Prostate Cancer

[sfmcfar]

Hi,

47 y/o white male here, history of kidney stones Family history of enlarged prostate difficulties. Only urologic symptoms are increased urination at night, occassional mild left flank pain. CT shows multiple stones in both kidneys, none in ureters. Recent DRE showed slight prostate enlargement. PSA at 5.3 (yuk). MD has prescribed 3 week course of Cipro and repeat PSA test - if PSA is still high, he recommends biopsy (yuk again). Blood was drawn for PSA test approximately 30 mins after DRE.

My questions are:

- could the DRE have raised the PSA, and if so, how much? The Wikipedia entry for PSA says it's a "myth" that DRE can elevate PSA.
- if the subsequent PSA is elevated, should I consider a Free PSA test prior to biopsy?
- could the kidney stones somehow raise PSA?
- how bad is the biopsy? I don't understand why you're routinely sedated for colonoscopy but not a prostate biopsy.
- and finally, how worried should I be? I'm pretty much a basket case, and not knowing anything for a month is going to be hard to handle.

Thanks in advance,

Stan

[tlund]

Hi scfmcfar,

Thank you for participating in the forum. Sorry to hear about your worrisome PSA levels. There is physician-developed and monitored information on PSA levels and biopsies on this website at the following link:
http://www.urologychannel.com/prostatecancer/diagnosis.shtml

I hope this information is helpful. Physicians who monitor these forums respond to some posts but not to all, so please continue to post in the forum as you learn additional information.

I wish you the very best.

[BusReilly]

Stan: I know what you're going through, ol' buddy. I went through the same thing five years ago--the waiting on the PSA results, the biopsies, the worrying.

Yes, I had prostate cancer. Read about my experiences on my blog, http://www.nubella.com/content/blogsection/108/8050/.

But based on what you're saying in this e-mail, keep in mind that prostate cancer, a benign prostate enlargement and a prostate infection can make your PSA go up. However, the more your PSA rises from one test to the next, the greater your chances are that it is caused by prostate cancer. (Read about PSA VELOCITY).

I would suggest that if your PSA has gone up on the next text, then follow your doctor's recommendation and get a prostate biopsy. It really doesn't hurt all that much. A urologist will give you a pain shot up the butt. The "pain" feels like you have a rubber band around your wrist and somebody pulls it and snaps it back.

One reason they don't conk you out is the urologist will perform the biopsy in his office, NOT in a hospital where an anaestesiologist is present.

I've blogged about my experiences with a prostate biopsy.

As for worrying about it, I know what you mean. The waiting for this and the waiting for that is the worst part of it all. I would suggest doing your research about the various treatment options for prostate cancer in case YOU DO have it. I found that just knowing what I faced IF I had prostate cancer went a long way to alleviating my worrying.

Also, keep in mind, if you have kept up with your health, if you have prostate cancer, CHANCES ARE you're going to be okay. You're not going to die. Now, it's not going to be a walk in the park, but here this: CHANCES ARE YOU'RE GOING TO BE OKAY.

Millions and millions of men -- John Kerry, Rudy Guliani, Colin Powell, Norman Swarzkopf, Harry Belafonte, Joe Torre, and me -- had prostate cancer and are living to tell about it. The ones who survive prostate cancer FAR OUT NUMBER the ones who die from it.

Prostate cancer IN MOST CASES is a very slow-growing cancer.

I hope this has made you feel better, Stan. You're going to be okay, IF you do have prostate cancer. Right now, you don't know. You may NOT have prostate cancer; you may just have an enlarged prostate. But you want to make damn sure that's all it is.

If you want to talk further, leave me a message on my blog,
Steve in Dallas