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PSA rise again

User
Posted 16 May 2017 at 11:14

Now extremely worried, after 4 weeks on antibiotics my PSA has risen again to 12.  Looks like the initial diagnoses of 3+3 and 1 core out of 24 was wrong.

User
Posted 17 May 2017 at 03:35

Sometimes antibiotics do not easily end a urinary infection and this can of course mean an increased PSA or contribute to it. However, antibiotics will not reduce cancer caused PSA in the way HT usually does. Inceasing PSA reading does not necessarily mean your previous biopsy was wrong in terms of the extent or mutation of cancer, although this can change over time and indeed it is sometimes the case that not all the cancer or the most advanced parts are found in the first biopsy. It seems your consultant has this in mind by calling for a further biopsy.

Barry
User
Posted 18 May 2017 at 02:01

Unfortunately, although scans have improved over recent few years, those interpreting them sometimes can see nothing even when cancer has been proven by biopsy. Then scans can be interpreted differently. I had what was described as a suspicious area within my Prostate and strongly suspected cancer in a lymph node due to uptake of Choline in an advanced scan according to my present hospital. However, 3 other hospitals with whom I have had past involvement also studied this same scan and were not convinced that there was cancer there although they agreed these areas were suspicious. So it can be a matter of interpretation. It can be helpful to compare with past scans. The reasons why in the case of the Iliac node the 3 hospitals were not convinced cancer was present was because the Choline uptake was not decisively strong and because the size and shape of the node in question was still the same as on scans taken quite a number of years ago. Sometimes an accurate diagnosis is difficult to arrive at and further scans and tests may be done to assist in this and to look for change.

Barry
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User
Posted 16 May 2017 at 13:13

Did they say what PSA level would 'ring alarm bells'?

When will you see them again routinely?

User
Posted 16 May 2017 at 13:22

I think doubling was an alarm bell, this is triple in 8 months.  Going in tomorrow.

User
Posted 16 May 2017 at 15:06

Just called me again, want a biopsy on friday!  Going to call and speak to me later....

User
Posted 17 May 2017 at 03:35

Sometimes antibiotics do not easily end a urinary infection and this can of course mean an increased PSA or contribute to it. However, antibiotics will not reduce cancer caused PSA in the way HT usually does. Inceasing PSA reading does not necessarily mean your previous biopsy was wrong in terms of the extent or mutation of cancer, although this can change over time and indeed it is sometimes the case that not all the cancer or the most advanced parts are found in the first biopsy. It seems your consultant has this in mind by calling for a further biopsy.

Barry
User
Posted 17 May 2017 at 19:57
Thanks for the replies.

Just been for follow up appointment, really confused. I had 3 Tesla MpMri which has been reviewed by the radiologist and consulting, it doesn't show anything. Apparently my prostate is big for my age at 35cc but other than that nothing remarkable.

Having another template biopsy on Friday just in case. Has anyone know anything like this? Apparently the 3T MRI is over 90% accurate when it comes to spotting significant cancer.

My concern is still it's being missed as I've seen it on here albeit with older diagnostic tools. The PSA velocity and density is very large. 4, 7.8, 6.7 to 12 in 9 months.

User
Posted 17 May 2017 at 20:12

Has anyone suggested doing a FreePSA test? That in conjunction with your normal PSA test would be more indicative but it seems this is more likely to be infection than cancer activity.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 May 2017 at 20:42
Hey Lyn

Yes I have 3 free PSA test. It has gone from 14.7% to 6.8%. Apparently BPH raises the free but prostatitis doesn't.

Thanks

User
Posted 18 May 2017 at 02:01

Unfortunately, although scans have improved over recent few years, those interpreting them sometimes can see nothing even when cancer has been proven by biopsy. Then scans can be interpreted differently. I had what was described as a suspicious area within my Prostate and strongly suspected cancer in a lymph node due to uptake of Choline in an advanced scan according to my present hospital. However, 3 other hospitals with whom I have had past involvement also studied this same scan and were not convinced that there was cancer there although they agreed these areas were suspicious. So it can be a matter of interpretation. It can be helpful to compare with past scans. The reasons why in the case of the Iliac node the 3 hospitals were not convinced cancer was present was because the Choline uptake was not decisively strong and because the size and shape of the node in question was still the same as on scans taken quite a number of years ago. Sometimes an accurate diagnosis is difficult to arrive at and further scans and tests may be done to assist in this and to look for change.

Barry
User
Posted 18 May 2017 at 08:49

Thanks for the insight Barry. That's is the dilemma on one side, he said what they found before can be present in 20-30% of people even at my age, though perhaps not to the same extent. The two scans show no obvious cancer specific differences yet my PSA has tripled... See what happens come the biopsy. I'm unsure whether to be pleased by the news or not! Not counting my chickens ha

 
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