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Author Topic: Elevated PSA  (Read 4458 times)

Steady

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Elevated PSA
« on: March 07, 2015, 06:37:33 am »
Upfront I want to say that I'm a bit biased against PSA testing but understand why the PSA for routine screening is so tempting. I believe anyone reading this forum is likely to be interested in how the PSA can impact TRT and male hormone therapy. I strongly recommend reading "The Great Prostate Hoax"  by Richard J. Ablin, PHD who is credited with the discovery of PSA.

If it is possible to avoid an elevated PSA then it should be avoided!
Now here is my experience with an out of normal range PSA:

Back in June my regular 6 month labs came back with a PSA of 4.1. It had been steady at around 1.5 before this. I had some symptoms of prostatitis a few weeks prior to the test, a burning sensation when I pee'd, mild fever, low back pain, that cleared in a couple of days .The clinic administering my TRT had me stop injections until I could be cleared by a urologist.. I chose a urologist near my home that my insurance company recommended. This doctor insisted on doing a prostate biopsy, no other options were offered. I wanted to clear myself and get back on TRT and agreed with an understanding that a biopsy wasn't that bad. Now, with a few months perspective, I will say that the biopsy is more unpleasant than it was portrayed. The doctor told me there would be a little discomfort. It is like having a bb gun stuck in your butt and shot 12 times, maybe that's "a little discomfort." He said "there could be blood in your urine and semen for a short time after the biopsy. "Fountain of blood" better describes ejaculation after the biopsy. I was still passing clotted blood more than 2 months after the biopsy, with condoms other wise unnecessary but just to keep from freaking out my wife. I endured two very unpleasant weeks of waiting for the results from the biopsy (is it cancer? what happens if it is? prostatectomy? incontinence?, impotence? penile atrophy?) and was reading a lot. Enough that I understood that maybe the biopsy wasn't called for, that I was pressured into it more because it makes money for the urologist than because it could save me from a horrible unnatural death.
The results were negative. The urologist simply said no cancer was found. I asked if there was any indication of inflammation or something that explains the high PSA, he had no answer. It seemed he was disappointed he wasn't going to get to remove my prostate, and he was surprised that I wasn't satisfied with "no cancer"  as the happy results from this painful, degrading procedure. When I asked where to go from here he said we would test PSA again in 4 months and if still high may need to biopsy again. I decided I didn't like his doctor and asked if I could get a copy of my results. He left the room for a copy and when he returned, surprise, there were in fact indications of inflammation. I checked later and this urologist charged my insurance more than 400 dollars to cover me on the results from the biopsy that he would not have even read if I hadn't asked for a copy.

4 months after the biopsy I had another PSA, this time it was way elevated, 7.1!

In the interim I had looked around for a progressive, compassionate urologist , instead of what I had searched for before , one that was near home and in network. My TRT clinic did not stop injections with this 7.1 PSA because I had  a recent negative biopsy and would provide evidence that I was under a urologist's care. I found a urologist at a Dallas teaching and research hospital. He authored and co-authored many papers on PSA, Prostate issues and TRT. It took a couple of attempts but I got an appointment. He reviewed my history and agreed that TRT likely had no impact on my PSA issue. He ordered a 3 Tesla MRI with Endorectal coil and contrast, imaging to see if there were some suspect area that might be appropriate to biopsy. The MRI was clean, no cancer, but BPH at 48.9 ML, and indications of inflamation, asymptomatic prostatitis, The procedure was uncomfortable, but way better than the biopsy, and I was better prepared for it.

So all told, I have BPH and some prostatitis that doesn't usually present symptoms. This incident prompted discussion with my brother and it turns out he has had prostate problems, BPH and inflammation, but never cancer since his 20's and so did my father, I had no idea.

I just had bloods done and PSA is 3.2. Which is not ideal but is headed in the right direction. I'm still on TRT, happy with everything it is doing for me.

I hope my experience can help others and want to point to key learnings. Take care in the selection of your care giver. Question the options. Research the impact and benefit of intrusive tests. And most important don't freak out about PSA.
« Last Edit: March 07, 2015, 07:46:40 pm by Steady »
2/12/12 - TT=212, FT=5.3
7/15/13 - TT=876, FT=26.5, E2=17.8
9/19/13 - TT=534, FT=12.5, E2=12
12/5/2013 - TT=701, FT=18.3, E2=15.1
4/21/14 - TT=1002, E2=10.4
6/6/14 - TT=752, FT=18.1, SHBG=28, E2=14.2
7/28/14 - TT=1093, FT=30, E2=65.6b & 46s
10/22/14 - TT=1104, FT=32.6, E2=10s
4/24/15 - TT=945, FT=20.2, E2=48.6s
Prior to last labs SubQ (11/3):
TCyp 34mg & HCG 250iu M/W/F
Current Protocol SubQ:
TCyp 36mg & HCG 250iu & 0.04mg AI - M/W/F

PeakT

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Re: Elevated PSA
« Reply #1 on: March 07, 2015, 02:32:31 pm »
Okay, Steady, that is weird:  my story is almost exactly like yours.   The #s are even the same!

For anyone int'd, here it is:

http://www.peaktestosterone.com/High_PSA_No_Cancer

Here is how I lowered my score:

http://www.peaktestosterone.com/How_I_Improved_My_PSA_Score

And here are quite a few links on the prostate:

http://www.peaktestosterone.com/Hdr_Prostate_Vasectomy_Fertility

And you can say that again about the biopsy!  The bloody ejaculate is also fun to explain right?
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Elevated PSA
« Reply #1 on: March 07, 2015, 02:32:31 pm »


fun2drive

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Re: Elevated PSA
« Reply #2 on: March 07, 2015, 03:43:26 pm »
I under went the same testing and I did have prostate cancer. I am betting if I had understood then what I know now about low T that I may have not had to be treated.
I found the biopsy no big deal and had little issues with blood in urine and anal discharge.
I have spent a great deal of my life in research so I researched the heck out of treatment options with surgery being the very last one. After much research I selected external beam radiation using 3 gold seeds as fiducal markers.
My PSA was 4ish and my Gleason score was not that high either however 10 of 12 samples came back with cancer.

When being treated I got nite sweats day sweats and other than that felt fine. The down side to the rad treatment is that it cooks your seminal vesicles. I am 1 1/2 years out from the treatment and in fact my PSA has bottomed around 0.7 which is pretty normal. New test this week.

Met my uro this week and if the PSA stays in that range we will begin to work my T up to where I think I will feel normal.
My T is 400-460 last test and E2 38-30 respectively but this was not sensitive Labcorp will be next time.

I think even though my weight is good and I exercise at least 4 times a week closer to 5 and do HIIT ever other day that this level is too low.
My uro seems to agree saying 600-700 seems to be the sweet spot.

All I know for sure is that our medical system is broken in regard to how important to overall health T, free T and E2 are.

My symptoms are that I can't seem to increase muscle mass no matter how much I work the weights, not loosing not gaining, bruising of my skin meaning it has thinned, fingers are now thinner than before, emotional level ridiculous tearing up at church and movies or even a show on TV where that never happened before and that includes a lot of locations like being deployed for 3 years where it would cause being emotionally upset.

Point is that the OP was lucky. I had hoped mine was inflammation but if it is not be sure to NOT follow some uro advice and do your own research. Some are doing hormone therapy to reduce your T which is ridiculous.

None of the uro's and oncologists I talked to had any explanation about why I was getting nite and day sweats. Well it is the T being cooked out of me. Disappointing to be sure and during my rad treatment I started researching why which lead me here and to Allthingsmale too which has helped me understand what is going on.

I will be going on some form of HRT based on whether I am primary or 2ndary (PSA being OK that is) to get my levels up then I can report if I am able to get back to what I was before. I don't feel bad I just don't have what I had before.

I am 63 and I am probably in better shape physically than most of the guys in their upper 40's because exercise has been a life long habit for me and no smoking or drinking and eating right most the time.

I have added Gene Levine's NO stacker over the last 3 months to increase vascular size and it is working. Side effect is about 50% of the time I get nocturnal wood not what it used to be but say 75% of what it was. Hoping the boost in total T and more importantly free T will get that to 100%.

Hope this helps those that will get prostate cancer. I honestly think if I boosted my T say 6 years ago that this cancer may have never happened. The medical community is very uneducated in this area and I thank God for this forum and a few others...

 

PeakT

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Re: Elevated PSA
« Reply #3 on: March 07, 2015, 03:58:46 pm »
thanks for the info fun to drive.sounds like you have a pretty savvy doctor.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Elevated PSA
« Reply #3 on: March 07, 2015, 03:58:46 pm »


Steady

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Re: Elevated PSA
« Reply #4 on: March 26, 2015, 04:43:08 pm »
It is typical for those of us on TRT to have PSA tested at least twice a year. The assumption is that we are at a higher risk of Prostate Cancer. I've never seen studies that supported that position and now here's one that shows no elevated risk.
http://www.ncbi.nlm.nih.gov/m/pubmed/24684569/

Combine that study with the American Urological Association's guideline: "For men 55 to 69, the test makes the most sense. The AUA panel recommends a shared decision by doctors and patient about the test. Once testing begins, the panel says it should be given every two years, rather than annually."
So why are we testing so often and why does a high read lead to automatically stopping TRT?
« Last Edit: March 26, 2015, 06:17:40 pm by Steady »
2/12/12 - TT=212, FT=5.3
7/15/13 - TT=876, FT=26.5, E2=17.8
9/19/13 - TT=534, FT=12.5, E2=12
12/5/2013 - TT=701, FT=18.3, E2=15.1
4/21/14 - TT=1002, E2=10.4
6/6/14 - TT=752, FT=18.1, SHBG=28, E2=14.2
7/28/14 - TT=1093, FT=30, E2=65.6b & 46s
10/22/14 - TT=1104, FT=32.6, E2=10s
4/24/15 - TT=945, FT=20.2, E2=48.6s
Prior to last labs SubQ (11/3):
TCyp 34mg & HCG 250iu M/W/F
Current Protocol SubQ:
TCyp 36mg & HCG 250iu & 0.04mg AI - M/W/F

PeakT

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Re: Elevated PSA
« Reply #5 on: March 29, 2015, 08:34:41 pm »
Festus posted an excellent video on Prostate Cancer and Vitamin D, which I split out here:

http://www.peaktestosterone.com/forum/index.php?topic=6914.0
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Elevated PSA
« Reply #5 on: March 29, 2015, 08:34:41 pm »