ChangeMe 
Grape Sorter
Posts: 313
 | | 09-15-2006 05:36 PM |
| Thought I would ask this here and get some input.
I got my blood tests back today, and even though my PSA was within range at 3.2 (range is 0 to 4.0), my doctor thought it might be a good idea to have an exam by a Urologist because last year my result was 0.5 and the year before it was 0.8.
Anyone with knowledge about these things have an opinion about the spike? I have made an appointment to see my Urologist on Tuesday, but would still be interested in opinions others might have.
Thanks. | | |
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Winegeek
San Francisco
Barrel Racker
Posts: 1533
| | 09-16-2006 02:41 AM |
| Steve,
(The standard warning that I'm not a medical professional in any sense of the word.)
Did you ride a bike, do strenuous exercise or have sex in the 24 hour period before your blood was drawn? I was told that any of those can cause an elevated PSA.
I was told thatafter having an elevated PSA and undergoing an unpleasant, expensive and, as it turns out, unnecessary prostate biopsy.
Needless to say I refrain from all those activities for 48 hours before my check-ups/blood work and haven't had an elevated PSA since.
Seeing your Urologist is probably still a good idea but be "good" before the appointment and obviously ask him/her to confirm what I was told. Good luck!
Richard | | | |
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David Niederauer
Los Gatos, CA
VinoCellar.com Extraordinaire
Posts: 30914
| | 09-16-2006 07:28 PM |
| A view from a person who has "been there": Actually it is a good idea for anyone over 50 to see a urologist every three or four years. The main things they check for is if the blatter empties fully when one urinates, how many times you "have" to get up at night to urinate, how urgent are one's "urges" and whether the prostate is enlarged. If one's prostrate is enlarged they will want to take a biopsy. This is no big deal. I will say that even with a load of Valium it still was the only time that my toes actually turned over and touched the top of my food. If it isn't cancerous they will still want to operate. They will tell you that you'll sleep better and be able to lead a "regular" life without having to always stay near a rest-room. I say, "DON'T DO IT!". The cure is worse than the disease! There are plenty of pills that one can take to "reduce" the symptoms but once they cut that's it! One wears diapers for six months because one is incontenent for a time after the operation. Erections are difficult to have without help. There is no such thing as an orgasm again (not to say that sex is not pleasurable). I'm not sure of the following but I have heard... Even if the biopsy comes back positive there is a camp that says just let it be. It is a slow-acting disease that probably isn't fatal for 30 years and most people by the time they get the disease they are already old and most likely won't live another 30 years anyway. There! Now I just hope this story doesn't end up somewhere on the internet  . | | | |
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BellaDonna
Barrel Racker
Posts: 1890
| | 09-16-2006 09:07 PM |
| PSA testing is controversial for those in the urology business. | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 09-16-2006 09:19 PM |
| I appreciate the replies so far. And I certainly appreciate any input from those who have "been there". Being honest with myself, I do believe this is nothing at all. BUT, common sense tells me that a spike from 0.5 to 3.2 is well worth taking a closer look. And, what guy can turn down a gloved exam of the prostate.  ...my favorite time of the year. To think about what IFs, as to the results of the further investigation of my prostate exams is something that I don't relish. One of the things that I have wished against in my life is any serious disease of that area. I've had enough issues over my lifetime, albeit not life threatening or even overly serious, to know that I would really like to avoid problems of any significance. Anyway, again, thanks for the input.....no pun intended.  | | | |
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Nicholas
Grape Truck Driver
Posts: 38
| | 09-20-2006 03:02 PM |
| Get the biopsy. You may be toast. | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 09-21-2006 12:00 AM |
| Quote:
Get the biopsy. You may be toast.
Dr. wants me to get the biopsy, so I am making an appointment. But toast lightly for now, please. | | | |
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Winegeek
San Francisco
Barrel Racker
Posts: 1533
| | 09-21-2006 01:53 AM |
| Quote:
Dr. wants me to get the biopsy, so I am making an appointment.
Did the 2nd PSA come back high as well? Did he say your prostate felt enlarged? If the answer toeither of those questions is yes, then a biopsy is the smart way to go. If the answer toboth those questions is no, then there's a very good chance that the doc is just covering his ass and needs help in making the payments on his new Jag. Sorry for my skepticism and I sincerely hope that you're 100% healthy.
Richard | | | |
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GATC
Wine Lover
Posts: 4740
| | 09-21-2006 06:53 PM |
| Interesting topic. Good luck and I hope that there is nothing wrong with you.
Since the biopsy could possibly be tested with an antibody and detection system we make and stained on an instrument that I designed and we manufacture, I know a little about this subject. The one thing that has always concerned me is that a lot of diagnosis is subjective, no matter how quantitative we make the tests. It is good to be safe and listen to the doctors, but you should also know that you can get different opinions from the same result. That is why the VA requires 2 of 3 pathologists to agree before action is taken. | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 09-21-2006 09:49 PM |
| Quote:
Quote:
Dr. wants me to get the biopsy, so I am making an appointment.
Did the 2nd PSA come back high as well? Did he say your prostate felt enlarged? If the answer toeither of those questions is yes, then a biopsy is the smart way to go. If the answer toboth those questions is no, then there's a very good chance that the doc is just covering his ass and needs help in making the payments on his new Jag. Sorry for my skepticism and I sincerely hope that you're 100% healthy.
Richard
Richard,
He said that my prostate was slightly enlarged, and that he felt that there was nothing really to be concerned about, but that he would rather do a biopsy and make sure. He did not do another blood test.
Should I have insisted on another blood test too?
He did say that there was something about one side of the prostate, but did not feel I should be concerned. | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 09-21-2006 09:52 PM |
| Quote:
Interesting topic. Good luck and I hope that there is nothing wrong with you.
Since the biopsy could possibly be tested with an antibody and detection system we make and stained on an instrument that I designed and we manufacture, I know a little about this subject. The one thing that has always concerned me is that a lot of diagnosis is subjective, no matter how quantitative we make the tests. It is good to be safe and listen to the doctors, but you should also know that you can get different opinions from the same result. That is why the VA requires 2 of 3 pathologists to agree before action is taken.
Thank you for the advice. I will definately make sure of getting multiple opinions before I do anything. | | | |
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Dr_Tannin
Barrel Sampler
Posts: 2498
| | 09-27-2006 09:30 PM |
| The number one cause of an abnormal lab test ---which you still didn't have--- is lab error. The best option is repeat the test.
Prostate cancer which in most cases is the most common cancer in men, but of the 300,000 cases diagnosed every year, only 1/9 will be lethal. As others have said for the vast majority it is a disease you live as you have your heart attack stroke etc. Most important it is a disease of older men primaily with only 1% occurring below age 50. Black men have more aggressive disease.
On the other hand, benign prostatic hyperplasia is extremely common over age 50, involving more than 50% of men; of those that have it half are symptomatic.It is by far a more common cause of elevated PSA.
While there is no reasonable objection to a biopsy, you are for better or worse following the example of why American medicine is the most costly and inefficient among advanced nations.
The likelihood of sifgnificant disease is very low, and the choice of therapy the most expensive. I see it everyday dozens of times. Welcome to the good ol' USA | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 09-28-2006 08:01 PM |
| Ok, having heard from DrT and Winegeek and David, I went this morning to my regular Dr and told him that I wanted another PSA blood test. IF it comes back normal, should I go ahead with the biopsy? Keep in mind that I did NOT hear that my prostate was ENLARGED, but rather that it was "slightly" larger on one side. The Urologist was very nice, and I liked him. But, it was the first time I has seen him and I have no idea what kind of doctor he is. He is in the group of a fellow wine buddy (well respected and well known) ENT that I just started going to in Marlton, NJ. That is why I decided to go to him.
I will report back my newest results. Keep in mind that my test results were .8, then .5, then 3.2.
I very much appreciate the input from others. Thanks. | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 09-29-2006 05:24 PM |
| Latest PSA test result is .6.
Canceled my appt for a biopsy and will recheck in 3-6 months.
Thanks for all the input. Much appreciated. | | | |
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David Niederauer
Los Gatos, CA
VinoCellar.com Extraordinaire
Posts: 30914
| | 10-01-2006 01:51 AM |
| These PSA numbers are wierd.
Under 4 and you are ok OR you might have cancer (what's with this?).
4-10 and you have a 75% chance of not getting cancer.
10 and above and it goes to a 50% chance.
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I understand that something like 80% of the men who are getting treatment don't really need any treatment at all.
This is really a pain in the ass (so to speak). | | | |
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BellaDonna
Barrel Racker
Posts: 1890
| | 10-01-2006 05:04 AM |
| Did I not read somewhere on this thread...but did anyone perform a DRE? | | | |
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ChangeMe
Grape Sorter
Posts: 313
| | 10-01-2006 06:24 PM |
| Quote:
Did I not read somewhere on this thread...but did anyone perform a DRE?
My regular doctor has done the DRE each year, and this year he did not see anything different, BUT, wondered about the spike from .5 to 3.2. I thought about it after he suggested I see a urologist, that I would feel better with another blood test....which would have made sense.
Instead, I backed down so to speak and followed his advice and went to see a urologist. He did a DRE and said that it was basically normal, buuuuut that maybe it was a little mishaped on one side, or something like that. He made sure to tell that it most likely is nothing, but to be sure, lets do a biopsy. BUT, he never repeated the blood test, which I felt was not the right way to go. Again, I decided to go with them instead of pushing my thoughts. BUt after making the appointment, I started to rethink it, as did my wife, and after reading what Dr T wrote, I went the next morning and got a new blood test.
With the new results exactly the same level as ALL previous test results, I decided to cancel.
The one question I would like to ask others who know about this stuff is, How long should I wait before having the PSA test AND more importantly, the DRE? | | | |
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BellaDonna
Barrel Racker
Posts: 1890
| | 10-01-2006 06:49 PM |
| Quote:
The one question I would like to ask others who know about this stuff is, How long should I wait before having the PSA test AND more importantly, the DRE?
Are you asking how long you should wait for ANOTHER DRE and PSA test?
Also, is this correct?:
Last year's PSA: 0.8
This year's first PSA test: 3.2
Second PSA test: 0.6
I know that this is something that you've probably been thinking about much. Did you say you were asymptomatic? Do you ever wake up in the middle of the night to urinate? How many times? Is it difficult for you to start a stream of urination? Do you feel like you completely empty your bladder each time you urinate?
As far as your physician saying that your prostate is slightly enlarged...almost all of the male cadavers we dissected had slightly enlarged prostates...it's just something that coincides with aging. | | | |
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David Niederauer
Los Gatos, CA
VinoCellar.com Extraordinaire
Posts: 30914
| | 10-01-2006 07:45 PM |
| Quote:
He did a DRE and said that it was basically normal, buuuuut that maybe it was a little mishaped on one side
No wonder you walk leaning to one side.
Quote:
Did you say you were asymptomatic? Do you ever wake up in the middle of the night to urinate? How many times? Is it difficult for you to start a stream of urination? Do you feel like you completely empty your bladder each time you urinate?
These are all good questions and I'm sure your vet asked you all of them.
How often did I get a PSA test?
When I was under 50 years old every four or five years.
Between 50 and 60 every couple of years.
Now (over 60) probably every year.
I always have some sort of physical every year. The physical always include the old "finger" test (whatever they call that) (can I say "finger up the butt"?)
I know this is not a reason not to get a PSA but it is my understanding that it is one of the most expensive tests you can get and, as it seems to indicate here, really isn't very dependable.
If any of you medical types disagree with me feel free to tell me I am full of .
All I'm saying here is what I did/do. | | | |
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BellaDonna
Barrel Racker
Posts: 1890
| | 10-01-2006 08:03 PM |
| Quote:
years.
I always have some sort of physical every year. The physical always include the old "finger" test (whatever they call that) (can I say "finger up the butt"?)
I know this is not a reason not to get a PSA but it is my understanding that it is one of the most expensive tests you can get and, as it seems to indicate here, really isn't very dependable.
A DRE is the least expensive screening tool available. | | | |
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