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Cancer: Prostate Message Board

Cancer: Prostate Board Index

Hi afg,

Welcome to the board, and Iím sorry no one responded earlier.

The urologistís plan looks sound to me, especially dumping the biopsy if the PSA pattern signals that an infection is driving the PSA. That kind of pattern could be benign growth, especially with TRT in the background, up to that January result of 4.46 :(.

Both your urinary symptoms and that rapid jump in PSA suggest an infection; infections breeze right through antibiotics that are not the ones needed for the bacterium that is causing the infection. Infections will often result in an up and down pattern of PSA results as the infection waxes and wanes; sometimes the changes will be rapid and large. That is not the pattern for BPH, and the rapid rising part isnít the pattern for cancer either unless it is one of the quite aggressive but uncommon types of prostate cancer. If cancer [I]IS[/I] driving this, you will see a substantial increase in PSA in the next test (but infection might cause that too). Also, infections, like cancer, affect free PSA scores, so itís understandable that the urologist's decision would be unaffected by the free PSA level in the context of a likely infection.

I can empathize with your frustration as a scientist. In 2012 I had had two highly advanced scans for bone and soft tissue metastases. But both were negative, so there was no explanation for underlying aggressive cancer except a simple CT scan, at the time of placing fiducials for radiation in 2013, that had revealed an enlarged area within the prostate itself. I really wanted a multiparametric MRI to characterize what was going on in my prostate. Like your urologist, my radiation oncologist was reluctant as it would not have altered his planning. I did appreciate his point, but I still kind of wanted to know, though I knew he was right; when you are used to analyzing things, it's hard to forego getting data. (All has turned out well.)

Hereís to a good PSA result! :cool:

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