptions and, if you happen to be younger and competently diagnosed with prostate cancer, then, of course, you should consider your options just a little bit faster than those who are older or not so diagnosed. Those "early" forms are swift moving and deadly but not necessarily non-treatable.

 

NO treatment is without risks and that certainly includes any for prostate cancer. Becoming informed as well as investigating the various options which include surgery, Rx therapy, radiation of more than one "stripe" as well as "freezing" and perhaps others, should be included in your quest for knowledge.

 

However, where you live and where you might receive "good" or "decent" or "appropriate" treatment can enter in to the equation. The bottom line in that statement is dollars. If you live in NYC, then possibly going to CA is not in your economic realm of possibility. There are reasonable options no matter where you live and no matter what your economic circumstance might be.

 

Just keep trying and learning.

 

Best regards,

KMEM