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I'm Nervous About My PSA

Sw1218's picture
Posts: 65
Joined: Jan 2016

hello, everyone. i received a call from the urology office and my PSA went down from a 7.6 to a 6.2. because my PSA is still above 5.5, my uro recommends a biopsy. my urologist understands since i had some concerns about him performing a DRE before having blood drawn, he doesn't mind re-checking my PSA. 

i asked the nurse about the results of the apifiny blood exam. she said those haven't come back, yet. i thought if the apifiny results were above a score of 59, that would be a reason to recommend a biopsy. so, i have a few concerns:

1. should i go ahead with the biopsy or wait 'til the apifiny results come back?

2. do you really think my uro performing a DRE before having blood drawn really caused my PSA to be 6.2?

3. since my uro recommends a biopsy with a 6.2 PSA, do you think he'll still recommend a biopsy if my apifiny results are under 59?

VascodaGama's picture
Posts: 3407
Joined: Nov 2010

Hi SW,

I do understand your worries for the high PSA and for the concerns regarding your doctor's ability in PCa matters in view of his error to draw blood after a DRE. Massaging the prostate would affect the PSA serum in the blood sample. I wonder if your initial PSA of 7.6 ng/ml were also a result from a sample drawn after a DRE. I think it wise to repeat the test with a "clean" blood sample at a laboratory you trust.

In any case, neither the PSA or the Apifiny (immune system markers) can diagnose you with prostate cancer. Only a biopsy can assure a positive result, therefore you should consider to undergo such exam if suspicious. I would recommend you to be financially (insurance) prepared before the procedure because no insurance would accept a new client and cover him for PCa treatments if he has been diagnosed positive previously.

Best wishes and peace of mind.


Sw1218's picture
Posts: 65
Joined: Jan 2016

no my initial PSA of 7.6 ng/ml was not a result from a sample drawn after a DRE. i went to emory only to have blood work done, on january 14th.

Posts: 1013
Joined: Mar 2010

I agree w/Vasco that you should just get the biospy done.   Your PSA is not so high that it is indicative of cancer but yet not so low that you might not have it.  I was diagnosed w/cancer w/only a PSA of 4.

A biopsy is not 100% definitive for determining PCa -- you can get false negatives, if the biospy misses the cancer -- but it is the only method that will give you some "real" data, since PSA is only an indicator (when taken over time) of the possibility of PCa.

As noted, even if you get a negative biopsy, you could still have Pca because the biospy missed it but, if you continue to monitor your PSA, and it continues to go up over the next 6-12 months, another biospy would probably be indicated.  Generally speeaking, biospies are NOT recommended more than every 12 months or so but if, your PSA starts to skyrocket, any earlier biospy may be necessary.

While most PCa is slow growing, some are not and, if you wait too long for another biospy which turns out positive, the cancer may spread and may become too agressive to deal with before it can be stopped.  That's the risk and there are no good answers on what to do other than paying close attention to what's happening by taking PSA tests at least every 3 months when there is some question about whether you have PCa or not.

There is a better way for determining if you have PCa or not -- it's called an MRI/MRSI or 3T MRI scan, which can determine the concentration of choline in the body which is an idicator of cancer.  However, this method of detection is VERY expensive and is not usually approved for use by insurance carriers unless there is some clear indication that the patient is postive for cancer but there is some doubt about its location or the possibility of recurrence. 

This is not your situation but, if you have the $ to pay for it, you can always ask for it to be done yourself.  It will probably cost you around $3-5k; maybe more and maybe less, since there is standardarized schedule for hospital tests/treatment.  This is the ONLY test which will tell you for certain if and where you have PCa in your body.

Good luck!!!!



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