BPH

[mmil]

Hello Friends,

This is my second post. I'm not sure which Forum to post this in? I also posted the same text over in the Prostate Cancer Forum.

I am a 56 year old male. Last year, I had a horrible case of prostatitis with my PSA level >50! I took Cipro for a month. The symptoms went away. The Urologist said that it may take a year for the PSA levels to return to normal. (Prior to the infection, I was in the 3.3-3.7 range.)

Well, it's been over a year, and the PSA remains in the 7-8 range. I just finished another month of Cipro, just in case I had a residual infection. No change in PSA. I have a Biopsy scheduled for October 30; I will have a blood test tomorrow to check my 'white count'.

When I take the BPH AUA (American Urological Association) Prostate Symptom Index test, I score 19 - 22, depending. This puts me in the low end of the 'severe BPH' category.

My question is, has anyone ever had similar PSA numbers? Cancer is obviously the worst case scenario, but I'm curious if severe BPH could cause the PSA level to be elevated, to the extent I am experiencing (7-8)?

Thanks to All Who Can Help,
Mark

[mrcoyote]

Mark>
It's fine to post in this forum. You may or may not get an answer here, but you're here! Ha! OK>now for the info. you are looking for. Yes, many many people have extremely elevated PSA numbers from a variety of things.....prostatitis can drive it up there, injury to the prostate, a recent biopsy can do it, sexual activity, and so on and so on. Even a digital exam can spike it up. The good news is: you are on the exact right track. I can tell by your post you have a urologist who is doing the right thing now. Prostatitis can be really nasty, I know. He is right in doing a biopsy now. You want to be on top of whatever it is that's bothering you. BPH can cause the PSA to be elevated as well. Mine fluctuates like crazy and I've had several biopsies just in case. Nothing. I also had Laser TURP as you can read about here in this forum. The important thing is, as you know, EARLY DETECTION. Sorry to highlight that, but it's true with anything, isn't it? Then you can deal with it the best way and I'm sure you will be fine. I used to worry about my PSA number being this or that. Now, I only care about the baseline figure and how from 6-mo. to 6 mo. it varies from that. So, you need a biopsy and then you need to WAIT some time after that before getting another PSA test. Very important! The biopsy will spike the PSA WAY UP.
The urologist will confirm this I'm sure. There is no need to be afraid of the biopsy. They use Lidocaine
which is a topical anesthetic and it's not painful, just uncomfortable a bit. Hey, if I can do it, anybody can! Then there will be some bleeding in your urine and then it's gone. They will biopsy 10-12 places in the prostate like a grid, hoping to get a good cross-section of tests. Results take a little time to come back, but you want a good reading. If there is nothing they detect, you are good to go until your next PSA test down the road. Then, you will use THAT as your baseline, provided you don't have any residual prostatitis or condition that would give you a funky reading. Got it?? OK!

Don't worry. I think you are going to be fine. Why do I say this? Well, you had a PSA of 50 and then it came back down to 7 or so. Right? If it was cancer, it may or may not have come back down to a 7 after that much time. I'm NOT a urologist, but I have had many friends go through this, some with cancer, some without. And typically, the PSA goes higher in time. It's a call your urologist must make, not me. I want to be clear about my comments. They are just that. But I have been through this prostate thing for years and monitor this site hoping I can help somebody in some small way. Hope I did. You have a good doctor, and that's the No. 1 thing. Everything else is secondary. :-)

[mmil]

Mr 'C',

Thanks for the reply.

What is really odd about this ordeal, is that prior to my Prostatitis, my PSA was consistant, and <4. Since then, I have these weird numbers 7-8. I had a blood count done today, just to see where the white count is.

Can Prostatitis trigger Cancer? That is my big question. I seem to indicate more symptoms of BPH as a matter of fact. Unfortunately, I am aware of no physical symptoms of Prostate Cancer, other than the tests reveal.

Regards,
MM

[mrcoyote]

Well, as far as I know, prostatitis cannot "trigger" prostate cancer. Cancer is one thing. Prostatitis is another, so I don't think you have to worry about that. Millions of guys suffer with mild to severe cases of prostatitis and never get cancer. EXAMPLE: me. I've had prost. all my life on and off. I never knew what it was and they said they didn't know why I had it and also they didn't have a "cure". I have had my urologist tell me I might have it on and off for the rest of my life. But, I've never had cancer, so there you go. You can take all the meds you want to for prostatitis, like Cipro, etc. and there are a ton of them, but some work for some people in a given period of time, and some don't work so well. I hear this all the time from my friends with problems. BPH may be upon you now and it can cause things to flare up, including your PSA for sure. Mine did and never really came down after that. I have an ongoing 7-9 now with no traces of cancer from biopsies. My doctor said, "Well, we will use that as your baseline number now" and that was that. The important thing is that you are monitoring it every 6 months or so for changes. And be careful what supplements you might decide to take for the BPH if you find out it's causing problems. Some of them can skew the PSA readings. I never knew that, but it's true. My urologist, who is on top of his game in his field, told me all about this. You want an accurate test each time to compare apples to apples. Right? I know I do. Have you taken Flomax for BPH or are you taking it now? If not, your urologist may suggest it. Also, they like to prescribe Avodart which shrinks the prostate, but it takes longer to work whereas the Flomax only takes a couple of days to work because it works differently.

OK<now relax!

[mmil]

Howdy Again,

I have been biding my time, going through the process. The Biopsy was performed last Friday. The results will hopefully be available tomorrow (Friday).

The Biopsy was a piece of cake. I followed the directions before and after the procedure. No blood in urine or from rectum. Blood was in the ejaculate two days later, and as has been explained to me, will be for several months. OK.

The wait for the results is almost intolerable. What a mind game! The mind plays lots of tricks, and lots of morbid thoughts are flooding my consciousness. I know, think positive. I've been trying.

Regards,
Mark

[mrcoyote]

Mark>
Yes, I know the waiting for results from any kind of test seems like agony sometimes, but consider this:
You are going to be fine no matter what, since you were smart enough to proceed with a biopsy and that's the only way to really know what's going on. So many people don't do this and then find out later.
They do so many of these biopsies, it's almost routine after a while. Please post what they found or did not find and then I have some more comments for you, ok? Rest easy...you are on the right track!

[brucew6]

I had the Holep Laser surgery about 3 months ago. My PSA was 4 - 5.5 before the surgery. I had a Psa test last week and it is 3.3. I thought it would be lower than this. Anyone experience this.

[mrcoyote]

Typically, after a surgery of that nature, you can expect your prostate to be significantly "traumatized" and therefore, expect a higher than usual PSA. I'm surprised it's even that low. My advice, and I'm not a doc. as you know, would be to wait a bit and have another PSA when your prostate has had time to settle down. What did your urologist say about the 3-something PSA? That's pretty good anyway, you know. I wouldn't worry at this point. My BPH keeps my PSA right up there, but numerous biopsies have shown no cancer.

[mmil]

"NO CANCER PRESENT"! Therefore, no 'Stage scale' applies, no 'Gleason score' applies. I am a lucky one, but realize that the Urologist did the right thing in ordering the Biopsy. I agree. Let's eliminate Cancer first, and we have.

I am already scheduled for my next 6 month physical with the Doc, and of course we'll get the PSA drawn first, then a day or two later, the DRE.

This is the first day in 2 months that I have not been living in 'terror'. What a great day it is. We hope the Free PSA levels increase. For the time being, damaged (not abnormal) cells in the enlarged prostate most likely from my Prostatitis (PSA >50) last year. The prostate works in mysterous ways!!!

Thanks for your support and encouragement!

Regards,
Mark