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My Dad PSA 600

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Posted 8/25/2018 9:33 PM (GMT -5)
My dad is 88 and has a pacemaker and heart valves replaced. Has been doing well, but last week he had some bruising show up on his leg, thinking it was the Warfarin, so we took him to his main hospital. They took some bloodwork and xrays sent him back home. Next morning we got a call that they thought it was prostate cancer because of the PSA of 600. Scheduled him for a bone scan.

Before we could do the bone scan we had to take him back because more bruising was found on the other leg, and some blood from his mouth on the pillow overnight.

He has been off the Warfarin for quite a while, but the doctors can not figure out why his blood is so thin and will not coagulate. They are going to infuse vitamins and try to get the blood thicker. Also plan on doing a biopsy tomorrow and going over treatment procedures.

The doctors say they can not understand where the high PSA reading came from and that all was normal back in April.

My dad feells OK, his hip is a little sore though, but eats fine, normal weight, no blood in stool or urine. Guess tomorrow we find out more. I hope he os OK through the night.
Posted 8/25/2018 9:38 PM (GMT -5)
I'm sorry to hear DJ. Please do keep us posted?
Posted 8/26/2018 12:43 AM (GMT -5)
Welcome to HW, sorry to hear of your father's problems.

They need to solve the blood issue first. I went through that with my father. It took awhile for them to stabilize it.

Keep us updated and let us know if you have any questions.
Andrew
Posted 8/26/2018 6:20 AM (GMT -5)

island time said...
I'm sorry to hear DJ. Please do keep us posted?

Thanks and will do.
Posted 8/26/2018 6:24 AM (GMT -5)

InTheShop said...
Welcome to HW, sorry to hear of your father's problems.

They need to solve the blood issue first. I went through that with my father. It took awhile for them to stabilize it.

Keep us updated and let us know if you have any questions.
Andrew

Thanks Andrew. Not sure if anything can be done , but I hope so. Even a couple more years would be nice.
Posted 8/26/2018 6:58 AM (GMT -5)
Prostate cancer does not normally cause a rapid rise in PSA. It is a slow moving disease that characteristically causes a slow, steady increase in PSA levels. So, if your father's PSA was normal in April, it would be unusual, I think, for prostate cancer to be responsible for such a dramatic increase.
Posted 8/26/2018 9:00 AM (GMT -5)
Did he have a PSA test done last April? As Canoe said, PC seldom moves so quickly..Many doctors overlook the fact that drugs like Warfarin can have a much greater effect on elderly people than on younger people..The bruising and bleeding is not common with prostate cancer..A biopsy may be risky. I would hold off on that until the scans come back...
Posted 8/26/2018 9:47 AM (GMT -5)
Honestly, at his age, with his other medical problems PC isn't going to be a major issue. I suspect the current PSA number is some kind of an error or due to problems other than PC.

A biopsy with bleeding issues might not be the best thing right now.

Andrew
Posted 8/26/2018 10:27 AM (GMT -5)

fiddlecanoe said...
Prostate cancer does not normally cause a rapid rise in PSA. It is a slow moving disease that characteristically causes a slow, steady increase in PSA levels. So, if your father's PSA was normal in April, it would be unusual, I think, for prostate cancer to be responsible for such a dramatic increase.

That is what I have been seen from the research I have been doing. I wonder if something in the lab was messed up?
Posted 8/26/2018 10:30 AM (GMT -5)
That has happened before. You might even consider asking the Dr to contact the lab and request a retest if the same blood sample.
That would be a whopper of a lab error
Posted 8/26/2018 10:32 AM (GMT -5)

Fairwind said...
Did he have a PSA test done last April? As Canoe said, PC seldom moves so quickly..Many doctors overlook the fact that drugs like Warfarin can have a much greater effect on elderly people than on younger people..The bruising and bleeding is not common with prostate cancer..A biopsy may be risky. I would hold off on that until the scans come back...

That is what the doctor said. I think you are right, scan first. Maybe even another PSA test?
Posted 8/26/2018 10:34 AM (GMT -5)

InTheShop said...
Honestly, at his age, with his other medical problems PC isn't going to be a major issue. I suspect the current PSA number is some kind of an error or due to problems other than PC.

A biopsy with bleeding issues might not be the best thing right now.

Andrew

I will mention it to the doctor.
Posted 8/26/2018 11:09 AM (GMT -5)
At 88, with bleeding/clotting issues, even if he has a horrible case of PC, care is likely to be palliative only. Most of the common interventions--even, as Andrew pointed out, a biopsy to really determine what is going on--are probably out of the picture.

This does sound like either some whopper of a lab error, or something entirely different is happening that is about his being 88 with a raft of other issues.

I recall a tale told in here several times, where a renowned PC surgeon supposedly said that he would only operate on a PC patient over the age of 75 if he brought both parents to the consultation. In other words, at 88, if he's never been diagnosed with PC before now, then you should only treat it if he's expecting to live to 113 (25 more years).
Posted 8/26/2018 11:14 AM (GMT -5)
This makes no sense.
What was his PSA in April?

Mel
Posted 8/26/2018 12:10 PM (GMT -5)

Pratoman said...
That has happened before. You might even consider asking the Dr to contact the lab and request a retest if the same blood sample.
That would be a whopper of a lab error



I will discuss this if I get a chance.
Posted 8/26/2018 12:15 PM (GMT -5)

halbert said...
At 88, with bleeding/clotting issues, even if he has a horrible case of PC, care is likely to be palliative only. Most of the common interventions--even, as Andrew pointed out, a biopsy to really determine what is going on--are probably out of the picture.

This does sound like either some whopper of a lab error, or something entirely different is happening that is about his being 88 with a raft of other issues.

I recall a tale told in here several times, where a renowned PC surgeon supposedly said that he would only operate on a PC patient over the age of 75 if he brought both parents to the consultation. In other words, at 88, if he's never been diagnosed with PC before now, then you should only treat it if he's expecting to live to 113 (25 more years).

Thank you for the reply, Im trying to figure all this out quickly.
Posted 8/26/2018 12:18 PM (GMT -5)

compiler said...
This makes no sense.
What was his PSA in April?

Mel

They did not say, just that it checked out good in April. When they called on the phone I had to ask what the current level was, I did not think to ask about the other one. They just acted shocked at 600 and said they never seen go up so quickly before.
Posted 8/26/2018 12:56 PM (GMT -5)
I vote for a PSA retest too. Did they ever do the bone scan? Is there any blood in urine? If a LOT of his bone marrow is affected, it could prevent clotting.
Posted 8/26/2018 9:17 PM (GMT -5)
Many blood labs have walk-in service. You can get a blood draw and PSA test done in less than a day. No prescription needed. The test usually runs between $60 and $90. Quest Diagnostics, Lab Corp, Walk-In -Lab are 3 blood testers that have fast walk-in service..You don't have to wait 3 or 4 days if you don't want to..
Posted 8/27/2018 8:32 PM (GMT -5)

Tall Allen said...
I vote for a PSA retest too. Did they ever do the bone scan? Is there any blood in urine? If a LOT of his bone marrow is affected, it could prevent clotting.

Still havent got an answer on the PSA score in April. I have asked my brother, since he is the one that stays at the hospital with dad.

No blood in urine.

They have just done a spinal epidural I think, no results yet, probably tomorrow, bone scan tomorrow I think.

They had to give him another infusion to prevent bleeding.
Posted 8/27/2018 8:39 PM (GMT -5)

Fairwind said...
Many blood labs have walk-in service. You can get a blood draw and PSA test done in less than a day. No prescription needed. The test usually runs between $60 and $90. Quest Diagnostics, Lab Corp, Walk-In -Lab are 3 blood testers that have fast walk-in service..You don't have to wait 3 or 4 days if you don't want to..

I think they will keep him because of a bleed risk.

Is there something they can do to make his blood better for a longer time? Hopefully long enough to be able to do some type of treatment?

They are saying its in his pelvic area pretty bad, I guess they know this from xrays, but dad still wants to get up and "walk it off". He says its just old age, lol. They dont want him walking around though I guess its a bone breakage risk or something.

I dont have much more new information. But I think that the blood being off might be a problem for treatment, I hope not.

I keep trying to find stories about other people in this situatioin around his age to see what they did, but I havent found any.
Posted 8/28/2018 1:14 AM (GMT -5)
The sort of bruising and bleeding that you describe can be caused by a lot of different things, among them metastatic prostate cancer. I think it is a bit rare but it does happen.

As a rule of thumb a man's chances of having prostate cancer show up on a biopsy is roughly his age expressed as a percent. So, if your dad is 88 then there is around an 88 percent chance that he has at least some prostate cancer. If they do go ahead with the biopsy you should expect some sort of prostate cancer. Most guys his age have some. What would be more interesting is whether he has the more aggressive forms. But, the doctors should be able to make a pretty good guess at that with a bone scan (to show bone lesions that might be prostate cancer metastases) and a repeat of the PSA test (to suggest that it probably is prostate cancer.) I'm not so sold on the biopsy. I'm not sure what else it will tell you.

I'm a bit vague about whether or not he has had a bone scan yet. It's an obvious thing to do. You mentioned that the doctors said he pelvic area was "pretty bad." Was that, maybe, a bone scan result?

The chances are fairly good that your dad's problems aren't caused by prostate cancer since he had a recent PSA test with a much lower level. But it might be. I'm not sure whether that would be better or worse. Clearly there is something going on with him and prostate cancer might not be the worst thing it could be. I found a few case studies for patients who showed up at the hospital with bleeding caused by prostate cancer. In general, they got the bleeding fixed, started them on medication to manage the cancer, and sent them home.

Good luck. I know this is all confusing. Keep us posted. It's unlikely we can help much in sorting this all out but we can keep you company while you try.
Posted 8/28/2018 7:23 AM (GMT -5)

PeterDisAbelard. said...
The sort of bruising and bleeding that you describe can be caused by a lot of different things, among them metastatic prostate cancer. I think it is a bit rare but it does happen.

As a rule of thumb a man's chances of having prostate cancer show up on a biopsy is roughly his age expressed as a percent. So, if your dad is 88 then there is around an 88 percent chance that he has at least some prostate cancer. If they do go ahead with the biopsy you should expect some sort of prostate cancer. Most guys his age have some. What would be more interesting is whether he has the more aggressive forms. But, the doctors should be able to make a pretty good guess at that with a bone scan (to show bone lesions that might be prostate cancer metastases) and a repeat of the PSA test (to suggest that it probably is prostate cancer.) I'm not so sold on the biopsy. I'm not sure what else it will tell you.

I'm a bit vague about whether or not he has had a bone scan yet. It's an obvious thing to do. You mentioned that the doctors said he pelvic area was "pretty bad." Was that, maybe, a bone scan result?

The chances are fairly good that your dad's problems aren't caused by prostate cancer since he had a recent PSA test with a much lower level. But it might be. I'm not sure whether that would be better or worse. Clearly there is something going on with him and prostate cancer might not be the worst thing it could be. I found a few case studies for patients who showed up at the hospital with bleeding caused by prostate cancer. In general, they got the bleeding fixed, started them on medication to manage the cancer, and sent them home.

Good luck. I know this is all confusing. Keep us posted. It's unlikely we can help much in sorting this all out but we can keep you company while you try.

They went ahead and did the biopsy, said it was a rare form of PC, had to give him some other type of blood clotting drug, starting chemo.

Doesnt chemo thin the blood?
Posted 8/28/2018 9:00 AM (GMT -5)
Do you know what sort of chemo drug(s) they are using? We probably have guys here with experience.
Posted 8/28/2018 6:54 PM (GMT -5)

PeterDisAbelard. said...
Do you know what sort of chemo drug(s) they are using? We probably have guys here with experience.

I do not know what they used. Scan showed it in his pelvis, spine and ribs. What do you guys think? Im trying to find some hope with this.
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