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enlarged prostate

kimber45
Posts: 18
Joined: Aug 2010

I curious as to how many of you had an enlarged prostate. I'm curious because my psa jumped this year from 2.7 to 3.8 and I was told it could be because of my enlarged prostate.

ProfWagstaff's picture
ProfWagstaff
Posts: 98
Joined: Jun 2010

DRE indicated that mine was normal sized, if not slightly below normal but rough spots could be felt. That's what prompted my GP to refer me to the urologist and not just request a second PSA. I hadn't been to a doctor in years before that. I'm not proud of that, but I wish in hindsight I'd caught this while still in stage 1. First PSA test I ever got came back ay 20.4. As my Gp said...we don't know how long it's been at that level or how fast it got there. By having regular PSA checks, your doctor will have a good complete picture of your history including how fast your PSA rises. They usually talk in terms of "doubling speed." Your PSA hasn't doubled yet, and you're right on top of the process where you need to be. Any number of things can account for an elevated PSA - that's why it's such an erratic indicator. As erratic as it is, though, it's still our first line of defense.

Skid Row Tom's picture
Skid Row Tom
Posts: 125
Joined: Apr 2010

I have a friend whose PSA increased (can't remember the exact scores), they did a biopsy, found nothing, and said it MAY be an enlarged prostate. Of course, the biopsy may have missed the cancer. I know they have increased the frequency of his PSA's and are keeping an eye on it. Probably more significant, is your PSA velocity. I'm not sure the "doubling" thing is correct. Obviously, if it doubles, you have a problem. But before it gets to that point, I think you'll find evidence that an increase of .75 within a year is significant. You would fall into that category. There are other indicators they can test for when you have a PSA. Are you going to a general practitioner, or a urologist? My GP didn't know squat.

Kongo's picture
Kongo
Posts: 1166
Joined: Mar 2010

Kimber, benign prostate hyperplasia or enlarged prostate is probably the most common cause for elevated PSA readings across the male population. It's difficult to gauge the size of a prostate at a digital rectal exam because it's just a guess. An ultrasound probe gives a much more accurate assessment of the true size of the prostate. Also, prostates tend to get larger as men grow older so a prostate in a man in his 50s is probably larger than one in a 30 year old. PSA also tends to increase with age.

The other poster's comments about PSADT (PSA doubling time) and PSA velocity are right on the mark and are fairly good indicators of whether or not there is a problem. There are various nomograms on the web (just google PSA nomograms) and you can enter the date and PSA reading and it will calculate your PSADT and velocity. Generally, the PSA velocity is a more precise indicator.

Also, be aware that several things other than BPH can cause asn elevated PSA. Sex within 48 hours of your PSA blood draw can cause your PSA to increase by as much as a couple of points. Also, make sure your GP does the blood draw BEFORE the DRE as massaging the prostate will increase PSA. Prostatitus, an inflammation of the prostate, can also be a cause for an elevated PSA reading.

steckley
Posts: 100
Joined: Aug 2009

Kimber,

I had an enlarge prostate (70grams). Each year my GP would do a DRE and tell me it was big; however, he could feel no nodes and the PSA stayed low so nothing more was investigated.

I began having problems urinating (low flow). As part of the work up the doctor ran another PSA. The PSA had risen (I think from about 3 to 7), it was thought that I might have an infection and I was treated as if I had an infection (antibiotics). The PSA was then retested, and it had gone up.

Based on the rise in the PSA, I had a biopsy, which showed I had PCa.

Hope this helps ... good luck and best wishes.

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