PSA Rise

bclark

Hey!  I'm new here.  I'm 61 years old and last year my PSA was 2.3 and one year later it jumped to 4.1.  My Uroligist is not worried at all.  He said wait 2-3 months and recheck it and if it goes up more we will worry but most likely it will come down.  He said the fact that it is only 4.1 and it has only beeen one year means if it is cancer it has not spread and won't until the PSA gets up around 10-12.  Is this sound advice or should I get a second opinion?

VegasMike

.

I would get a second opinion.  Usually anything above 4 a prostate biopsy is recommended.

Clevelandguy

Wait?

Hi,

Thats a pretty high jump for 1 yr.  it could be BPH, urinary tract infection, or cancer but if it does go back down you still need to keep an eye on it.  Your PSA can also be high if you rode a bike before your test or had sex.  I think another test in 2-3 months is fine but if it really worries you go to another doctor(internist, general MD) and have it checked ASAP.  A biopsy is the only true way to dermine if you have cancer. Just hope it's something else other than Pca, good luck.

Dave 3+4

bclark

My Urologist said my DRE was

My Urologist said my DRE was normal but the jump is the concern.

 

Rob.Ski

PSA

I've had my PSA go from 4.1 to 3.7 to 4.6 in a 6 month period.   So results can vary some and like Dave said, they tell you to avoid certain activities before testing as it can affect results as well.   Another PSA will give you more data for a trend.

Max Former Hodgkins Stage 3

PSA

bclark,

While a 'static' (one-time) high PSA can be meaningful, equally or more important is the PSA vector, also called a doubling rate.  (The doubling rate is the amount of time that it takes for a PSA test result to double.)  WIth a PSA of 2.3, a doubling rate of 1 year would have put your second test at around 4.6.  It is necessary that the innterval of time be exactly 12 months, or the calculations have to be adjusted accordingly.   I guessing off top of my head, but your 4.1 probably represents a D.R. of around 14 or 15 months (the calculation is a simple proportion equation).

By itself, a PSA of 4 or 5 is NOT cause for immediate alarm, but I was diagnosed with Stage 2, and my PSA was never above around a 4.2.   Certainly waiting three months for a follow-up test is reasonable, but do get it done.  If it has increased a bit more, then your doc should schedule a biopsy.  If not, I would go to another doctor.   

While a negative DRE is better than a positive one, most guys with mild PCa diagnoses seem to report that their DREs were always normal.   A postitive DRE is almost always suggestive of possibly serious PCa involvement.

There is no magic PSA level that proves metastasis; by throwing 10 or 11 out there, your doctor is making a generalization.

max

bclark

Thanks for the advice i truly

Thanks for the advice I truly appreciate it.

Josephg

Get a Second Opinion

My PSA history and doctor's comments mirros yours.  My PSA rose to 5, before my doctor recommended a biopsy, and he never felt anything with the DRE.  When he finally recommended a biopsy, it came back 4+3.  I should have sought a second opinion a year or 2 earlier.

Your case may well be different.

Old Salt

Good advice, so far

I second the above contributions.

Let me repeat, a one-time PSA value of 4.1 needs further investigation. Will this value go up or down from here on? I suggest to follow up every three months for now.

Also, although a DRE can provide useful info, the doc can only access part of a prostate with his/her finger.

 

bclark

PSA Recheck

I had my PSA rechecked and it is now 2.61.  Quite a difference and the Uroligist said it was likely due to sex.