Hi Everyone...We're new at the prostate thing and I'm hoping someone else with some similar experience can help us understand what's going on...

My husband, 55, had his first PSA test in September. The reading was 8, so they asked him to return for another, and the reading on that was 6.5. Each time he had a digital rectal exam, which was totally normal. He has had no symptoms of prostate cancer.

After the 6.5 reading, his urologist did a biopsy (in October), which came back negative. He suggested that my husband have a PSA test every 3 months, just to be safe. He just had another one done, and the results this time were a PSA reading of 11...A digital rectal exam once again was normal and he continues to have no symptoms.

The urologist tells my husband that he is puzzled by these results and would normally suggest a biopsy with an 11 PSA. But since my husband just had a biopsy in October, the urologist thinks he should just wait and have another PSA done in April!!

We are wondering if one can be totally healthy and have a PSA of 11?? If so, why is it going up?? Could waiting until April cause a problem if this is something aggressive that just didn't show up in the October biopsy? Are these readings a precursor to eventual prostate cancer??

I am worrying myself crazy and would like some reassurance if anyone else has experienced something like this??

Thanks for your help!!

Hi randi
I am no medico,just an engineer looking for answers for myself and a group of others with similar problems.This the first time something quite like this has turned up in the very wide ranging research we have done.Perhaps ,because we have taken the elevated P.S.A. as a sure indication of trouble.
One possibility which bobs up is this.A biopsy will only show positive if it actually penetrates an area where there are cancer infected cells.What happens if the problem is in a small localised area that the biopsy did not touch,but where there is a very acute problem?
Seems to us that a series of SCANS carried out by a team with experience in this field would be a VERY good thing,...but yesterday if possible.
NEVILLE

NEVILLE--

Thanks so much for the quick response!! When you suggest a scan, do you mean an ultrasound?? I forgot to say in my initial message that the urologist did an ultrasound of my husband's prostate the same day he did the biopsy and said everything looked fine.(This was in October) The biopsy was done in either 6 or 8 different spots in the prostate as well...

Is there anything other than cancer or an inflammation of the prostate that can cause a high PSA level? In my limited research, that's all I've been able to find....Also saw something about a man should avoid sex for several days before a PSA test because that could cause a higher level....Can't remember if that could have been the case here.

Is there a chance that my husband just has a normally high PSA level and we just never knew it because he never had a test before age 55???

Thanks so much for your help!! (I won't be able to access my computer for several days next week, but will be looking forward to hearing any suggestions when I get back!)

Thanks for your info Randi. With regards to a biopsy of the prostrate, the Urologist that I went to said that they take the samples in predetermined areas. Past testing has indicated that these areas are the likely sites of cancer. I also wonder what if the cancer is so minute, or not in one of these predetermined spots! I will have another PSA test late in March and I will post the results.

Also an enlarged prostate can give higher reading but the way yours is going up and down would make me think of an infection or cancer. You should have a free PSA test done which could give you a better idea if they might have missed something on the biopsy.
I am a stage C prostate cancer survivor since I was 1993 when I turned 51 years old. I have done a lot of research since then.

[This message has been edited by moderator3 (edited 03-19-2001).]

Randi,
I facilitate a Man to Man prostate cancer awareness group. You might want to check to see if there is one in your area. The American Cancer Society can let you know.

A PSA of 11 should raise a red flag. The normal PSA for a 55 year old is below 4.0.
As for the DRE (digital rectal exam), the doc can only feel the bottom part of the prostate. Fortunately this is where most tumors are found, but there are times when the tumor is located in an area not reachable with a finger.
Just because a biopsy came back negative does not mean that there is no cancer. As one of the replies mentioned, If the doc doesn't snip where there is a tumor there can be no evidence of cancer. Ask that he take 12 samples next time, just to be sure. It is normal to take the biopsy during the ultrasound.
As an alternative, you might go to a different urologist. It doesn't mean yours is not good, but sometimes, a different doctor will find the cancer when another won't.
As for your husband's PSA being normal at 11, this is not possible. It could be from some other prostate problem though.
As for having sex within 48 hours of getting the PSA, it is a good idea not to do this.
There are no true symptoms for prostate cancer unless it is an advanced stage.
The symptoms that do occur could be from an enlarged prostate or cancer. They are: difficulty in urinating, frequent urination at night, a slow stream, pain in urinating.

I hope this helps you. I was diagnosed in 1997, had radiation & mine is back.

Brad

[This message has been edited by moderator1 (edited 07-06-2001).]

Randi,

I facilitate a Man to Man prostate cancer awareness group. You might want to check with the American Cancer Society to see if there is one anywhere near you. You can get many answers there in a face to face situation.

An 11 or 6.5 is not a normal PSA for a 55 year old man. The normal for this age is below 4.0.
If it were me I'd get another biopsy and this time would ask that the doctor take 12 samples. I might even try another doctor to do the biopsy. A PSA that high should raise a red flag.

When doing a digital exam, the doctor can only feel the lower part of the prostate. Fortunately most tumors grow in this area, but some grow in the upper area. This is one reason both the digital and the PSA are used to test for cancer.

Most prostate cancers are slow growing & so the need to treat quickly isn't as great as with some other cancers. The marker that determines how aggressive the cancer is is the Gleason Score. You only get this score once cancer has been officially found & it can only be truly found by a biopsy. One possible reason for the negative biopsy is that he missed clipping from where the cancer is, this is why I would opt for 12 samples instead of 6 or 8.

I'm not a doctor, but have researched the disease very thoroughly, as I was diagnosed in 1997. Our group is constantly checking on any new developments related to prostate cancer.
If I can be of further help let me know.

Brad

Randi:
I have posted results of my latest PSA test under the subject "PSA test".