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Should I be worried?

RustyS
Posts: 3
Joined: May 2017

I just received a PSA of 2.3. It was .9 last year at this time. The doctor will take another one in 6 weeks. Should I be worried?

I think my main reason for worry is the fear that it will rise again when I get it redone. I know 2.3 in itself is not alarming, but the fact that it rose from .9 is causing Anxiety, because I have no symptons of all the other causes of PSA rising. 

Also, I read that when biopsied from 4.0-10.0 there is a 25% chance of having PC, but if you don't have an infection or BPH at that point why else would you have a high PSA? So is it still 25% for people without BPH or infection?

I'm starting to understand the logic in not not recommending PSA testing. The stupid anxiety is brutal!

Clevelandguy
Posts: 471
Joined: Jun 2015

Hi,

I would follow your doctor and see what the next PSA test will be.  Coild be nothing but in my case my GP got concerned when my PSA kept rising over several years.  I would not get too concerned at this point.

 

Dave 3+4

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3328
Joined: May 2012

What is your age Rusty, and your prostate health history ?

PCa almost never hits a guy under 50, although there have been a few cases here.   0.9 sounds like it was either an inaccurate test, or you are a teenager with a recent number that low -- which is why I asked for a few more details.

What is more brutal than testing for PSA is learning too late that a man has advanced PCa. Recommendations against testing have just been insurance companies wanting to cut expenses at the cost of a few deaths here and there. But I too know the anxiety.  My GP was a "PSA is overused" guy.  But my vector was steadly climbing over two years, but like your results, no static number by itself was ever alarming.  So I went to a urologist who recommended an immediate biopsy, and it came back as Stage II PCa.

It made a believer out of me.  Anxiety is less problematic than cancer.

max

RustyS
Posts: 3
Joined: May 2017

Max,

Thanks for your response. I'm 58. I get a yearly physical. 2014 it was .7, 2015 it was .6, 2016 it was .9. This year it is 2.3. Th jump to 2.3 has scared me. I guess I need to chill out but am worried about the next one. I guess, logically, if it is cancer it should be early on. Right?

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Many men have PSA's iat the 0.9 level....this is in a normal range.

The PSA is an indicator only; and one cannot make a decision based on one score.

There are many factors that affect the PSA; ie sex or bike riding before the test, even a hard stool. Additionally there can be an infection that can affect the PSA, andmay need tto be treated with Cipro or a like drug. 

Your doctor ordering another PSA is appropriate.

As far as your question about the stage of a possible cancer. The only way to determine, whether or not you have cancer is to have a biopsy, and  at that time the stage is determined. The PSA will not do this.

Don't worry , most likely you will be fine.....you are not a member of our club.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3328
Joined: May 2012

The reason annual PSA draws are good is that they allow vectoring or doubling rate to be established, a Baseline if you will.

As was mentioned by hopeful and optimistic, only a biopsy can ever confirm any cancer idagnosis; no PSA level can do that. Guessing about "early" or "late" regarding a disease you probably don't even have is emotionally counterproductive.  

Just do the annual checks.   I would intentionally try to completely forget about "PSA" for the next year.

max

ASAdvocate
Posts: 117
Joined: Apr 2017

The next time, request a PHI test, which is a blood test that inlcudes PSA and Free PSA, and other factors, and is more accurate than PSA alone, and less affected by benign causes.

RustyS
Posts: 3
Joined: May 2017

Thanks for the info. The reason for my anxiety is that I have no symptoms of any of the causes of  a rise in PSA; therefore my brain tells me that the rise from .9 to 2.3 must be a sign of cancer.  Why is my logic wrong? I am too logical for my own good and realize that those who read this probably think I'm overreacting and shouldn't even be on this board. 

Avery
Posts: 1
Joined: May 2017

My husband had his prostate removed in 2014, he went through the radiation  treatments  for 8 weeks and has been cancer free since, however he has been going and getting blood work every 3 months and the levels have been zero. The last two tests showed 0.1 and now this last week 0.3  The Dr. has ordered a bone scan where they inject the solution and you wait three hrs and get the scan. Do I need to be worried?

 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3328
Joined: May 2012

Avery,

It sounds as if the doctor is checking him for potential relapse.  After surgical removal of the gland, PSA results need to be what is termed "undetectable," but "undetectable" almost never is the same as a result that reads all zeros.   I have been "undetectable" since January of 2015, but no result was ever all ".0000"

Labs and cancer centers differ in what amount of PSA in a result constitutes clinical failure.  Ask his oncologist what their numerical threshold is. The fact that he has remained undetectable this long is a good sign.

Worry is part of the human condition, expecially when dealing with cancer or former cancer, but one cannot yet assume that there is in fact metastasis.  I would do my best to relax and pray for the best.   I hope you choose to update us following the scan,

max

VascodaGama's picture
VascodaGama
Posts: 3044
Joined: Nov 2010

Avery,

The increase of the PSA is not a good sign as it should be in the zeros after the RP plus RT of 2014. As Max above suggests, recurrence is highly suggestive of the actual happening. In any case, the scan (99mTc bone scintigraphy) will provide some clues of any metastatic cancer in bone, which is the typical affected area in recurrences of aggressive cases. I suggest this because I think that your husband's initial diagnosis was aggressive for the choice of the initial therapy (two radicals: prostatectomy plus radiation), commented by you above. Can you tell us his PSA, Gleason score/Clinical stage, found at diagnosis (2014)?

Apart from the bone scan I would recommend your husband for getting additional image exams (such as PET and/or MRI) to try locating lesions in tissue too. His doctor may have order the bone scan alone because this is the traditional sequence in prostate cancer care. After RP and RT the following therapy relates to systemic palliative treatments that include hormonal and chemo. In case of a negative bone scan he may recommend the traditional hormonal therapy (HT) alone, however, if positive he may start chemo in addition to HT.

Surely the above approach is palliative but it can hold the bandit at bay during many years (till one dies of other illness). I would recommend you to wait for the results and worry only if they find it to be widely spread, difficult for being treated. In any case, many recurrences (from RP+RT) can still be handling with intent at cure if these metastases are fewer in number and radiation can be applied to those spots safely. This is called oligometastatic cancer. We have discussed the matter here before and will help you if such becomes the case.

Can you share the age of your husband and any symptom past and present, or other illness he has/had?

Best wishes,

VGama

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