1 round of antibiotics - PSA fell from 8.7 to 6.4
Hi guys
I had a routine medical which showed a PSA of 8.7.
I went to see a urologist, who gave me the "standard" treatment - take a round of antibiotics and repeat the test after 6 weeks
After this retest, my PSA is now 6.4
Still high (I am having a biopsy done in a couple of weeks) but quite a bit lower than before.
Has anyone had a similar thing? Could it be I have both a prostate infection *and* PC ?
Hi fabkebab, unfortunately I'm not in a position to answer your question (though I would tend to think it's yes-- there's a little aphorism that doctors use that is pertinent here: just because a dog has fleas, doesn't mean that he doesn't have ticks, too!).
However, I do have a question of my own: did you have any symptoms of a prostate infection or inflammation when you had the 8.7 PSA?I have some of the typical "enlarged prostate" symptoms, such as peeing in the night or low amounts of flow in the morning - but I dont have any pain or anything that differentiates my condition as an infection (I also didnt get anything show up in the urine analysis indicating infection) - but yet... the antibiotics lowered my score
You can have both. These are questions you need your urologist to answer. Require that your providers tell you everything you don't know you don't know. Medical providers are notorious for not sharing information that we would find helpful and we don't know which questions to ask.
Guy B. Meredith, moderator.
Hi
. The question of what it means if PSA decreases with antibiotic therapy is a tricky one. I'm going to change your question a little to could you effectively lower your PSA with antibiotic treatment and still have prostate cancer (since your PSA lowered, but it is unknown if you had an infection) and the answer is a qualified yes. I say qualified because, as seen in this research paper, the percentage that PSA decreases and from how high to how low matters: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006782/. For example, every case in this study that PSA decreased to less than 4 had no cancer detected. Perhaps the most interesting find was that "For patients who had unchanged or decreased PSA, carcinoma was found in 40–52% and 7.7–20.3%, respectively." The takeaway for your case is that the decrease is promising, but that PCa is still a possibility. If you are concerned about getting an unnecessary biopsy, perhaps you could talk to your doctor about urinary biomarker testing. At least one of the tests, I believe the one from U. Michigan, has become commercially available. Your doctor may be able to provide further information. Wishing you the best and please feel free to keep us posted on how you are doing. Richard (ProstateCancer.net Team) )
Richard, my mother had a term (learned from HER mother) 'geshmak' to express pleasure or delight, that I will now borrow-- in a cold, and badly uninformed world, I feel utter geshmak when I read one of your knowledgeable, helpful contributions to members of this website.
What's very interesting about the first article you linked to is that it makes clear that although the biopsy is indeed carried out with MRI guidance, it is preceded by another MRI, this one a multiparametric MRI, in order to target lesions (in this study, just one lesion: the most cancerous-seeming one) to biopsy in the second MRI. And it indicates that, really, there are many ways to take advantage of the power of the mpMRI to differentiate between cancerous and normal prostate tissue. As long as you first use the mpMRI to target areas of the prostate for later biopsy, it doesn't much matter how you incorporate that information into the biopsy (thus the way they did it here, or with a fusion biopsy, which also is viewed favorably by the authors).
And the authors mentioned that this targeting allows for fewer cores to be taken without compromising the success of the mission (of course, in this context, success means finding clinically significant cancer-- something that is only pleasing in the sense that if you actually have cancer, the sooner it's found the better.)
So I say thank you, Richard, as I ride the wave of geshmak into the sunset!Thank you
. I also want to go back to an earlier discussion and note that with fewer cores needed the possibility of dissemination of CTCs is probably less as well. Best, Richard (ProstateCancer.net Team)
Thanks Richard! I am still going to go ahead with the biopsy, and lets see what they find - but I was wondering if anyone had seen it before. As soon as I read your reply, I realized someone could have an infection *and* prostate cancer, which would account for a decrease in PSA after antibiotics but a positive biopsy later.
Thanks again for such a thorough reply!
