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New guy here with rising PSA/descending free PSA %

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Posted 3/19/2013 4:05 PM (GMT -5)
Hello everyone. I've been trolling on here for a few days and finally decided to post.

In 2006 I had a PSA of 1.7, Around 2009 it was around 3.5 or so.

In October 2011 I had a physical and it came back 4.8 with a 15% free PSA. Saw a urologist and went on antibiotics, which brought it down to 3.5. Did a biopsy anyway and the results were negative.

November 2012 I went in and my PSA was 5.3 with 13% free. Urologist put me on a 3 month schedule. I just had that done and my PSA came back at 5.9 with 10% free. I've scheduled another biopsy for 3/28.

Looking at the trend has me worried to say the least, though I have a tendency to worry about things before they're really a problem. I have no family history of prostate cancer on my dad's side of the family; Dad is 76 and doing well in that regard--he did have a spike in his PSA level when he was around my age (I'm 50), but there was no cancer. My maternal grandfather was diagnosed with prostate cancer in his mid to late 70's (or maybe early 80's). Beyond that, we don't have any data on my mom's side of the family.

Any suggestions or comments? (BTW...I put the PSA levels in my signature. I don't know if they'll pop up with this post or not).
Posted 3/19/2013 4:42 PM (GMT -5)
Hi, Ken
You sound more like a lurker than a troll :)
It sounds to me like you are doing the right thing by getting the biopsy. I know of friends that have had prostatitis that elevates PSA, even sometimes quite a bit higher than your readings. The fact it came down some with antibiotics was also a good sign. However, it has been elevated for an extended period of time so I think you are making a good choice with the biopsy.

I'll say the obvious, but at this point it does no good to worry. You have done what you need to do, and it is better to keep your mind off of this subject until you get the biopsy results. If it turns out negative, give yourself a good long break from this subject. If it turns out positive, we'll be here to help you with our experiences and support.

Best wishes, Jeff
Posted 3/19/2013 4:50 PM (GMT -5)
Hello and Welcome, Ken.

From what you write, this next biopsy is needed. I had a steady rising PSA, and no infection, and all negative DRE's, and it still took 3 biopsies to find the cancer spread over 18 months. When they found it finally, it was like a mother lode. Conventional 12-14 core biopsies can be so hit or miss. My doctor said it was like sticking a needle in a loaf of raisin bread. If it comes out clean, doesn't mean there aren't raisins.

Good luck,

david
Posted 3/19/2013 5:50 PM (GMT -5)
Hi Ken-

I'd try not to get too worried about it. My PSA has gone from 1.5 back in 2003 to 10 as of last summer. My % free PSA ranges from 7 to 12.  3 biopsies (including a 24 core saturation) were neg. Uro says my prostate shows inflammation on each biopsy. Put me on Flomax after last biopsy, which artificially lowered my PSA to 5. I had been experiencing slow start & frequency, the Flomax helped. While it is troubling that PSA keeps rising, I try to put it out of my mind til my semi annual PSA test. Unless it spikes or DRE is abnormal, URO does not see benefit of another biopsy.

I worried myself sick about this for awhile.

Dan

Posted 3/19/2013 11:18 PM (GMT 0)
Ken,

It took 3 biopsies for me over 12 years before they found PCa. Had infections and an enlarged prostate before finding cancer. You are doing the right thing. If you are lucky and dodge the bullet this time, have your PSA checked yearly from now on.

Don't worry about anything for now, worrying is like riding a rocking horse, it gives you something to do but doesn't get you any where.

Bill nono
Posted 3/19/2013 6:25 PM (GMT -5)
I think you're doing the right thing by having a second biopsy. I had a negative biopsy in 2007, but my PSA continued to rise (and my free PSA to go down). I had a second biopsy in 2012 that was positive and in retrospect I shouldn't have waited that long.

That said, who knows what the story is for you. There's lot of possibilities and while your PSA scores are worrisome enough to be prudent and have the second biopsy, they're not super alarming either. Good luck and keep us posted.

Michael
Posted 3/19/2013 6:44 PM (GMT -5)
Thanks for the encouragement everyone. It's easy to get worried and think of the worst-case scenario. I work in the airline business and I have to remember that my knowledge of the medical profession is about like the fearful flyer who, with every bump, is sure the wings are going to come off. Education is the key and this forum is the mother-lode.

Jeff--yes, I think "lurker" is more in line with what I meant!

Dan--Thanks for passing along your numbers and experience. Very encouraging. BTW, Do you know anyone over in Sitka? I have a former student who used to be the harbor master there.

I was in the grocery store today and saw a young lady who put this all in perspective. She was just growing her hair out after chemo and had about a 4" surgical scar from an incision that started at the base of her skull and ran down her neck. She's obviously been through hell and I'm worried about a high PSA? I think that was God's way of telling me my situation really isn't all that bad and to do what I need to and count my blessings. I'll post when I get my biopsy results.
Posted 3/19/2013 7:26 PM (GMT -5)
You might want to consider doing an MRI before your biopsy if your insurance will cover the cost. In NY the urologists are starting to do MRI's before the biopsy. It shows if there is cancer and where the cancer is, so that the urologist knows where to stick the biopsy needles. Both the urologist who diagnosed my husband with PCa and his surgeon both do MRI's before biopsies now. My husband's friend just had a high PSA. The urologist did an MRI (approved by insurance) which showed a grey area suspicious for cancer and he has a biopsy scheduled.
Posted 3/19/2013 9:10 PM (GMT -5)
Thank you for the MRI idea. I'll certainly look into that option.
Posted 3/19/2013 11:27 PM (GMT -5)
I believe that the MRI shows where areas there *may be* cancer, as opposed to showing that there is actual cancer, which can only be diagnosed by a biopsy. Sorry, if I'm being a stickler, but this can be an important distinction.

That said, I think the MRI can be extremely helpful before a biopsy and makes sense to pursue.
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