Total PSA raised 1 ng/ml over a year

[goggoga]

46 yr. old, white, no family history for PC. For the last few years, 2004-2008 my PSA was between .6 - .75 with the last values on June 2008 .61. Free ratio was .57. Annual check up on June 2009 said PSA 1.75 and frees ratio .27. Seeing the urologist on July 2009 he said that I should have a biopsy, which it is coming on October 5th, 2009. In the last six years, I had asymptomatic microhematuria in urine, which disappeared for a while and coming back. Always traces no small amount. The specialist performed cytoscopy on July 2005 and June 2009 and he did not found any reason for hematuria. I have a discomfort on my pelvis, no back pain, no joint pain only burning on urethra after urination. That happens when I drink a lot of water on short time and I need to go to washroom more often. Over night going out one time and not on every night. Starting with 2005, the specialist put me on Flomax which helped to remove the symptoms on the beginning but on 2007 the doctor said to take one in the morning and one in the afternoon. I am still on Flomax, once a day for now how the specialist prescribed. End of July 2009 the urologist performed DRE and he told to me NAD - supposed to means that nothing detected. I will go for transrectal ultrasound on next week. Now, on September 09, 2009 I ask my family doctor for one more PSA and free ratio to see the evolution over three months. The result scared me like crazy because PSA came back 2.25 and frees ratio .33 - this values bigger than June 09 does. The first result did not scared too much because I supposed that I was lucky to catch something pretty earlier, but the second one make me crazy. I am taking prescribed pills for sleep and also pills for days, so I can be able to concentrate at work. The DRE was done on July 25, 2009 and it was a hard one because the doctor used a lot of pressure to try to catch something on my prostate. As I already told you, NAD. Can the result from September 09, 2009 be not so accurate because of the DRE done on the end of July 25, 2009? Or the disease is aggressive? Also, can I have other symptoms? I asked urologist couple of years for a biopsy but his answer was NO because my entire test. This year, he asked me directly if I want to have a biopsy or I want to stay and watch. I choused biopsy but I am really scared. Can somebody tell me something from own experience and has an advice? I am dealing very hard with this situation. Thanks a lot

[goggoga]

Hello everybody,
I am back with a lot of news, bad or good and also a lot of question.
Before the biopsy, like a week, I had an transrectal prostate ultrasound stating that prostate is normal in size and echogenicity with a volume of 29 cc. No suspicious lesions were identified. The seminal vesicle demonstrated some cystic change but is otherwise unremarkable. The urinary bladder appears normal.
First of all, I had my biopsy on October 5, 2009. I would like to ask people here what they think about how the procedure was done and also how the pathology report was obtained. The biopsy was performed with a flex cysto and it was a finger guided prostate needle biopsy. My concern is regarding the accuracy of the biopsy.
The specimens were from right and left prostate sides.
Gross examination:
A. Specimen: right prostate biopsy, consists of seven strips of biopsy tissue ranging in size from 0.4 to 1.6 cm in length. All tissue is embedded in one cassette.
B. Specimen: left prostate biopsy, consists of seven strips of biopsy tissue ranging in size from 1.4 to 2.1 cm in length. All tissue is embedded in one cassette.
Microscopic Examination:
A. B) Slides examined.
Pathological Diagnosis
A. Right prostate, needle core biopsies: Portions of benign prostatic tissue; no tumor seen.
B. Left prostate, needle core biopsies: Portions of benign prostatic tissue; no tumor seen.
Comment: Immunohistochemical stains are performed using antibodies to AMACR and CK34BE12.
I am asking you people if you can help me with some advice regarding my whole procedure. How accurate can be? Do I need to take another one, biopsy? I am thinking to schedule an appointment with Dr. Lee on Rochester in order to have a color Doppler US and maybe biopsies on necessary point. Does anyone have experience with color US? Also, should I retest my PSA and fPSA ratio because I have the latest from beginning of September 2009 and I am almost 6 weeks from the biopsy? If I will have biopsy with color US I will not be able to get another PSA for two months from now.
I still have problems when urinating, pain around the base of penis which is gone after urination, sometime burning after urination. They are worse when I'm sitting or laying on the couch but not so bad when I am standing. The urologist prescribed me Flomax and Xatral and he told to me to take the one doing better job. It is looking for me that Flomax is doing better, but I am concerned about the Flomax and the PSA value. Also, I used to take Flomax for a while but when I stopped it the symptoms coming back. The concern for me is the PSA velocity but my GP and urologist does not pay to much attention to it.
Please, I need some answer because I already into depression so I do not really what can be the right thing to do. My wife and my friends keep telling me do not worry how long the doctors said that is no cancer and they keep telling me that I have a head problem and everything is generating inside of my head.
Thanks,
Gog Goga