50 replies to this topic

[CallMeLucky]

Had my annual physical on Monday and GP called with test results, everything looked good but PSA was 4.4.  Referring me to urologist to pursue further.  A quick google shows that a range of 4 to 10 indicates a 25% chance of Prostate cancer.  I'm only 39 so there should be no good reason for this unless the Gleevec is causing my PSA to go up.  I checked a few sites and could not find PSA elevation as a side effect.  I called my onc and she said go see the urologist, elevated PSA is not related to CML or Gleevec.

This is kind of a nasty deja vu, two years ago I had a physical and my GP (same one) called to tell me my white counts were elevated and I should go see a hematologist.  That turned out to be leukemia.  Now my PSA levels are elevated and she is telling me to go see a urologist.  What's the over under on me having two cancers in two years?

I know life isn't fair, but it can be too much sometimes.  I do the best I can to get along with what I have, I really don't want to battle this on another front.

Now I get to mull over this for the next couple of weeks while trying to get this figured out.

Calvin: You know, Hobbes, some days even my lucky rocket ship underpants don't help.

[oscarsst]

Lucky, I have found nothing about Gleevec raising PSAs -- the reason I know is because I have looked (as has our URO) . . . my husband's PSA was .5 prior to Gleevec (age 39) but has been 1.1-1.2 since Gleevec (ages 40-46). The "velocity" of the change (.7 in a year in a younger man) caught the PCP's eye (like you, same PCP who dx'ed the CML!) so he sent us to a URO. . . we had it checked every 4-6 months for quite some time afterwards and it hung tight at 1.1. and 1.2 for most of the readings (with one increase to 1.5 that came back down to 1.1 on recheck) so we were getting it checked yearly. But his last  was 1.6 -- which has the URO rechecking in 6 months . . . All I can tell you is the test is notoriously finicky -- and can be impacted by lots of things . . . . just like with the PCR, our URO looks for a trend . . . you're number is higher of course, but it still could be a prostate infection, inflammation or something else. . . google to see the myriad of things that can cause a PSA to be elevated that are not cancer related. . . the URO will help you get an answer! Try not to worry in the meantime! Good luck. Stephanie

[Trey]

CAUTION: THOSE WHO ARE EASILY OFFENDED SHOULD NOT READ THE FOLLOWING.

Still reading?

"Ejaculation within 48 hours before taking a PSA test can also cause a higher reading of your PSA level."

http://zerocancer.or...esting/results/

Maybe you did not "fast" .........as in.......well you know.......... 

[Susan61]

Hi Lucky:  I hope it turns out to be nothing.  My husband Gary had Prostate Cancer 5 years ago.  He went in for a routine exam, just like we did when we found out we had CML.  She asked Gary if he ever had an exam to be checked, nd he said no.  She said drop your pants and bend over.  She stuck her finger up there, and told him something did not feel right.  She sent him to the Urologist, and we were shocked to find out he had Cancer.  He had a few options, and he chose to get the seed implant instead of Prostate Surgery, due to his age.  He was only in his 50's.  Lets hope that it is what Trey said, and nothing more.  I will tell you that Gary has been in remission now for 5 years, and he sees his Urologist every 6 months for a PSA test.  Gary's numbers were low on the actual  PSA test, they only found it through a biopsy due to what the primary thought.  She is the same one who caught my CML early.

  I know how you feel with the what now.  I have been having a few weeks of all kinds of things going on, but I think you will be fine.  You can ask me anything at anytime.

Susan

[CallMeLucky]

Trey - I read that it can cause increase of 0.8 so that would get me back under 4.0 which would be good, however given my age a 3.6 would still be on the higher side and put me on watch list.  I have an appointment with urologist on Monday.  It'll be a long weekend thinking about it, but I will do my best to keep it out of my mind.  I expect they'll do the "fun" exam (DRE), probably repeat the PSA and we'll see from there.

Of course the last time I did this, the repeat test on my WBC test went from 35000, which was "very concerning" to 45000, which erased all doubt.  So we'll see how it goes this time.  I would love for it to be a fluke, but I don't believe in those so much anymore.  I'm not saying it is PC, but the number is high and no amount of "lovin" is going to change that.   Hopefully what ever it is it will be benign although I am preparing myself for a long "watch and wait" approach.

[Gorgumplatz]

Lucky,

I am very sorry to hear about you Leukemia.

Do not worry about elevated PAS levels. It is not necessarily always an indicator of prostatic cancer. The PSA levels essentially correlate with the mass (size) of the prostrate, and not exclusively cancer. It couldhigh because of infection or aging (my case).

A little background: I am 58 years of age. My father at 75 years of age and uncle at 68 years had prostate cancer. So I have at least one risk factor for prostrate cancer; it runs in the family.

Back in 2005, a routine PSA had me at 5.84,  I was referred to a urologist who did more total PSA testing. My total PSA shot up to more than 11 between 2005 to 2009. I had 3 transrectal biopsies, which turned up negative every time. To get a better assessment of the risks of cancer, my my urologist did Free PSA, in addition to the regular PSA test.

Base on these results, my urologist concluded that I have Benign Hyperplasia of the Prostrate (BHP). He put me on Avodart in 2009, which has dropped my my levels to below 0.2 with no side effects.  Hourrah! It apparently reduces the size of the prostate and my urologist/oncologist said that it also "helps" to delay or prevent prostate cancer.

 

By the way, earlier this year I was diagnosed with non-Hodgkin lymphoma (diffuse large cell lymphoma), which is considered to be an agressive form of cancer. Treatments are going well and my prostrate is doing just fine.

In summary, total PSA is not a "buller proof" test for cancer. Your urologist should also do a FREE PSA to have a better idea. There is some debate amongst professionnals about the reliability of total PSA tests for cancer testing. Your urologist will also do a digital rectal examination (DRE) to determine of it is enlarged  or normal.

You will only get a confirmation by undergoing to a biopsy. Although it may be somewhat uncomfortable at first, overall the procedure is a piece of cake. Ask your urologist to freeze your prostate before taking the samples. It makes the test a lot easier; just like going to the dentist.

I hope this provides you some reassurance and comfort. You need not worry about these results but please do get it looked at. While it is fairly prevalent, prostate cancers are usually slow to develop and men usually die from other illnesses.

My thoughts of healing are with you.

Don D

[Trey]

5 X .8 = 4.0

Just sayin'

[CallMeLucky]

Don,

Thanks for your feedback.  Can you tell me with your BHP did you have any other symptoms?  I looked at that and most of what they talk about with frequent urination and stuff like that I do not have.  I have had a problem with groin pain.  It's been on and off for years since I was a kid and in last couple of years has gotten a bit worse.  I thought it was a hernia and went to urologist who said it was nothing, just muscle pain.  I thought about prostate but we never discussed it.  I wound up going to a surgeon who said he did feel a small hernia and between that and what he felt was a nerve problem in the groin he said that was the cause of the pain.  The crazy thing is my doctor wasn't even going to do a PSA, I'm only 39 but when I was walking out of the office I mentioned it to the nurse.  She called back to the doctor who said "why not".  Everything else came back normal except the PSA.

I'm trying not to go to a dark place, it's just hard.  It is like 2 years ago all over again.  I was feeling fine, went in for physical and next thing I know I get a call that everything looks good except my WBC.  I tried to figure if there was anything else that could be the cause but the more I read I was able to rule out everything else.  Now I get the same phone call from same doctor with same message, everything looks good but PSA is high.  I've been reading trying to see if there is anything else I can attribute it to, but nothing else seems to line up properly.  I don't have any of the signs of prostitis or BHP.

I so don't want to do this to myself, but I have that same feeling I had when I got my CML diagnosis.  It's a different kind of feeling where you just know something isn't right.  Last year my doctor thought my Thyroid was enlarged and I had to go from an ultra sound, I worried about it but I knew in my gut it was ok.  This time I have a bad feeling.  I really hope I am wrong.  It would be seriously messed up if I get two cancer diagnosis within 2 years before the age of 40.  I mean that just shouldn't happen.  Sadly I know all too well that it can happen.  Nothing I can do about it accept ride it out and see what happens.

Just so tired of dealing with all of this......

Trey - where did the 5 come from?

[scuba]

THINGS THAT MAY CAUSE YOUR PSA TO RISE

Be sure to review these before you take a PSA test. An elevated reading caused by something other than cancer could cause needless anxiety.

Lab error isn't likely, but it is possible. If you have an unusually big rise in PSA, you should retest.

Infections, including prostatitis. If you have a burning feeling when urinating, and your PSA reading seems abnormally elevated, suggest to your doctor that you take antibiotics for a couple of weeks before re-testing. Be sure to stop long enough before the test to avoid having it be affected by the antibiotics (which would cause your PSA to fall).

• About prostatitis

Benign Prostatic Hyperplasia (BPH), a noncancerous growth in the prostate that may put pressure on the urethra and lead to more frequent urination.

• About BPH

Anything that might massage the prostate, such as long bike rides.

Ejaculation within the previous 48 hours. (Studies seem to be evenly split on whether or not this has an effect, so abstinence is the safest course.)

Any procedure that may stimulate the prostate, such as a TURP (transurethral resection of the prostate, a surgical treatment of benign prostatic tumors), a biopsy, a digital-rectal exam, or a cystoscopy (an examination of the urethra, prostate, bladder, and/or kidneys that involves a catheter-like instrument).

[Gorgumplatz]

Lucky,

In response to your question, I did not have any other symptons of BHP.  However, when I started my chemotherapy for Lymphoma, I started having to get up several times at night to urinate, which  may be because, I have been drinking plenty of fluids as recommended by my oncologist.

Scuba raised and interesting point about cycling and PSA levels. My peak value of 11 was in 2009, which correlates with the year when I did over 2,000 km of cycling. In the past year I have done less than 50 Km and my PSA is 0.2. Interesting.

Hang in there. I wish you all the best of luck.

Don D

[scuba]

Gary - Stay away from the Mrs. beginning now. You don't want to have a "false" reading on Monday.

[Skittles]

Lucky,

You're getting a lot of great advice and support here.  I just wanted to add that I hope & pray your gut feeling is wrong this time.  Looking forward to good news.   Skittles

[CallMeLucky]

So I went to urologist today and unfortunately did not get too much more information, and what I did get didn't make me feel that much better.  Overall he said it would be rare for someone my age to have prostate cancer, but the numbers on my PSA test were very high for my age and indicate some kind of problem.  SInce I don't have any symptoms of infection or anything like that he doesn't have an answer why the numbers are high.  He wants to repeat the test in 6 weeks and decided to give me a round of antibiotics to see if it brings down any inflammation although he doubts there is any.  Physical exam was normal.

I'm trying to keep a level head about this but it is really difficult.  I spent the last two years getting used to the fact that I was going to have leukemia for the rest of my life, but there is a good chance I would live, at least for a while.  Now after everything else I have been through this year with losing my brother in law and my father in law and I have to get this handed to me.  Nothing is definitive, but you know that is almost worse.  I am so tired of worrying, I am just so tired.  I am in pain all the time, but I try to suck it up and just keep going.  I am tired all the time but I just keep going.  I don't know how much more I can take.  I don't have the luxury of being sick, I have to keep getting up and going to work to pay the mortgage.  I just want a little peace of mind, that's it just a little peace of mind and some time where death and illness are not the forefront of my every thought. 

I mean is it really possible that I am going to get 2 cancers (that are typically associated with being older) within 2 years and before I even turn 40?  It's not like I went swimming in a vat of nuclear waste WTF!!!!!???

I wanted to come out of there today feeling like maybe it would be alright but I just didn't.  I mentioned to the urologist that the blood work from GP also showed slightly decreased testosterone.  I asked my GP to run that test due to my muscle pain and fatigue.  I had a theory that maybe the Gleevec was reducing testosterone and if that was the case I would see endocrinologist and maybe try to come up with some therapy to battle side effects.  I asked him what he thought and he said I didn't want to know.  I told him to tell me everything and he said lower testosterone could be masking the problem and making the PSA results lower than they actually are.  So my 4.4 which is way too high for my age is possibly higher than the test is showing.  All signs are pointing to prostate cancer.  I guess I just have to wait and hope that its not.

I must have been a real piece of work in a previous life, because I can't think of anything I have done in this life that is so bad to warrant this kind of punishment.

Sorry, I'm just feeling bad for myself.  I'll stop now......

[Susan61]

Hi Lucky:  I can tell how upset you are, and I am feeling bad right along with you, not even for the thought of having Prostate Cancer.  You have been through a lot this past year, and this is just the icing on the cake.  I think the waiting to find out is worse than the problem itself.  The fact that your only 39, could indicate that is something other than what you think it is.  There is nothing you can do until they repeat that PSA test on you.  IT could be something like an enlarged Benign Prostate Issue also.  Did your father or anyone on your side of the family have Prostate Cancer?

     Gary's father had Prostate Cancer, and that was one of the reasons why they checked him.  His father never died from his Prostate Cancer which he had for a very long time.  He had a very bad heart.

     I wish I had something more I could say, but I just know that my husband by the Grace of God did very well with the Seed Implant rather than having a Prostatectomy, and we do not even know if you have anything serious.  An enlarged prostate is also very common.

    You know everyone is here for you all the time.  I am still up because I had to get an extraction of a tooth today, and its bothering me a little bit.

    I hope one of the guys here can say something to make it all better for you.

God Bless You

Susan

[CallMeLucky]

Hi Susan,

No history of prostate cancer in family, although my father died from sorosis of the liver due to bad habits, so hard to tell what he would have had if he had lived.

Thanks for the note I hope your tooth feels better.

[TeddyB]

I sympathize with you CallCeLucky.

I have had my fair share of crap with family lately as well. (Last year we used to say it can only go up from here, but we stopped saying that after i got CML)

I just wanted to say i always value your input on this forum, and i wish you luck in the coming weeks, i will keep my fingers crossed for you, and hope this is not PC.

Teddy.

[LivingWellWithCML]

Gary,

Our treatment paths/responses have been so similar, so I'm now "expecting" to have an elevated PSA when I go in for my annual physical next month, LOL; we'll see.  My PSA has always been normal, but as you know - I've had that strange lower-right abdomen pressure/pain roughly every 3.5 months since I started Gleevec 400mg in April 2011.  I've seen two urologists about it and have been prescribed several courses of antibiotics along the way.  The symptoms feel like BPH and both urologists ultimately diagnosed it as such.  One guy recommended starting me on an alpha blocker (huh?  I'm 43 ... you're kidding, right?), but I did not pursue it.  So I decided to focus on other issues to see if they were causing the symptoms.

At one point I thought it was a side effect of Gleevec, but the cyclical nature of the "flare-ups" didn't seem to make sense.  Since that time, I focused hard on treating my deep-rooted anxiety over CML (even though I don't feel overly anxious anymore), and I've made tremendous progress on that front.  Once I dealt with that aspect, the symptoms disappeared and I haven't felt them in over four months ... a pretty long stretch for me.  So perhaps it isn't BPH or prostate cancer at all?  I am convinced that the prostate reacts negatively to stress ............ perhaps there's a correlation there?

I've got my annual physical in 3 weeks and the doc always checks my PSA, so I will let you know how that goes, so we can compare notes.

Please try to stay positive, my friend -- I continue to follow your treatment journey and hope to continue responding well to Gleevec like you have.

[Sneezy12]

Lucky-You can resolve the question by having a Prostate Biopsy. It is very simple and not painful. I have had both CML and Prostate Cancer, and am doing very well in both areas. Regards, Frank

[scuba]

Gary - What's good to see in your note is that your physical exam was "normal". I assume 'normal' means no nodules that could be felt and no enlargement. There is a very high chance that it's nothing. Just a normal PSA increase due to other factors that may even be gone by now. I am surprised they didn't re-test now for anxiety reasons.

http://www.wellnessl...out-psa-tests/#