PSA velocity concern

[concho160]

After many years had Physical Exam on July 20,2009 which showed PSA of 10.18. On Aug 10 it was 12.1.  In mid Sept it was over 13 and on Nov 1 it was 17.5.  Normal DRE.  I have had no symptoms other than PSA results. Have biopsy scheduled for Nov 23. Very concerned. Any info is greatly appreciated. Frank

[concho160]

Had biopsy on Monday,11/23. in hospital. Held overnight for observation. This is because 2 stent were insered this past August and I had been on Plavix + aspirin. Five days prior to biopsy was taken off plavix + aspirin and placed on lovenox. I was released Tuesday morning, the 24th and late that evening had first BM post-op which resulted in massive rectal bleeding. Over next 2 days had 4 more massive bleeding episodes until punctured(during biopsy) artery was sutured on Nov 26 at 6pm. No bleeding since. Released from hosp yesterday(12/4).
  Resultsof biopsy as follows :

               Left Prostate Biopsy
Adenocarcinoma of the prostate, Gleason= 3+3 in 2 of 12 cores involving 10-20 % of tissue + up to 0.1CMin max. dimension. Several sites of high grade prostate intraepithelial neoplasia(pin)

               Right Prostate Biopsy
Adenocarcinoma of the prostate, Gleason= 4+3  in 5 of 10 cores 30-60% of the core + up to 0.4CM in max. dimension. Focal high grade prostatic intraepithelial neoplasia(pin)

No lymphovascular or perineural invasion identified.

Subsequent bonescan  + abdominal catscan negative.
I have just started casodex and am in process of finding another urologist. Onr  at Sloan Kettering has been highly recommended an oncologist in the Yorkville area. I am unsure of best treatment option for my particular case. Frank

[Ash Tewari, MD, M.Ch.]

Thank you for your question. Please read my other posts on PSA rises in this forum. Sugardown is correct in that a biopsy is really the only way to know if you have prostate cancer. A PSA level > 10 ng/mL is often predictive of malignant disease. What is concerning is that your PSA doubling time is almost 6 months.

One question, are you receiving DREs prior to the blood draw for PSA testing? This could result in false positive results. Although at the 12-17 ng/mL level this may not be likely.

Thank you for your question and good luck.

Sincerely,

Ashutosh (Ash) K. Tewari, MD
www.cornellroboticprostate.org

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[sugardown]

The biopsy is the only way to determine your situation.