Biopsy?
in [Prostate Cancer]
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From: Larry on 25 Apr 2008 12:02 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
From: whoknew on 25 Apr 2008 12:21 "Larry" <larry(a)nospam.net> wrote in message news:4812005d$0$25032$607ed4bc(a)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. Personally I'd find anohter uro. It sounds more like he just bought a new BMW and need someone to make payments for him
From: Larry on 25 Apr 2008 12:28 LOL! Thanks! I just think he's looking to CYA. BTW, PSA over 4 is not the only criteria used. The rate at which it increases is also a consideration. Larry whoknew wrote: > "Larry" <larry(a)nospam.net> wrote in message > news:4812005d$0$25032$607ed4bc(a)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. > > Personally I'd find anohter uro. It sounds more like he just bought a new > BMW and need someone to make payments for him > >
From: ron on 25 Apr 2008 12:31 On Apr 25, 10:02 am, Larry <la...(a)nospam.net> wrote: > 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...A PSA increase of 0.75 ng/ml, some say 0.50, in a year suggests further evaluation. A repeat of the PSA test is a good idea, IMO. Better yet might be a retest after a 2-3 antibiotic regimen to see if prostatitis might be the real culprit (unfortunately not all prostatitis responds to antibiotics)...ron
From: Alan Meyer on 25 Apr 2008 13:38
"Larry" <larry(a)nospam.net> wrote in message news:4812005d$0$25032$607ed4bc(a)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 I'm not a doctor but it is my understanding that prostatitis does elevate PSA levels. Furthermore, I suspect that PSA tracks flareups. When you're having a bout of prostatitis the PSA may go up during that period and then come back down if the inflammation recedes. Apparently, PSA levels can go up due to a number of different factors. If you had sex the night before the blood draw, or if you had a digital rectal exam shortly before the blood draw, that could elevate PSA levels (again, I'm not a doctor, but those are the conventionally accepted views.) The theory is that there should be no stress on the prostate for 48 hours before the blood draw in order to get an accurate reading. It is commonly held that people with prostatitis should get a round of antibiotic treatment to see if it goes down. From my reading, I think that the majority of prostatitis cases are not in fact due to bacterial infections and won't respond to antibiotics. I know that I've suffered from prostatitis and had no response to antibiotics except a queasy stomach for 28 days. I personally don't believe in taking antibiotics unless you really need them, and would ask the uro to do a urine culture to find out if there are higher than normal levels of bacteria in the urine - which might indicate that an antibiotic would do some good and not just wipe out beneficial bacteria in your body and help breed antibiotic resistant organisms. As for labs making mistakes, well, I'm sure it's true that mistakes are pretty rare. But no matter what systems they have in place to prevent them, there are still human beings running the labs. I would have liked your doctor's statement better if he had said that mistakes are rare rather than that they don't happen. Still, the odds are high that the reading is correct. The main issue is, is this increase in PSA really due to cancer? Did the uro feel anything on his digital rectal exam? If he did, then I think he's right that a biopsy should be done. If not, then I like your idea of repeating the PSA rather than getting a biopsy. I'm a little reluctant to contradict your uro. He's a credentialed expert and I'm not. However, your PSA is well within normal limits, you have an alternate explanation for the recent rise (prostatitis), a biopsy is expensive and invasive, a PSA test is cheap and non-invasive, and prostate cancer is normally a very slow growing disease anyway so that waiting a bit and re-testing is unlikely to put you at much risk. The usual theory is that anyone with a PSA below 10 and a Gleason score (which you can't get without a biopsy unfortunately) below 7, has a very high probability of successful treatment. So, I'd schedule another PSA test. I'd be sure there is no sex, no digital rectal exam, maybe even no bike riding, for 48 hours before, and see what it says. I think there is a good chance it will be lower than your last reading. If it's higher, then maybe you should get a biopsy. Good luck. Alan |