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Question about Father's very high value of PSA

Posts: 13
Joined: Mar 2018

Hello Members,

Thank you for reading my message.

My father is 81 years old and lives alone in India. He was diagnosed with Recurrent Urethral Stricture in 2001 by his Urologist. He was on Tamsulosin and Darifenacin for a lot of years and was fine until Sept 2016, when he had pain in the entire penis shaft and part of his pelvis just above the penis. He rated the pain as 3/10. In Oct 2016, his PSA was 0.522 and the ultrasound of the kidney and abdomen was normal(with a normal prostate). His Urologist did a flexible cystoscopy and dilated his stricture and he had no pain until Dec 2017.

In Dec 2017, he had a penis pain of 3/10 and EColi infection in his urine. After antibiotics and repeat urine cultures, the urine was clear. An ultrasound of the kidney and abdomen in Jan 2018 was normal(with a normal prostate).. For the last three months, his penis pain has been 1/10 or 2/10 and his Urologist prescribed him some creams, which helped.For the last two days, his pain stayed at 2/10 and so went to see the Urologist again. The Urologist is doing a flexible cystoscopy on Monday, March 19. Several blood tests were done today. The following values were abnormal and they worry me a lot:


1)Prostate Specific Antigen(PSA): 11.22 (0-6.5)

2)Prothrombin PTE: specimen blood citrate - clotting assay - 14.2 (9.5-12.5)

3)Urine ph - 7.5 (Acidic)



•Urine leucocytes: Present

•WBC pus cells: 10-15 (3-5)

•RBC - 2-4(0-1)

•Epithehleal - 1-2 (2-3)

•Remarks: Bacteria seen


He has no other symptoms. No pelvic pain or issues with urination. The urine stream is fine, no burning sensation or dibbling, change in skin color or discharge. His primary care physician does a physical every six months. The last physical was done a week ago and the tests of Complete Blood Count, Urine, Lipid Profille, HBA1C were all normal. He is 5 ft 3 inches in height, weighs 125 lbs, with a waist size of 36 inches. He walks twice a day and uses his exercise bike once daily. He is physically and socially active and eats a healthy vegetarian diet.


1) In a span of 15 months, his PSA has jumped from 0.522 to 11.22? I am very worried as a 21 fold increase in his PSA over 15 months could be an aggressive form of prostate cancer? What are your thoughts?

2) What specific tests should be done to get further information? 3D MRI of prostate? DRE? Biopsy?

3) I will be talking to his Urologist on Monday after his cystoscopy. What questions should I ask him about his PSA of 11.22? 


Thank you,


VascodaGama's picture
Posts: 3180
Joined: Nov 2010

The diagnosis of prostate cancer is done with a biopsy. The PSA could be high due to other causes. In your shoes I would repeat the test at a reliable laboratory and consult an urologist if the value is confirmed.

Hope for the best.


Posts: 13
Joined: Mar 2018

Thanks a lot for your reply, Vasco! I will talk to my father's urologist about doing a repeat PSA. I will update once I have more information.




Posts: 457
Joined: Mar 2017

I think the implication is to find an independent lab that can do the test. Not that your urologist is undependable, but verification should come from a completely independent source from the original test.

Your urologist is probably tied into referrals to a specific lab, and will be willing to repeat the PSA test again, but likely at the same lab.

If it were me I'd find an independent lab not tied to the urologists clinic and have them keep scores confidential. You dont have to do this, it is just what i would do.

Posts: 13
Joined: Mar 2018


That makes a lot of sense, Grinder! I will certainly consider that.  Thank you for the reply.




Old Salt
Posts: 720
Joined: Aug 2014

I agree with the points made so far (not that it matters much). And, IMHO, the first PSA test result (0.5) seems low for an 81-year old, unless different units were used. The usual one for PSA is ng/mL.

Posts: 13
Joined: Mar 2018

Thanks, Old Salt! I will check again.




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