Early in my journey, question

tonkinese88

So I’m 53. A year and a half ago my PSA was 1.91 and a few weeks ago it was 2.74 and my PSA percentage was 30%. My urologist has me scheduled to get another PSA next week. And if concerning he will order an MRI. in your opinion, aren’t my numbers encouraging with having 30%?? I’m still scared to death.

jc5549

Hello and sorry you’re going through this scary situation.

Many variables influence one’s risk for prostate cancer; family history, digital rectal exam, and multiple PSA values supporting an increasing trend are some. The more PSA data points available the more meaningful velocity changes are. The two values you have do support a significant change, but it would not be unusual if your follow up PSA value drops back down to earlier lower values. Your free PSA definitely supports benign disease.

I wish you well on your follow up lab value, it seems very reasonable to pursue an MRI and possible biopsy if your velocity continues to trend in the wrong direction, unfortunately, the percent free PSA alone is not in itself diagnostic

jc

jc5549

swl1956

I can not advise, but I just read this via google: "If you have a total PSA level between 4 and 10, doctors may test your blood for free PSA. A percent-free PSA above 25% is considered normal. Some doctors recommend that if you have a percent-free PSA of 18% or less you should have a prostate biopsy." Sounds encouraging!

In any event, as scary as it is, try not to stress out. Your PSA is relatively low, but don't procrastinate. I procrastinated during Covid and I'm now dealing with Gleason Grade 3 cancer. The earlier you discover PCa you'll likely have plenty of time to figure out what to do. In most cases Prostate cancer is slow progressing. MRI is logical next step.

tonkinese88

https://csn.cancer.org/discussion/comment/1713973#Comment_1713973

I might add I’ve had microscopic blood in urine for several years and my urologist did a cystoscopy twice over last few years and found nothing but did state my prostate was enlarged. So I’m hoping this is the reason for the increased PSA. And I’ve had many intestinal surgeries since 2008 and had my entire large intestine removed and have a jpouch made from my small intestine. So can’t have anything done rectally and if it was cancer I can’t do any type of radiation or I would end up with a permanent bag.

tonkinese88

https://csn.cancer.org/discussion/comment/1713975#Comment_1713975

I’ve read this info too.

jc5549

If you, you end up needing a prostate biopsy, it can be done transperineally and avoid your pouch or doing anything through it.

jc

dsbailie

rising PSA is always a trigger for investigation. Get a PROSTATE specific MRI with contrast. if no lesion should be good. if a lesion, get a fusion targeted trans-perineal biopsy NOT transrectal. Then you get a definite answer on Gleason score and can make informed decisions. Treating just a PSA is not a good idea as many people with PCa have low PSA and some with elevated PSA do not have PCa. it is an over-diagnosed and over-treated cancer.

tonkinese88

https://csn.cancer.org/discussion/comment/1714278#Comment_1714278

I had a followup PSA 2 weeks ago and it went down from 2.78 to 2.38. Urologist said I can get another PSA is 3 months and then if I wanted to do a MRI , Cleveland clinic offers a MRI PROSTATE LIMITED which is without contrast. Its an out of pocket MRI they offer for about $350 cash. As insurance usually won’t pay for an MRI unless PSA is at least 4. So going to wait and see in 3 months. I know 2 people that have it had prostate cancer and they stated if cancer PSA rarely goes down.