Massive PSA increase!

Baby_Jay

Hi guys,

I'm new to this group. I have been on TRT for the past year, my baseline PSA was .51. I just had my follow up test and today my PSA is 12.93. That is a 2,431% increase in one year. From what I'm reading, that is highly suggestive of cancer! I have seen the results through patient portal and I haven't even talked with my doctor yet. Tech suggested repeat sequential tests. My heart dropped when I saw those results. Some things I read suggested this could be a highly agressive cancer. I guess I will just take it one day at a time.

Baby_Jay

I forgot to mention I am 50 years old and my paternal grandfather had Prostate cancer, that's my only family history that I know of.

centralPA

Hey, sorry you fund yourself here.

I would definitely get another test done, just to confirm it wasn't some strange lab test error. After that, see what the doctor says. Lots of possible causes that aren't cancer, along with possibly being caused by cancer. Don't get ahead of the horse.

If cancer is truly suspected (no obvious infection causing it) then expect him to request an MRI and then perhaps a biopsy. Make sure they come in that order. The MRI steers the biopsy.

Like you said, one day at a time!

VascodaGama

I agree with above central centralPA's comments. Get another PSA in one month and check if the laboratory reports in (ng/ml) units.

Typically, aggressive prostatic cancerous cells produce low volume of PSA. Inflammation (BPH) are common in sudden increases and decreases of PSA.

Be vigilant. Get informed by professionals.

Best

VG

VascodaGama

Clevelandguy

Hi,

Why were you on TRT therapy? Is this your 1st PSA test since being on TRT? Like the other folks have suggested do more tests looking for trends up or down. Something sounds off……

Dave 3+4

Baby_Jay

https://csn.cancer.org/discussion/comment/1724281#Comment_1724281

https://csn.cancer.org/discussion/comment/1724290#Comment_1724290

Thank you, right now I'm in panic mode. That just seems like an astronomical jump in one year.

https://csn.cancer.org/discussion/comment/1724290#Comment_1724290

I'm on TRT due to severe fatigue and very low T. TRT has helped me so much to feel better. This is my second PSA test since I started.

Baby_Jay

https://csn.cancer.org/discussion/comment/1724287#Comment_1724287

Josephg

I will just re-confirm what the other folks above have stated. Panic mode is expected, and we've all been through it. It is up to you to settle and control your panic mode to the extent possible, and stay in touch with your medical professionals to get the appropriate follow-up moving forward.

Please keep us apprised with updates.

Baby_Jay

https://csn.cancer.org/discussion/comment/1724294#Comment_1724294

Thank you so much, I will.

Baby_Jay

My Doc is referring me to an oncology Urologist, so I will go from there.

Old Salt

Good advice!

Baby_Jay

I've been doing some reading, and it is very concerning what I am learning. PSA > 10 is suspected cancer (more than 50% chance) rate of increase .75 per year is suspicious of cancer (mine was >10), >2.0 ng/mL/year is associated with a higher likelihood of aggressive disease (again mine is >10). I did a calculation, my PSA doubles every 3 months. If it doubles in less than 3 years they find that concerning. I'm not feeling very optimistic right now...

Old Salt

Yes, I think we all agree that your numbers are concerning. I do hope that your upcoming consultation will relieve you of these concerns. In the meantime, it's best to keep an optimistic outlook.

Baby_Jay

Had my repeat PSA today, 3.24. Last test must have been a lab error, however, it is still elevated. Should I be concerned? Because I still am.

Wheel

keep in mind TRT can increase PSA levels and yours did not rise until your treatment. That being said you do want this investigated further. I would imagine frequent PSA tests. Consider asking your urologist about the ExoDx urine prostate test. This is non invasive and can help in determining if you need to go forward now with a biopsy or monitoring your PSA. It measures genomic markers of cancer cells if found in the urine as to the likelihood they are of a more aggressive nature.

Josephg

https://csn.cancer.org/discussion/329637/massive-psa-increase

I don't believe that you stated what type of doctor administered TRT to you.

My recommendation to you after this latest test is to see a Urologist, if you have not already done so. That is the expert who should monitor your case going forward. You are probably OK at this time, IMO, but I believe that we should leave it to the expert to determine. The Urologist will determine if and/or when a biopsy is needed to make a definitive determination regarding whether or not prostate cancer (PCa) is present.

Just remember that PSA values do give some information, but they are not linear, and they are not a determining factor regarding the aggressiveness of the PCa, if present. For example, my PSA was 5.2 when I finally visited a Urologist (my PCP fiddled and diddled for 5 years, before advising me to see a Urologist), and my PCa had already fully engulfed my prostate gland and escaped out of the prostate. My Gleason score was 4+3.

Baby_Jay

https://csn.cancer.org/discussion/comment/1724437#Comment_1724437

Thank you, yes I have an appointment with my urologist on Tuesday, he is the one who ordered the repeat PSA. My GP had me on TRT.

Clevelandguy

Hi,

If your PSA went from .51 to 3.24 in about a year, yes that should raise some flags. Keep monitoring your PSA over the next few months/years looking for an up or down trend. As others have said with the TRT therapy your PSA would be elevated vs no therapy(.51). MRI, digital rectal exam, biopsies are the current tools doctors use.

Dave 3+4

Baby_Jay

Urologist wants to repeat PSA in 6 months to check trend then do MRI/ biopsy if necessary. He said I could have MRI or Biopsy right now, but I want to wait it out.