Question about Father's very high value of PSA

jetski76
jetski76 Member Posts: 13
edited March 2018 in Prostate Cancer #1

Hello Members,

Thank you for reading my message.

My father is 81 years old and lives alone in India. He was diagnosed with Recurrent Urethral Stricture in 2001 by his Urologist. He was on Tamsulosin and Darifenacin for a lot of years and was fine until Sept 2016, when he had pain in the entire penis shaft and part of his pelvis just above the penis. He rated the pain as 3/10. In Oct 2016, his PSA was 0.522 and the ultrasound of the kidney and abdomen was normal(with a normal prostate). His Urologist did a flexible cystoscopy and dilated his stricture and he had no pain until Dec 2017.

In Dec 2017, he had a penis pain of 3/10 and EColi infection in his urine. After antibiotics and repeat urine cultures, the urine was clear. An ultrasound of the kidney and abdomen in Jan 2018 was normal(with a normal prostate).. For the last three months, his penis pain has been 1/10 or 2/10 and his Urologist prescribed him some creams, which helped.For the last two days, his pain stayed at 2/10 and so went to see the Urologist again. The Urologist is doing a flexible cystoscopy on Monday, March 19. Several blood tests were done today. The following values were abnormal and they worry me a lot:

 

1)Prostate Specific Antigen(PSA): 11.22 (0-6.5)

2)Prothrombin PTE: specimen blood citrate - clotting assay - 14.2 (9.5-12.5)

3)Urine ph - 7.5 (Acidic)

 

Urine:

•Urine leucocytes: Present

•WBC pus cells: 10-15 (3-5)

•RBC - 2-4(0-1)

•Epithehleal - 1-2 (2-3)

•Remarks: Bacteria seen

 

He has no other symptoms. No pelvic pain or issues with urination. The urine stream is fine, no burning sensation or dibbling, change in skin color or discharge. His primary care physician does a physical every six months. The last physical was done a week ago and the tests of Complete Blood Count, Urine, Lipid Profille, HBA1C were all normal. He is 5 ft 3 inches in height, weighs 125 lbs, with a waist size of 36 inches. He walks twice a day and uses his exercise bike once daily. He is physically and socially active and eats a healthy vegetarian diet.

Questions:

1) In a span of 15 months, his PSA has jumped from 0.522 to 11.22? I am very worried as a 21 fold increase in his PSA over 15 months could be an aggressive form of prostate cancer? What are your thoughts?

2) What specific tests should be done to get further information? 3D MRI of prostate? DRE? Biopsy?

3) I will be talking to his Urologist on Monday after his cystoscopy. What questions should I ask him about his PSA of 11.22? 

 

Thank you,

Zent

Comments

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Try checking the veracity of the high PSA

    The diagnosis of prostate cancer is done with a biopsy. The PSA could be high due to other causes. In your shoes I would repeat the test at a reliable laboratory and consult an urologist if the value is confirmed.

    Hope for the best.

    VG  

  • jetski76
    jetski76 Member Posts: 13
    Thanks a lot for your reply,

    Thanks a lot for your reply, Vasco! I will talk to my father's urologist about doing a repeat PSA. I will update once I have more information.

     

    Regards,

    Zent

  • Grinder
    Grinder Member Posts: 487 Member
    edited March 2018 #4
    IMHO

    I think the implication is to find an independent lab that can do the test. Not that your urologist is undependable, but verification should come from a completely independent source from the original test.

    Your urologist is probably tied into referrals to a specific lab, and will be willing to repeat the PSA test again, but likely at the same lab.

    If it were me I'd find an independent lab not tied to the urologists clinic and have them keep scores confidential. You dont have to do this, it is just what i would do.

  • jetski76
    jetski76 Member Posts: 13
     

     

    That makes a lot of sense, Grinder! I will certainly consider that.  Thank you for the reply.

    Regards,

    Zent

     

  • jetski76
    jetski76 Member Posts: 13
    edited March 2018 #6
    Thanks, Old Salt! I will

    Thanks, Old Salt! I will check again.

     

    Regards,

    Zent

  • Old Salt
    Old Salt Member Posts: 1,277 Member
    Agree

    I agree with the points made so far (not that it matters much). And, IMHO, the first PSA test result (0.5) seems low for an 81-year old, unless different units were used. The usual one for PSA is ng/mL.