I'm 43 had started having some problems urinating with lowerback pain. Doctor did rectal exam and felt something abnormal with prostate. Sent me for ultra sound of prostate and did PSA test. Was also put on Cipro (antibiotic) for 10 days which did not help symptoms. PSA Test level was 1.0. But ultra sound shows asymmetrical prostate. Left side of prostate is enlarged. Im now scheduled to go see urologist in the next few weeks. Anyone have any ideas. Could I have cancer even though PSA was low?
The American Urological Association (AUA) publishes a document online called the "Prostate-Specific Antigen Best Practice Statement: 2009 Update". You can easily find this with an online Google search. It is fairly easy to read, and would be an excellent reference document for your to understand prior to going to your urologist...I highly recommend it.
In very general terms, 4.0 ng/mL has been the widely accepted threshold for looking more closely for Prostate Cancer (PC). However, the PSA test is (simply put) "imperfect" and PC risk exists even at traditionally low PSA values. Some of the statistics are in the AUA document.
As you will read in the AUA document (or other sources you may be referencing), a biopsy is the only definitive way to tell if you have prostate cancer. (But even a biopsy, which pulls out small samples of tissue, might miss cancerous cells, which generally form together in a clump.) However, there are other tests which might be valuable before jumping to a biopsy. After reading and becoming familiar with the AUA document, I suggest learning about these 2 additional tests, and consider asking your urologist about them: the "free-PSA" test, and/or the PCA3 test. (Google these for more info.) Both tests are intended to more clearly indicate whether a biopsy is necessary & appropriate.
KCon -- I agree with everything you said, but I have never seen any evidence that free psa results are meaningful where total psa is below 2.5 -- so with a total psa of 1, I probably would not put a lot of stock in the free psa percentage.
Thanks, medved, you are right. In fact, I think it most often used in the "gray zone" between 4 and 10ng/mL.
Grendel, the flow diagram in the AUA PSA Best Practices document you downloaded says on page 10 says that men with "DRE abnormal/PSA low for age" should consider a biopsy. Nonetheless, you might still want to inquire about the PCA3 test with your doctor (after you read-up on it).
If I were in your shoes, I'd ask for a biopsy. You can read all the arguements about PSA tests, but as far as I know, the biopsy is the only way to really check (even though it is -possible- to still miss it).
That's just me.....I'm not a big fan of the whole 'watchful waiting' approach to prostate issues.