Fluctuating PSA

jos5051

Fiive years ago a PSA test revealed elevated PSA of 11. Within a month or two it went up t0 18 and then 23.

I underwent two biopsies and one MRI. The biopsies were negative for cancer but did shos acute prostatitis.

The MRI showed possible areas of concern but nothing definite.

In 2013 my PSA started declining and got as low as 7.9.

In 2015 - 2016 it hovered around 12.

This Januray (2017) my PSA shot back up to 21.9. So over the 5 year period, no major change, but over the last 6 months a substantial increse.

My question is, has anyone else experienced anything similar (major fluctuations of PSA up and down at an elevated level but no steady increase).

I would apppreciate any input anyone might have. Thanks.

Old Salt

Prostititis?

Looks to me like 'typical' prostititis, but do see your urologist to confirm. Ask for a DRE.

He may want to do another biopsy.

Max Former Hodgkins Stage 3

Very possible

Jos,

Your PSA could be prostatitis in orgin, but I would monitor it closely.  I had prostatitis so badly in the late 80s that I was passing bright blood at differing times, which I contracted while on a cath during a 25 day stay in ICU.  It is difficult or impossible to cure, and often requires numerous antibiotic routines, but you are approaching four years with this as an explanation.  The pain was overwhelming, unlike anything PCa ever caused me (like many guys, I never had PCa-associated pain), and I had high (101+) fevers.

A PSA of 21 is objectively quite high, and I would continue occasional biopsies if its causality is not convincingly resolved.  You do not give the dates of your biopsies, but if you have not had one in the last year or two, me personally, I would ask for one now.  It is (compared to most things in the medical world) relatively cheap, fast, with few side-effects, and definitive.  

Like all other writers here, I disavow any medical expertise: I've had no medical training, just every medical thing  (advanced Lymphoma, Stage II PCa, massive trauma, years of rehab, numerous gastric and neurological disorders, massive arthritis and orthopedic degeneration, lung fibrosis, asthma, around 20 surgeries, and other stuff I can't recall at the moment).   But I work today full time, and most people meeting me and later learning of my medical history say they would have never guessed I had ever been sick.  People can come back from very nearly anything.

The PSA test had just received FDA approval in 1986 when I had my problems beginning in early 1987, so I have no PSA data to share.  Plus, I was only 30, and no doctor would have been likely to order a PSA for a patient that age anyway.

max

hopeful and optimistic

.

As mentiond above, probably prostatitis, however there is a relatively new high tech biopsy that is available that you may pursue to bring peace of mind:

First a T3 MRI is taken; a radiologist finds suspicious lesions and ranks them from 1 to 5, 5 being the most aggressive...next these MRI results are are merged into a three dimensional biopsy machine t, so the urologist is able to target these lesions and be more likely to find a cancer if it exists. The patient will have more confidence in the results of the biopsy. Additionally the doctor using this method, if a cancer is found can go back to the exact spot at a future biopsy.

The above method is different from the two dimensional biopsy, using ultrasound, that most doctors use....these biopsy are basically a stratefied random sample, that is, the protocol calls for a sampling of different parts of the prostate, but there are no targets.

You appear to be a ideal candidate for the three dimensional biopsy....(there are a few different machines that do this, one is the Artemis).