PSA test

[cheeryble]

When starting to worry about a.high PSA it's important to know that the one thing PSA mirrors most accurately is the size of the prostate. So if you have BPH....as I do.....and your prostate is just 50% wider in each dimension one can expect a PSA higher than normal by 1.5x1.5x1.5......over three times normal. Obviously for double dimensions PSA would be 8x normal....and so on....

 

 

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[elektrified]

8 hours ago, cheeryble said:

When starting to worry about a.high PSA it's important to know that the one thing PSA mirrors most accurately is the size of the prostate. So if you have BPH....as I do.....and your prostate is just 50% wider in each dimension one can expect a PSA higher than normal by 1.5x1.5x1.5......over three times normal. Obviously for double dimensions PSA would be 8x normal....and so on....

 

 

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I've never heard that before. Where did you read that?

I used to check PSA every 3 months for about 2.5 years but now the PSA has stabilized according to the doctor, so I check every 6 months now. I would rather be on top of things and know what is happening. I also had the biopsy a couple of years ago.

[LannaGuy]

19 hours ago, NancyL said:

Your friend had benign prostatic hyperplasia.  According to Dr. Wiki about 50% of men some evidence of it by age 50 and 75% by age 80.  It is correlated with the use of alcohol and caffeine and some studies suggest it's also correlated with consumption of high amounts of protein.  It's really a very common condition in older men who live a western lifestyle.

 

https://en.wikipedia.org/wiki/Benign_prostatic_hyperplasia

 

 

 

Funnily enough he has been vegetarian for 30 years and drinks moderately (he's late 50s) just unlucky I guess 

[Bill97]

I've never heard that before. Where did you read that?

Sure bigger prostate=higher PSA. That is why the little guys all get low PSA scores. Just common sense.??[emoji12]

[cheeryble]

Sure bigger prostate=higher PSA. That is why the little guys all get low PSA scores. Just common sense.[emoji849][emoji849][emoji12]

 

Haha perhaps not so common.....wouldn't the little guys have less blood to dilute the less PSA and average out the same as the big guys?

However it's quite sure prostate volume is related to PSA and of course volume is proportional to the cube of the dimension, even if the prostate is not a perfectly regular shape it's going to pretty much hold true.

 

 

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[moe666]

On 5/8/2017 at 6:23 PM, NancyL said:

Hubby and I wrestle with the "to test or not to test" PSA issue every time he has his annual (or more like every 14-16 months) health screening.  This is because both the size of his prostrate and his PSA number started to get larger about five years ago.  He had a biopsy a couple years ago and everything was OK, but having a biopsy carries risks and having a negative reading doesn't necessarily mean that someone is cancer-free.  It just means they didn't find any in their samples.  

 

But, in my Lanna Care Net activity, I've seen about a dozen men go through end-of-life due to prostate cancer and it is the one of the worst forms death I've seen.  The cancer spread into bones, usually the pelvis and spine, crippling the victim and creating a huge burden for his family or caregivers.  The victim is bedridden well before death comes.  

 

Most people would like to die at home, but it's difficult with this disease.  They become a dead weight in the bed, difficult for their family to bathe, move about, keep from getting bedsores.  They really should be in a hospital-type bed, tended by people with proper equipment.  Sadly, the man is unable to assist his family in moving himself.

 

That's because the cancer has invaded important bones, and the pain is intense.  Also, it doesn't take very many days of constant bed-rest before someone's muscles wither.  Pain control at home is very difficult.  Someone must keep an ongoing relationship with a doctor, someone willing to prescribe oral morphine for home use.  Doctors here will prescribe only to people they know and only if there is someone responsible at home to monitor and administer.  At some point that ceases to work or someone is unable to take the medicine by mouth.  There is no way to have nurses visit and administer morphine by IV here.  There are no patient-controlled pain medicine pumps here.  

 

The best alternative for someone dying of prostrate cancer is to spend their final weeks at McKean Rehabilitation Center, a skilled nursing facility with some nice private rooms at a reasonable price.  Your loved one could come and stay with you there.  Vivo Bene Village in Doi Saket has also helped people with more money to spend through the end-of-life and their entire family would be welcome in their upscale surroundings.  These facilities have the equipment, nurses and knowledge to take care of a dying man's body, keeping him as pain-free as possible, clean and comfortable, permitting his family to focus on being with him during his final weeks and not expending all their energy caring for him.

 

I've gone on a little to long, but this is a subject close to me.  Many of the men I've watch die were under age 70.  Some actually "caught" their cancer in early stages with a PSA test and decided to do nothing, but most hadn't.  The "cure" for prostrate cancer is daunting and can be expensive to someone living pension-check-to-pension-check, which is why the men who caught it early decided to "do nothing".  But, there is less invasive action, like taking drugs to suppress hormones production and slow down the cancer, etc.  

 

Options like this make me push Hubby to have a PSA test with each health screening and then retest three months later just to make sure the number isn't rising significantly.  I'll continue to push him after he gets in his 70s, until it's obvious he's going to die from something else within a 2-3 years.  At this time, though, he's very healthy, except for the need to take longer when he pees.  It's probably that enlarged prostate.  

a few years ago had the psa done over 10 which indicates you have a 50 percent chance of having cancer. Got started on finisteride next test down to 2.5 just keep taking 1mg a day and zinc to prevent amrotese or testosterone conversion to estrogen feel good no problems and I am 72 this year. take the test get on treatment if high DHT levels, be safe

[moe666]

No one here mentions DHT that is what basicly causes the prostate to swell. Testosterone and DHT compete for the same receptor sights but DHT being 5 times stronger than test. will usually win out and the DHT is what eventually leads to enlarged prostate. Too do this right have more blood work up than just psa also check Testosterone, estrogen, and DHT they are all interrelated

[Bill97]

 

However it's quite sure prostate volume is related to PSA and of course volume is proportional to the cube of the dimension, even if the prostate is not a perfectly regular shape it's going to pretty much hold true.
 
 
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"The cube of the dimension"

The shit one reads here is so often either sad or comedy or both.

[xylophone]

23 hours ago, cheeryble said:

When starting to worry about a.high PSA it's important to know that the one thing PSA mirrors most accurately is the size of the prostate. So if you have BPH....as I do.....and your prostate is just 50% wider in each dimension one can expect a PSA higher than normal by 1.5x1.5x1.5......over three times normal. Obviously for double dimensions PSA would be 8x normal....and so on....

 

 

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Not so sure about your statement above, because I suffered from BPH and prostatitis for some 20 years and my PSA score was always below one!! And my prostate has always been small, and still is,  so the correlation between BPH and prostate size just doesn't add up for me.

 

In addition, others have mentioned about PSA levels and what should be done about them, however it's important to note that taken as an individual score, it means not a lot at all – – it has to be viewed in light of any inflammation or any infection of the urinary tract, the size of the prostate when measured by a DRE, any pain or noticeable growth in size of the prostate and any quick rise in PSA scores.

 

Sexual activity just prior to a PSA test can mean that it elevates slightly and as I said above, inflammation or infection of the prostate will also lead to a higher PSA score.

 

Just yesterday I had a PSA test done and for as long as I can remember my score was under one, however yesterday it was just under 10. Cause for alarm you may well think, but I have a UTI due to catheter use and in my opinion and that of the specialist I saw, that will certainly increase the PSA score, so keeping an eye on how that score progresses over the course of some antibiotics I am on is important.

 

Follow-up appointment scheduled in one weeks time however I would think that my best bet would be to get another PSA test done in about two weeks to a month.

 

[LannaGuy]

16 hours ago, xylophone said:

Not so sure about your statement above, because I suffered from BPH and prostatitis for some 20 years and my PSA score was always below one!! And my prostate has always been small, and still is,  so the correlation between BPH and prostate size just doesn't add up for me.

 

In addition, others have mentioned about PSA levels and what should be done about them, however it's important to note that taken as an individual score, it means not a lot at all – – it has to be viewed in light of any inflammation or any infection of the urinary tract, the size of the prostate when measured by a DRE, any pain or noticeable growth in size of the prostate and any quick rise in PSA scores.

 

Sexual activity just prior to a PSA test can mean that it elevates slightly and as I said above, inflammation or infection of the prostate will also lead to a higher PSA score.

 

Just yesterday I had a PSA test done and for as long as I can remember my score was under one, however yesterday it was just under 10. Cause for alarm you may well think, but I have a UTI due to catheter use and in my opinion and that of the specialist I saw, that will certainly increase the PSA score, so keeping an eye on how that score progresses over the course of some antibiotics I am on is important.

 

Follow-up appointment scheduled in one weeks time however I would think that my best bet would be to get another PSA test done in about two weeks to a month.

 

Good luck and hope you kill off that UTI very soon. Let us know how you get on.

 

BTW my friend tells me that the insertion of his catheter at Bangkok Hospital was painful every time but in UK was painLESS. Not sure why that would be.

[cheeryble]

"The cube of the dimension"

The shit one reads here is so often either sad or comedy or both.

You have a problem with my post? Specifically what, pray?


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[xylophone]

2 hours ago, LannaGuy said:

Good luck and hope you kill off that UTI very soon. Let us know how you get on.

 

BTW my friend tells me that the insertion of his catheter at Bangkok Hospital was painful every time but in UK was painLESS. Not sure why that would be.

Thanks for your concern LannaGuy, much appreciated and sure when I have my next appointment in a week's time, I'll let you know how I get on.

 

I can't say that the catheter insertion is completely painless, however I would describe it as sometimes a little uncomfortable rather than painful, depending upon what is happening in the urethra and prostate. For the moment because mine is inflamed, it's not as easy as it used to be and if I'm doing it five or six times a day, it's surely going to aggravate the situation HOWEVER the use of pain relieving gel called Xylocaine helps tremendously.

 

I can only assume that your friends experience at the Bangkok Hospital was due to a couple of things, namely incorrect use or lack of use of the Xylocaine (or equivalent) and an inexperienced nurse. Of course if his urethra was inflamed, that would also be a consideration.

 

Here's hoping that the catheter use will only be for a short period of time to enable me to train the bladder again and from then on I will have to keep a close eye on my frequency of urination to ensure that I'm not holding too much back, which then can set off the cycle again!

[xylophone]

On 5/9/2017 at 3:26 PM, cheeryble said:

When starting to worry about a.high PSA it's important to know that the one thing PSA mirrors most accurately is the size of the prostate. So if you have BPH....as I do.....and your prostate is just 50% wider in each dimension one can expect a PSA higher than normal by 1.5x1.5x1.5......over three times normal. Obviously for double dimensions PSA would be 8x normal....and so on....

 

 

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Sorry to quote you twice, and no malice intended, however you do mention PSA and BPH in the one quote as well as the size of the prostate, so that brings me onto another point.............

 

As I said in a previous quote of mine, my prostate never increased in size despite two specialists determining that I had BPH, this as well as having a low PSA score??

 

Well BPH is a general term, under which several other conditions occur. Firstly it's important to know that the word "hyperplasia" means an abnormal increase in cells so although some folks prostates can certainly increase in size looking at the outside dimensions, it's also possible that the cell growth occurs within the prostate, and most specifically around the bladder neck, causing bladder neck obstruction (B00), indeed one of the internal lobes can grow into the lower bladder causing an obstruction.

 

Technically of course it is known as BPH, however that does not mean to say that the prostate necessarily becomes enlarged externally. To try and visualise it, imagine a small doughnut (yes the ones with the holes in the middle) and whilst the external size of the doughnut stays the same, the bit in the middle where the hole is actually decreases in size due to growth........ not the best analogy, but may serve the purpose here.

 

PSA tests may or may not be an indicator of anything serious if taken as a sole marker and likewise BPH may not necessarily increase a PSA reading, or it may! It is my opinion that the reason why the medical profession in some areas rails against PSA tests is because there are so many other indicators and it is not reliable on its own.

 

In addition the next action is often a needle biopsy which can be painful and can have some serious side-effects and again may not even pick up cancer if it is there. So you can see why some medical professionals are not keen on going down this route. However new tests, including an MRI or PET scan are pointing the way towards less invasive methods of detecting cancer of the prostate as well as producing clearer/better results.

 

It's a complicated subject and some aspects of which even the medical profession are still baffled by and indeed during some of my research into this condition and especially prostatitis, one eminent surgeon, part of a practice of surgeons specialising in the prostate, called it something like, "a scientific/medical wasteland".

 

From my perspective and in summary, a yearly PSA test along with a DRE as well as noting any "adverse symptoms" with regards to my lower urinary tract and associated functioning would encourage me to seek further investigation via an MRI scan, but I certainly would not go down the route of a needle biopsy..............

[cheeryble]

Thanks Xylophone.
Was your prostate measured by ultrasound?



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[xylophone]

12 minutes ago, cheeryble said:

Thanks Xylophone.
Was your prostate measured by ultrasound?



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Actually I didn't ask this time, but will do on my follow up visit on Monday........having said that it has always been 30 ml or thereabouts if my memory serves me well, and just about every specialist has commented; "you have a small prostate".

 

However that may well have been said in the context of them looking for signs of BPH and not finding any outward sign??

[Bill97]

You have a problem with my post? Specifically what, pray?


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What dimension? Cubing a dimension only gives correct volume for a square and the prostate is only a square if it is cut out and forced into a square container. Does not work for a rectangle or other shape.

[cheeryble]

What dimension? Cubing a dimension only gives correct volume for a square and the prostate is only a square if it is cut out and forced into a square container. Does not work for a rectangle or other shape.

Not trying to be contrary, but the volume of a sphere is 4/3pi.R cubed


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[cheeryble]

Actually I didn't ask this time, but will do on my follow up visit on Monday........having said that it has always been 30 ml or thereabouts if my memory serves me well, and just about every specialist has commented; "you have a small prostate".
 
However that may well have been said in the context of them looking for signs of BPH and not finding any outward sign??

Oh for a 30ml prostate :)


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[xylophone]

Just now, cheeryble said:

 

Oh for a 30ml prostate :)


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Can still have its problems though :)

[Bill97]

 

Not trying to be contrary, but the volume of a sphere is 4/3pi.R cubed

 

 

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Oh so your prostate is a sphere?

[cheeryble]

Oh so your prostate is a sphere?

 

1. No I didn't mention rectangle.

2. I think it's useful information to be aware of this very common cause of high PSA and what a large difference in volume/PSA a typical rise in dimension can cause, so I passed it on. Anyone can see the principle will hold for shapes that are even vaguely spherical, including my urologist.That's it.

 

 

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[idman]

A PSA and Free PSA test should only be used as a baseline, too often you get a high number and you freak out and your Urologist wants you to have a biopsy. That my friends causes a lot of unnecessary worry. The Doctor who came up with the PSA test in the first place has gone on record as saying it is no longer valid for a diagnosis of Prostate cancer. Since you can screwer the results of the test by riding your bicycle a lot before the test or ejaculating within 72 hours the best thing is to have another test done within 4 to 6 months and see what the numbers are then. 92% of all males over 70 are going to die with Prostate cancer present in their body and NOT FROM Prostate cancer. That percentage is not some pie in the sky it is based on numerous studies both in Europe and America. If after three or four PSA tests the numbers are high then a biopsy is warrented and after the results are back if your Gleason number is below three then watchful watching is the best course with twice yearly PSA tests and maybe a biopsy once a year depending on the numbers from your PSA tests. How am I so knowledgeable???? I have Prostate cancer now for six years but my Gleason numbers remains low, I have altered my diet, I take better care of myself and I follow the advice I gave above. I will die with this cancef not from it.

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[LannaGuy]

2 hours ago, idman said:

A PSA and Free PSA test should only be used as a baseline, too often you get a high number and you freak out and your Urologist wants you to have a biopsy. That my friends causes a lot of unnecessary worry. The Doctor who came up with the PSA test in the first place has gone on record as saying it is no longer valid for a diagnosis of Prostate cancer. Since you can screwer the results of the test by riding your bicycle a lot before the test or ejaculating within 72 hours the best thing is to have another test done within 4 to 6 months and see what the numbers are then. 92% of all males over 70 are going to die with Prostate cancer present in their body and NOT FROM Prostate cancer. That percentage is not some pie in the sky it is based on numerous studies both in Europe and America. If after three or four PSA tests the numbers are high then a biopsy is warrented and after the results are back if your Gleason number is below three then watchful watching is the best course with twice yearly PSA tests and maybe a biopsy once a year depending on the numbers from your PSA tests. How am I so knowledgeable???? I have Prostate cancer now for six years but my Gleason numbers remains low, I have altered my diet, I take better care of myself and I follow the advice I gave above. I will die with this cancef not from it.

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good for you thanks for info... changed diet?  you mean cutting down proteins?  alcohol?  caffeine?  do you take a biopsy once a year?  I had read that many advise against it but go for a non-invasive scan?

[elektrified]

6 hours ago, idman said:

A PSA and Free PSA test should only be used as a baseline, too often you get a high number and you freak out and your Urologist wants you to have a biopsy. That my friends causes a lot of unnecessary worry. The Doctor who came up with the PSA test in the first place has gone on record as saying it is no longer valid for a diagnosis of Prostate cancer. Since you can screwer the results of the test by riding your bicycle a lot before the test or ejaculating within 72 hours the best thing is to have another test done within 4 to 6 months and see what the numbers are then. 92% of all males over 70 are going to die with Prostate cancer present in their body and NOT FROM Prostate cancer. That percentage is not some pie in the sky it is based on numerous studies both in Europe and America. If after three or four PSA tests the numbers are high then a biopsy is warrented and after the results are back if your Gleason number is below three then watchful watching is the best course with twice yearly PSA tests and maybe a biopsy once a year depending on the numbers from your PSA tests. How am I so knowledgeable???? I have Prostate cancer now for six years but my Gleason numbers remains low, I have altered my diet, I take better care of myself and I follow the advice I gave above. I will die with this cancef not from it.

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That applies to the Free PSA test, not the total PSA test.

[elektrified]

3 hours ago, LannaGuy said:

good for you thanks for info... changed diet?  you mean cutting down proteins?  alcohol?  caffeine?  do you take a biopsy once a year?  I had read that many advise against it but go for a non-invasive scan?

A scan - MRI? once a year? That seems excessive. You would also have to head down to Bangkok to have it done. I think an MRI once a year is over the top. I've never heard of it. I've also never heard of a once a year biopsy. I had the biopsy about 3 years ago. I'm glad I had it. No cancer, so now I check the PSA and DRE twice a year. The doctor pushed for a 2nd biopsy 18 months later, then backed off. For a couple of years I did the PSA and DRE 4 times a year but now the doctor feels twice a year is fine for the time being.

[moe666]

Check your sex hormones at least yearly these are very important. Testosterone, DHT, and estrogen, the thought of some professionals is that excess estrogen is the cause of prostate cancer and not testosterone. We have to have some estrogen but at very low levels if your estrogen is high you can bring it down by taking zinc and you will notice a uptick of testosterone..High levels of PSA try some finisteride see if the PSA comes down.

[lelapin]

I visited my Dr in London having seen a small speck of blood in my urine. He said it was probably a small stone but on hearing I had private insurance suggested I saw a prostate cancer specialist. 

 

I went along and had a finger probe which found a slightly enlarged prostate and a PSA which was found to be slightly  high. He strongly recommended a biopsy which I then went for and after a very painful session I went back to then specialist the following Friday. On reviewing the results he said I needed urgent treatment and offered some various alternatives but as he was a surgeon he said that if I was his father he would recommend a radical prostatectomy ( removal of the prostate). I asked when this could happen and he said he wanted me in for the operation the following Monday.

 

After the op they did a biopsy on the removed prostate and found that the cancer spread to the outer wall without going through. I subsequently had a review of the level of success of the op and the Dr said I had a 70% chance of living 10 years. I was 57 at the time so that didn't sound too bad. I still had a PSA done every year and to my great surprise after 8 years I was advised that my PSA was slowly starting to move higher. I was then advised and had 30 sessions of radiotherapy.

 

I have just turned 76 years old - 19 years on - and have read so many different results of studies and reports over the years about the best way to detect and treat  prostate cancer.

 

I like to keep things simple. If I have the choice to undergo a procedure whose results may give me unnecessary concern as they may be misleading but in some cases will find a life threatening situation that can be treated or to say I will only proceed with tests that studies have proved are 100% correct and reliable, I will go with the former. Maybe it is my cautious nature but I was most fortunate enough for that approach to work for me.

 

As an aside I understand the procedure I had that long time ago has advanced considerably and my doctor now uses a robot for the op which is much more precise in the cutting and greatly reduces the subsequent chance of impotence or incontinence.

 

What the operation clearly didn't do was to cut down on my waffling on and on, so I will end there.

Edited May 15, 2017 by lelapin

[WHIER]

On ‎1‎/‎9‎/‎2017 at 3:15 PM, d4291797 said:

Dr Morgan at Hang Dong, about 650 baht for 'total psa'.


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How to find this Dr. Morgan ?

[cheeryble]

5 hours ago, WHIER said:

How to find this Dr. Morgan ?

http://www.healthcaremedicalclinic.com/contact-us.html

[d4291797]

Again a very emotive subject!
What one is looking for ,is a spike in PSA levels, or a 'doubling' as the urologists say.
Critical if there is a spike , is to find the cause , which can be a big inflammation of the gland or it could be the start of cancer.
Yes biopsy does have risks and is bloody unpleasant ,unless you have a G/A! But critical again to catch this early.
A very successful treatment is Cyberknife, google ,and go to their forum.
Very informative. Every case is different, as is the result, every Dr or Urologist will 'push a barrow'!!!
Generally if caught early ,therefore requiring lower dose radiation, Cyberknife will be better at retaining normal body function.
However if high PSA and more than a T1 tumor, with a high Gleason score there can be issues with radiation damage to the urethra, causing a stricture.
Sorry this is a ramble, but one needs to be informed.
My PSA 12, T1 tumor , Gleason 8, which means very aggressive cancer.
After Cyberknife my PSA now 0.9, have has issues with urethral stricture.
But all body functions 100%.
Chairman of my local prostate cancer support group ,had the DaVinci robotic procedure, poor guy has not had an erection since!
Plus with surgery you do end up with a reduced length penis.
One can only do research and be guided by gut feelings.
Diet is critical, together with detox.
But catch this early in its infancy, and one has every chance of retaining quality of life.


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