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soares.glaucio@gmail.com
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 Posted: Sat Apr 26, 2008 2:11 pm Post subject: Re: Biopsy? |
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On Apr 25, 1:02 pm, Larry <la...@nospam.net> wrote:
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Hi.
I'm 51 y/o with history of chronic prostatitis. Just had an increase in
PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
him why not repeat PSA, just in case? He said the labs don't make
mistakes. Should I push him on this or just accept the biopsy?
Larry
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Larry:
you donīt need a "permission" from your uro to have another PSA test.
There are good reasons to have several, preferably spaced by time
intervals. PSA may vary within a short time and results are affected
by many activities and conditions. Get the information and learn about
PSA velocity and PSADT (doubling time). Always get a second opinion.
And labs do make mistakes.
best of luck |
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Claude
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| Posted: Sat Apr 26, 2008 6:17 pm Post subject: Re: Biopsy? |
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"Larry" <larry@nospam.net> wrote in message
news:481266fe$0$11635$607ed4bc@cv.net...
| Quote: |
Thanks, I can appreciate your story and why you would recommend it.
Actually, I just verified that my PSA went from 1 to 1.6 to 1.8 over 2
years (not 1 year). I am still going to question him about it again.
Regarding the biopsy, can you provide any sense for what "unpleasant"
means to you re the biopsy? I mean, a biopsy needle goes through the
intestinal wall and about an inch into the prostate. That is only
"unpleasant"? What exactly do you feel? Pressure? Pain? Very quick? How
would you describe it?
Thanks!
Larry
NB wrote:
"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
Hi.
I'm 51 y/o with history of chronic prostatitis. Just had an increase in
PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
him why not repeat PSA, just in case? He said the labs don't make
mistakes. Should I push him on this or just accept the biopsy?
Larry
Hi Larry. Get the biopsy. I'm 45 years old, had a normal PSA, but a lump
was found during my annual physical. I was sent off for a consultation
with a urologist and they repeated the DRE. As a result, I had a biopsy
done right on the spot. My test results came back positive for prostate
cancer. My surgery was on March 20th and I'm recovering slowly.
A PSA test is not the definitive answer as to whether there is a problem
or not. Get a DRE and get a biopsy just to make sure. The biopsy is
unpleasant but releatively painless and it will take about 10 to 15
minutes depending on how many samples need to be taken. Waiting for the
results is actually worse.
If you have any questions, feel free to ask.
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I can't say it was pleasant, but I've had a number of other medical and
dental procedures that were a lot worse. I had no anesthetic outside of
possibly a numbing material on the the probe (I'm not even sure I had that.)
Before I underwent the procedure, I read someone describe it as feeling like
someone was snapping rubber bands against the inside of the rectum. That
was pretty much descriptive of my experience. |
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Larry
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| Posted: Sat Apr 26, 2008 6:37 pm Post subject: Re: Biopsy? |
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Leonard,
The only "abnormality" from the DRE was the "left lobe was slightly
larger than the right lobe". I'm not sure that really constitutes an
abnormal DRE. And I confirmed the PSA numbers. It did not go from 1 to
1.8 in one year. It went from 1 to 1.6 in one year, and then from 1.6 to
1.8 in the subsequent year. In other words, it took 24 months for it to
go from 1 to 1.8, not 12 months.
Larry
Leonard Evens wrote:
| Quote: |
whoknew wrote:
"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
Hi.
I'm 51 y/o with history of chronic prostatitis. Just had an increase
in PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I
asked him why not repeat PSA, just in case? He said the labs don't
make mistakes. Should I push him on this or just accept the biopsy?
Larry
First off if your doctor thinks labs don't make mistakes he's a fool.
Second, to my knowledge biopsies are not usually considered until PSA
is usually up around 4.
That is way out of date. For a 51 year old man, a much lower threshold
would be appropriate. But it is the rate of change that is important
rather than the actual value., and if the trend shown in the last test
continued, it would be reasonable to go to biopsy.
It is possible, on the other hand, for PSA to vary for a lot of reasons
other than prostate cancer, even assume the labs anever make mistakes.
Many doctors would wait a few months and take another reading to see if
the trend were continued.
Did your doctor suggest any other reason for concern, such as a
suspicious DRE?
If you are really concerned about the matter, you could seek another
opinion,
Personally I'd find anohter uro. It sounds more like he just bought a
new BMW and need someone to make payments for him
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Steve Kramer
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| Posted: Sat Apr 26, 2008 9:11 pm Post subject: Re: Biopsy? |
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"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
| Quote: |
Hi.
I'm 51 y/o with history of chronic prostatitis. Just had an increase in
PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked him
why not repeat PSA, just in case? He said the labs don't make mistakes.
Should I push him on this or just accept the biopsy?
|
Well, it's not exactly true that labs don't make mistakes. But an 80%
increase over 12 months is significant. It's best to rule out cancer.
--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08
Non Illegitimi Carborundum |
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gabachin
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| Posted: Sun Apr 27, 2008 3:17 am Post subject: Re: Biopsy? |
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On 25 abr, 11:02, Larry <la...@nospam.net> wrote:
| Quote: |
Hi.
I'm 51 y/o with history of chronic prostatitis. Just had an increase in
PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
him why not repeat PSA, just in case? He said the labs don't make
mistakes. Should I push him on this or just accept the biopsy?
Larry
|
Hi Larry,
Labs do make mistakes. My PSA went (supposedly) from .5 to 1.8 in
about 18 months, and I freaked out. I went to a uro, who examined me
and told me a biopsy was not necessary, and suggested I monitor my PSA
every six months. The subsequent six month readings were 1.6 and 1.9.
Well, it turns out that when I had my yearly physical last October, my
GP and I looked more closely at my past tests, and, sure enough, there
were other discrepancies on the lab tests in which the PSA was .5. For
instance, my lipid profile was also way off my "usual" results. This
does not, of course, prove the lab screwed up, but it does make it
more plausible.
One thing about PSA velocity. Two readings are not enough, you need at
least three PSA tests done at the same lab on the same equipment over
at least 18 months to get any useful information. The general idea is
that you're trying to distinguish exponential from linear PSA growth,
which can not be done with two readings alone. I'm a mathematician and
can vouch for this. Do some research and you'll see what's going on
here. The .5 ng/yr threshold should be an average of at least three
readings taken at least six minths apart.
You'll get great feedback from this group, Larry. I have learned much
from the posters, and still occasionally lurk here, reporting in with
my PSA numbers. As of yet, I'm not a certified member of the club, and
have no desire to change my status. I get a DRE and a PSA test every
year, without fail.
Good luck. |
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Bob Eld
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| Posted: Mon Apr 28, 2008 11:01 pm Post subject: Re: Biopsy? |
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"Larry" <larry@nospam.net> wrote in message
news:4812005d$0$25032$607ed4bc@cv.net...
| Quote: |
Hi.
I'm 51 y/o with history of chronic prostatitis. Just had an increase in
PSA from 1 to 1.8 over one year. My uro is ordering a biopsy. I asked
him why not repeat PSA, just in case? He said the labs don't make
mistakes. Should I push him on this or just accept the biopsy?
Larry
|
Thanks, Alan. The only thing he noted upon DRE is the left lobe bigger
than the right. He said sometimes that means something and sometimes
not. And in fact, I am having a bit of dull pain on the left side, so
I'm thinking it could be the prostatitis
Based on what you said in the first paragraph you should push for more
information and a Second PSA. However, based on the second paragraph which
you added for another poster, you should get the biopsy. It's always good to
give complete information if you want an accurate answer. Getting the biopsy
will give you peace of mind one way or the other.
I suspect the Uro is concerned about the unevenness or lump in the left lobe
as well as pain more than the PSA. He's probably not concerned about the PSA
that's why the dismissive answer.
I got a biopsy after a lump was felt during an DRE and, fortunately the
biopsy was negative. It's no big deal, you don't feel the needle which
usually samples a number of times, not just once. There is no pain. The
biggest issue is the feeling of having to poop with the ultrasound probe
pushing this way and that over about 10 minutes. The Doc is using ultrasound
to view the prostate and find locations to take the biopsy samples. The
needle pops out of the probe very fast taking it's sample and that part
doesn't feel like much of anything. Again the biggest problem is the feeling
of fullness and pushing in the rectum. |
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