We started by going over all past history, tests and symptoms.
He explained the process and began with a Digital Rectal Exam. You think I
would get use to this by now, but no such luck. His DRE was more aggressive and
painful on my Prostate than the previous exams, he found a small lump at the
base of my Prostate very near the midline, and said it could have been easily
missed by others. He ordered a urine test for infection and took a sample for
another PSA-3 test. He explained different labs might vary in how they evaluate
the PSA-3. He preferred to use Bostwick Laboratories for the PSA-3 and felt
their evaluations more accurate than most. The PSA-3 test result came back in a few
days at 49.4, higher than previously
tested. Not good, though Dr. Tamburri explained the score rise could be from
different procedures in different labs.
Dr. Tamburri also ordered a PSA Total and Free test that is additionally called a Free/total
Ratio PSA or a Percent-Free PSA test. Upon release into the blood, PSA is
enzymatically active, but protease inhibitors rapidly inactivate it. Most PSA
is bound to various serum proteins. The bound PSA is called “Complexed” PSA.
The unbound PSA is called “Free” PSA. The standard PSA test measures both
components of PSA: free and protein bound. The PSA Total and Free blood test
measures only the unbound (or damaged) type of PSA, called the Free PSA. In patients
with Prostate Cancer, a higher proportion of PSA is bound. A low percentage of
free PSA may warrant a Biopsy, while a higher percentage of free PSA would tend
to be better for the patient. This test greatly helps to refine the standard
PSA test results and provide for a clearer picture when it comes to deciding on
a Prostate Biopsy. My score for the PSA Total and Free Test later came back at
31%, better and higher than the Cancer cutoff limit of 25% suggesting a lower
possibility of Prostate Cancer.
At this point we proceeded with the Power Color DopplerUltrasound. It was done in his exam room and after applying sufficient amounts
of lubricant to my anus a rather large probe was inserted up my rectum and focused
on my Prostate. I had thought the DRE’s uncomfortable, but they paled to this procedure. During the Ultrasound I was able to view with Dr.
Tamburri most all areas of my Prostate. He pointed out several small spots that
looked like calcium deposits or cysts. Based on the Color Doppler Ultrasound, they
had no significant blood flow to them, which was contraindicated of Prostate
Cancer. Cancer tumors often grow rapidly, he said, and will show extensive
blood flow near their sites on the Ultrasound. He also pointed out the small
lump he felt during the DRE at the base of my Prostate near the midline. This
as well did not have the localized blood flow to indicate Cancer, though he
didn’t know for sure what was causing the spot. Overall my Prostate exhibited, as
Dr. Tamburri pointed out to me, a greater blood flow than normal. This suggested
to him that there could be an underlying infection throughout the Prostate. As
Dr. Tamburri explained sometimes with Prostatitis, a swelling and inflammation
of the prostate gland, there may be physical symptoms without the infection
showing in the urine. Symptoms of Prostatitis can include painful urination, pain
in the groin, pelvic area or genitals, and sometimes, flu-like symptoms. This
certainly matched for several of my past symptoms.
After the exam we chatted about the results and options. Based
on Prostate blood flow patterns, my Prostate over sensitivity, symptoms, and test
history, Dr. Tamburri prescribed a treatment for Prostatitis that included
taking Cipro for 30 days. He also said with the PSA and PSA-3 test results, and
the spot on my Prostate, there was an indication that I may have a
non-aggressive Prostate Cancer that should be closely monitored over the next
year. He felt that metastic disease was not a high risk at this time. In
addition to the Cipro he suggested I begin taking 4g to 5g per day of Ascorbate
Vitamin C; 4 Caps per day of Metagenics EPA-DHA 720 essential fatty acids from
cold-water fish, and 8 Caps every other day of Thorne Meriva-SR Curcumin
Phytosome. (More on this to follow)
I stopped at a pharmacy on my way to the Phoenix airport and
began taking the Cipro. Within a few days I was taking the other supplements.
Taking this much Cipro over a month can be problematic. It has a risk of tendonitis
and tendon rupture in all ages and the risk is further increased in patients over
60 years of age; in other words me. The first 3 weeks were without problem.
Into the fourth week I began to experience pain near my joints in several
places including arm and leg. As I continued to take the Cipro the pain began
to increase so I did stop the Cipro slightly before the full course, and over
time the pain subsided and went away. Later I found out that there are other
medications that could have been supplemented for the Cipro.
The good news is that after the course of the Cipro, I went
in to Group Health for a PSA test and the result came back with a score of 3.5.
This was a significant change. I felt much relieved though cautiously
concerned for what the future may hold.
Next installment: Decision for the Prostate Biopsy
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