Right Doctor???

mylo83 · New User Joined: 19 Jan 2010 Posts: 1

I'm new here, so please bear with me if you will. My brief history---age - 71.
All my PSA's have all been under 2.50. My PSA on 4/6/09 with my personal physician was in fact 1.97. Then a PSA with my VA doctor three and a half months later, (7/29/09) came in at 6.64. VA suggested seeing a urologist. Personal urologist PSA on 8/5/09 showed 4.7. At my suggestion, he biopsied on 9/4/09. Test results were negative, (twelve cores). AH!!!! AMEN I thought! Negative---nothing to worry about now.
Follow up PSA on 10/8/09 was 19.2. He suggested waiting until April 2010 for another PSA test. At my request again he retested on 10/21/09 with PSA at 11.3. Again he suggested waiting until April for any follow ups. At my request once again, another PSA was taken on 1/5/10. That was 2 weeks ago and I still have not heard from this doctor.
I know prostate cancers are suppose to be very slow growing cancers. However that does not ease my peace of mind. Just the word cancer is enough to scare the bejeebers out of me. I'm very anxious to know where I'm standing now with my numbers. Yet I feel I've pressured this doctor enough on this already. Should I persue a doctor who will treat my case in a more aggresive manor? I would like to be as pro-active as possible on this. I only have one life to live. OR---am I making a mountain out of a mole hill?
Any comments will be most appreciated. Thanks for listening.
Mylo[/u]

MaxBuck · New User Joined: 03 Jan 2010 Posts: 6

I won't criticize your doc, since your post doesn't give me adequate reason to do so. But 2 weeks is long enough to get your blood test results; call the doctor's office and demand the report!
_________________
Dx at age 56
PSA 5.8, then 9.9 2 weeks later
Biopsy results - Gleason 8 (4+4), cancer found in 8 of 12 cores
Open radical retropubic prostatectomy (awake - spinal) 12/4/09; did 2 laps walking around ward later that day
Post-op pathology T2c N0Mx (but clean CT and bone scan pre-op), Gleason 7 (4+3, but 5 tert), 21% cancer in gland, clean margins but perineural invasion
After 6 weeks continence nearly complete (1 pantyliner/day)
On Cialis 5 mg/day but woodless currently

az4peaks · Experienced user Joined: 23 Oct 2009 Posts: 74

Hi mylo, - I understand your concern because of the high PSA, but you should understand, that your Urologist isn't rushing you into aggressive treatment because there is not sufficient evidence to do so.

The fact that your PSA elevated rather suddenly and has varied substantially, UP AND DOWN, is much more typical of Prostatitis than PCa. This possibility is further supported by the Negative results from your 12 core Biopsy. PCa and BPH don't normally have such substantial swings in PSA results.

There are two items, however, that you make no mention of, that are often applied in cases like yours. The first is the result of the digital rectal exam (DRE), negative or positive, and the second is the prescribing of a 4 to 6 week course of Cipro , Levaquin, or other high powered anti-biotic, immediately followed by another PSA test.

If the elevated PSA is dramatically lowered by such a regimen, it would INFER that Prostatitis, caused by bacterial infection, would be a likely cause of, at least a substantial portion of the PSA elevation. Not all Prostatitis is caused by bacterial infection, however, and so a less dramatic PSA reduction would not eliminate the possibility of non-bacterial Prostatitis involvement. Was it mentioned on the Biopsy Pathology Report? Do you have a copy for your records? Ask how long it takes to get results and if they haven't called you, call his office!

I would suggest that you have a "chat" with your Doctor and let him know how concerned you are, and that you want to define the likely cause of the PSA elevation, as soon as possible, - - so you can relax. If he doesn't seem to get the picture, consider changing to someone who better reacts to your EXPRESSED concerns. Good luck! - John@newPCa.org (aka) az4peaks

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