I am 56 and due to Type II diabetes, have a blood test every 6 months. I also have a PSA test once each year. My test on 6/99 results were 1.7 mg/ml, similar to previous tests. Results for 9/00 were elevated, 13.8mg/ml and I was refered to a Urologist. He told me that due to the higher number of the PSA test, an additional test was done, I forget the type, and the results advised an immediate biopsy of the prostrate. This was done and the results were no cancer found. He cited various reasons why the PSA would be higher but none seemed to fit me. I am now to have a PSA test every 6 months for two years. Anyone have any thoughts about this? Thanks!!!

Hi Ewilliam --

I don't know if you read my previous posting on the board, but my husband is in about the same situation you are in and we're trying to find answers as well.

You said in your posting that your doctor gave a number of reasons for a high psa level, but none seemed to fit you....Can you tell me what those reasons were so that I can see if any might apply to my husband?? We're at a loss for an explanation as well...Thanks so much and good luck!!

Randi -

The two reasons that I remember are infection and increased sexual activity. Hitest showed no infection and sexual activity has been the same for last ten years.

Hi Ewilliam--

Sorry it took me so long to respond, but we've been spending our recent "worry alottment" on my mother-in-law who has had surgery....

But prior to her surgery, I went out and bought a bunch of books on prostate-related stuff and have been reading about the psa test...

Apparently it is a very controversial test and doctors have mixed feelings about it...all agree that it should only be used in conjunction with the other tests (digital exam, ultrasound and biopsy) for it to mean anything...These books say that doctors still are unsure of exactly what the psa results tell them....Usually, if a man has prostate cancer, his psa level is high. But not all men with high levels have cancer. (As I'm sure you know, 0-4 is good; 5-10 is borderline; above 10 is something to worry about.) HOWEVER, these books say that of the men whose psa level is above 10, only 65 percent are found to have prostate cancer! Often, they can find no reason that the other 35 percent have high levels.

These books mentioned infection as one reason for the high reading. But they also said that if you have sex up to 10 days before your test, it can show an elevated reading. Also, any "trauma" such as the digital rectal exam just before the test and a previous biopsy of the prostate can make you have elevated readings...The books didn't say how much time has to pass between the biopsy and the next psa test for the reading to be accurate...My husband's negative biopsy was in late October and his next psa test was in January, so that seems like enough time for it to heal completely, but who knows?? Also, I've heard that bike riding can affect the psa reading (my husband and I both bike a lot.)

What scared me from my readings was that both ultrasound and biopsies can miss prostate cancer in some cases...And the fact that my husband's psa level went from 6 to 11 between October and January worries me (Although it was 8 the first time he had the test)....The doctor has him scheduled for another psa test in early April, but I'm wondering if that's waiting too long?? What do you think???

I have now had my 6 month PSA test as recommended by my Urologist. The result is a reading of 2.13, considerably lower than my last test. This lower number pleases me greatly. I will continue to have this test done every 6 mths for the next 1 1/2 yrs as requested by the Urologist.

The other test that was done mentioned in my original posting was a fre PSA and the result of that was 7%.

[This message has been edited by ewilliam (edited 03-27-2001).]

Randi & EWilliam,
One thing about PSA's that is important: always have them done at the same lab. Different labs come up with different results.

Randi, the controversy about PSA & doctors is more about whether men ought to have the PSA done or not. The test has only been around since 1993. It is one of the best markers we have for determining the possibility of cancer. When it is abnormal most urologists will recommend that the person have an ultrasound and biopsy. The biopsy is the only way to absolutely verify that a person has prostate cancer. You are right, Randi, in that biopsies can miss the cancer. One way to possibly overcome this is to have 12 done instead of the normal 6. (12 samples instead of 6 samples).

April will not be too far away to have another PSA or biopsy. PCa is slow growing enough that decisions don't have to be made immediately, like with some other cancers. I have recurrent PCa and went 22 months before starting treatment. The reason being that I felt good, we were tracking the growth and it was slow and if I'd started treatment earlier it would have meant a diminished quality of life because of the side effects. Try not to worry too much. For the people who catch their PCa early it is not a death sentence. It is one of the most cureable & if not cureable, controlable cancers going.

Doctors have now found that having sex within 48 hours of having a PSA doesn't raise the PSA enough to cause any concern. I believe the normal amount it might raise it is about .13

Remember that the PSA, and digital exam are merely tests that might indicate cancer, but the only was to be sure is via a biopsy.

I would be glad to help either of you in any way possible. I have 4 years of dealing with it and researching all angles of it.

Brad