I'm doing some research to correlate data from recent papers I've read and would like to know the stories of men whose prostate cancer diagnosis began with BPH and/or chronic prostatitis. What was the duration and progression of your PSA rise and at what point did you decide to have a biopsy.?
Thank you
I had BPH and probably some prostatitis and elevated PSA since my mid 40s. My annual PSA followed a zig-zag pattern, characteristic of prostatitis. I had my first biopsy when my PSA was 4.0 in my mid-40's, which was a mistake. 5 years later, I had another biopsy (also, a mistake with hindsight). In my mid-50s my PSA climbed to over 7.0 and stayed there. I took finasteride for my BPH and my enlarged prostate (65 cc). When my PSA didn't go down, I had another biopsy (not a mistake).
Hey TA, thanks for the prompt response. I've recently run into a lot of friends and friends of theirs that are plagued as you were with BPH and some chronic prostatitis. They are mainly in or slightly below that PSA zone 4-10, with most in the 3-6 range. Knowing my history, they're asking me about triggering the biopsy Many of them, due to insurance reasons, are going to urologists. Not sure of your opinion on it, but that gap between urological issues and prostate cancer is where they tend not to shine. I did recommend that the ones that could go to the GU Onc clinic at a NCI cancer center. I did find at least one paper in Clinical Urology dealing with the issue:
scielo.br/pdf/ibju/v35n5/v3...
I can tell you that most of the men had at least one course of antibiotics with no prostate enlargement whatsoever. The study concludes this is ineffective. Some to me seem to have symptoms of internal swelling of the prostate (urge and flow problems, bifurcated stream et al) for which finasteride is usually effective, yet none have been prescribed. Also, possibility of bacterial infection in the seminal vesicles is never tested (vesiculitis?) Could I ask how fast your PSA rose from 4 to 7 if you know that? I know this is a real grey area but I appreciate your knowledgeable input as always.
It was slow - about 5 years. The real indicator was the lack of reduction with finasteride. Of course, that was before PHI.
In my case , first time PSA was tested in 2015, it was 40.2 PCP office did not inform me.
It was tested again in 2016, it came out to be 50.9 ( Again PCP office failed to inform me)
Third time PSA was tested in 2018, it came out 164 (Still PCP office did not call me).
All these years, I hardly had any symptoms so I assumed everything should be fine.
In got copies of all medical records and testing records in June 2019..that's how I found out about PSA rise over last few years.
Then in May 2019 I had severe urinary infection, Got to Urologist, who prescribed Antibiotics and ordered PSA...Lo and behold.. my PSA came 830. And I got multiple frantic phone calls from Urologist office. He told me I have severe prostatitis and most likely have prostate cancer.... He was right. .I was admitted ..various scans and MRIs were done ..all showing metastatic bone disease. No w, PSA has come down to 0.6 after ADT.
I n my case, I believe prostatitis was going on before it eventually led to cancer.
I also think. .chronic gastric leads to stomach cancer, chronic pancreatitis leads to pancreatic cancer, chronic endometritis leads to uterine cancer , chronic cervicitis leads to cervical cancer. Treat ITIS early and prevent cancer..
My message to all the people is that do not trust your doctor's office ...check all your test results yourself every time. Do Not assume that doctors office will call you if you have abnormal test results.
Ouch, you really have to take the reins on managing your own healthcare records in the modern environment. When you get near full employment there are a lot of "bottom rungers" working in positions they're not really qualified to do.
That PCP was a quack if he took no interest in the results of the test he ordered and his office was derelict in not communicating those results to you. That led to a criminal delay in treatment.
I had TURP surgery for BPH in my 50's, ten years prior to prostate cancer diagnosis. My PSA readings were all below the 4.0 alarm threshold through the years. I was also screened with the DRE test every year. Abnormal firmness on one side got me sent for a biopsy at age 66. Gleason 8. My PSA at diagnosis was 2.7, same as it was the year prior. So PSA was not a useful screening criteria for me.
Wow! You were quite fortunate. What type of MD did the DRE? The first urologist I went to after my PSA at 42 said he felt no nodules or thickening(had 1.3 cm tumor on left side) and maybe it was slightly enlarged. (Was at 97cc, 2.5x normal) So, you got one of the good ones. Needless to say, I was off to the best NCI cancer center I could find.
Just a family PCP performed the DRE. I did have to get after him to perform it -- it happened months after my first visit to him. I had just gotten on medicare and was forced to select a new doctor. I didn't have a urologist at that time and hadn't seen one since my TURP surgery.
Do you mean Big Penis Hardon? Well that used to be me...........
Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 12/19/2019 7:26 PM EST
Yes, that is the alt meaning
An ex girlfriend used to work next door to American Medical Systems in Minneapolis. They're doing wonders now
I had several bouts of prostatitis before being diagnosed with PCa. In one case my PSA was 11+ and after 30 days of Cipro (big mistake) it came down to 3. Another time it was over 8 and again 30 days of Levaquin (another mistake) it came down.
Even now, two years after having had focal laser ablation for the PCa, my MRIs still show signs of inflammation in the prostate.
Did you have the tendinitis with Cipro? What was the problem with Levaquin? Can ou tell me how long you had issues with prostatitis until the Pca was diagnosed?
Yes, I had problems with my Achilles tendons after taking Cipro. Same problem with Levaquin, which is also a fluoroquinolone.
I had the first bout of prostatitis about 6-7 years before PCa diagnosis.
Update to my inquiry: I went to a urologist visit yesterday with one of my best buds. The urologist he saw (second opinion per my recommendation) stated that a 10 day course of antibiotics was nowhere near enough to combat a prostate infection. Ironically, he had just finished the said 10 day course prescribed by another urologist in the same office! After the 10 day course produced no results ( actual minor jump in PSA) the first urologist was recommending immediate biopsy. So, the clinical paper I cited was probably old thinking and guess we're still in the transition period? I don't really believe it was flawed, but certainly explains why they concluded no efficacy for the use antibiotics on non enlarged prostates.
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