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Old 07-01-2010, 08:21 AM   #1
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Worried - PSA Levels

Iím a 44 year old male and overall in good health. I see my primary care doctor every year for a physical and in Feb 2010 my PSA level was 1.4 (thatís down from 1.5 in 2009)

I just recently switched primary care doctors and went ahead and had another physical completed to establish some benchmarks with him. My PSA level rose from 1.4 in February to 4.9 in June (4 months later)
Heís doing some additional bloodwork to check the PSA againÖ.he did mention an infection can cause the levels to rise quickly.

Is it likely that I have a problem (ie..cancer) given the rapid rise in the PSA or is this more likely a result of infection?

I am a worry wart by nature and this has me very concerned.....any experience regarding this would be appreciated greatly.

 
Old 07-01-2010, 08:28 AM   #2
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Re: Worried - PSA Levels

Likely that you have an infection, and unlikely that you have prostate cancer. Prostate infections can cause rapid swings in PSA, but the vast majority of prostate cancer cases cause a slow, continual rise.

hope this helps...

 
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Old 07-02-2010, 09:43 AM   #3
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Re: Worried - PSA Levels

Additional comments regarding the very rapid rise in PSA...

PSA testing can raise a "red flag" for you to look into what's going on, but it is not "specific" to prostate cancer...that means that other things can cause one's PSA level to rise, and elevated PSA does not specifically mean one has prostate cancer. It turns out that prostate infection or non-cancerous BPH are the most common causes of elevated PSA; not prostate cancer (according to the AUA).

The extremely rapid rise in your PSA could mean that you have an very rare case of extraordinarily aggressive prostate cancer...but it probably doesn't. It still seems more likely to be caused by infection.

Prostate cancer is only diagnosed through a biopsy; the PSA test only raises a flag for further investigation. However, before jumping to a perhaps needless biopsy, the American Urological Association recommends eliminating other possible non-cancerous causes first. The AUA's "Prostate-Specific Antigen Best Practice Statement: 2009 Update" suggests that the "Free PSA Test" also be used to help reduce the number of needless biopsies. [Prostate biopsies, in case you are unfamiliar with them, are somewhat costly and uncomfortable.]

PSA exists in two forms--free and bound; together they make-up the total PSA (which was measured in your PSA test). Benign prostate has a higher percentage of free PSA. The "Free PSA Test" measures the percent of free PSA in your total PSA.

Prostate infections can be hard to identify and treat, but hopefully this is your urologist's first course of action...to try first to identify or eliminate non-cancerous causes of high PSA. A follow-up PSA test seems in order...if your results go both up and down, then you know that something besides cancer is involved because cancer would only drive it up (not down, too). You may also discuss the merits of a "Free PSA Test" with your doctor as another way to minimize the likelihood of PC.

best regards

 
Old 07-02-2010, 05:43 PM   #4
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Re: Worried - PSA Levels

It's a worrying time for you, but if it is the worst case scenario and prostate cancer is diagnosed, it would appear to be caught early. The prognosis for 5 year survival rates when caught early is close to a 100% success rate. I was delighted to read and hear that. Caught early usually means a PSA level of under 10, a a Gleason score of 6 or less and a normal DRE. (Digital rectal examination).

As Kcon says, pc normally will increase the PSA levels, not have them going up and down. My husbands PSA levels were something like 5.4, then 7.3 a year later, and finally 9.75. I think his GP let him down by not acting upon the 7.3 level.

Go to the library and get some books to read on the subject. Remember knowledge empowers you. There are several things that can push those PSA levels up, such as an enlarged prostate, or prostatitis which is the infection you refer to. Both of these are picked up in a biopsy, along with any sign of cancer. I also read in several books, that sexual trauma, which simply means sexual activity, can push PSA levels up if intercourse has taken place 24 - 48 hours before your blood test. So there are a lot of other things that could be creating your raised PSA.

Hold onto the positive, but work with your Dr to get a diagnosis. It might simply be a matter of treating the infection. If you do need a biopsy, while it wasn't me that had it done, my husband was very nervous, and said it was almost a non event - over and done with in 15 minutes, and quite bearable.

Good luck, and you'lll find many great people here to help you regardless of what the result is.

Jude

 
Old 07-03-2010, 10:16 AM   #5
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Re: Worried - PSA Levels

I once read that riding a bike before getting a PSA test can raise your PSA level. Why that would be I'm not sure. It might have something to do with those narrow seats putting a lot of pressure in one spot and restricting blood flow.

 
Old 07-22-2010, 07:09 AM   #6
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Re: Worried - PSA Levels

I just received my latest PSA results and they are back up to 4.3. To refresh your memory I was at 1.4 just four months ago (went to 4.9 in four months ---- down to 3.6 and now back up to 4.3).

I'm sure my GP is going to send me to a urologist but is this still indicative of an infection (going up and down like this?)+

 
Old 07-22-2010, 07:45 AM   #7
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Re: Worried - PSA Levels

Quote:
Originally Posted by broderbund View Post
I just received my latest PSA results and they are back up to 4.3. To refresh your memory I was at 1.4 just four months ago (went to 4.9 in four months ---- down to 3.6 and now back up to 4.3).

I'm sure my GP is going to send me to a urologist but is this still indicative of an infection (going up and down like this?)+

Yes. Remember what I wrote back in posting #3, below:
Prostate infections can be hard to identify and treat, but hopefully this is your urologist's first course of action...to try first to identify or eliminate non-cancerous causes of high PSA. A follow-up PSA test seems in order...if your results go both up and down, then you know that something besides cancer is involved because cancer would only drive it up (not down, too). You may also discuss the merits of a "Free PSA Test" with your doctor as another way to minimize the likelihood of PC.

What did your doctor say about doing the "free PSA" test?



Added note: infection or BPH and prostate cancer can co-exist; but the up-and-down portion is not PC.

Last edited by kcon; 07-22-2010 at 07:53 AM. Reason: added the "Added note..."

 
Old 07-22-2010, 08:03 AM   #8
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Re: Worried - PSA Levels

Still waiting to hear back from my GP (faxed him the results)

I appreciate the encouraging words........I'm sure they'll try antiobiotics next ----- I just dread the thought of having to go through the biopsy route if that is not successful.

 
Old 07-23-2010, 11:18 AM   #9
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Re: Worried - PSA Levels

Ok...spoke with my urologist (family friend) on the phone. He's going to prescribe a coupld weeks supply of antibiotic (assuming it's Cipro) and I'm going to go see him in a few weeks to check the PSA again.

I've read conflicting things about the effectiveness of antibiotics on chronic prostate inflammation (certainly hoping it works for me!). Any thoughts on how effective this will be if indeed this is just a case of inflammation?

 
Old 07-23-2010, 01:03 PM   #10
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Re: Worried - PSA Levels

Quote:
Originally Posted by broderbund View Post
Any thoughts on how effective this will be if indeed this is just a case of inflammation?

Yes...the thought is that some cases are easily treated by Cipro, and others are not and may need other medication. Sorry, but neither I nor you doctor could offer any more at this point.

 
Old 08-05-2010, 06:47 AM   #11
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Re: Worried - PSA Levels

All -

Just recieved my psa results after roughly 10 days on Cipro......taking it for the full 14 days but couldn't wait to see if it was going down so went and had my own labs done.

My psa has fallen to 3.6 (it was at 1.4 four months ago, then went to 4.9) Two weeks later it was at 3.6 and then 4.3 two weeks after that without any medication). As a reminder I'm 44 with no family history.

While I'm hoping it may still fall further still before my urologist appt on Monday I really want to do the biopsy as my last option. I've spoken to two friends of mine who are urologists and both of them feel this almost certainly an infection given the huge initial rise (1.4 - 4.9 in only 4 months).

Fairly certain they will do a free psa test on me next week....assuming that comes back ok do you think I still should have a biopsy or perhaps continue the medication, ask for a different antiobiotic, etc.

 
Old 08-05-2010, 07:13 AM   #12
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Re: Worried - PSA Levels

Quote:
Originally Posted by broderbund View Post
...do you think I still should have a biopsy or perhaps continue the medication, ask for a different antiobiotic, etc.

Unless you are also a board certified urologist, I would wait until meeting with your doctor on Monday and discuss all options with him/her...


Generally, you and he both seem to be on a solid path of eliminating possible non-cancerous causes of elevated PSA first. This is also what the American Urological Association advises in the free online document "Prostate Specific Antigen Best Practice Statement: 2009 Update."

relax...

Last edited by kcon; 08-05-2010 at 07:20 AM.

 
Old 08-15-2010, 12:28 PM   #13
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Re: Worried - PSA Levels

Quote:
Originally Posted by JohnR41 View Post
I once read that riding a bike before getting a PSA test can raise your PSA level. Why that would be I'm not sure. It might have something to do with those narrow seats putting a lot of pressure in one spot and restricting blood flow.
This article may helP:


J Urol. 1996 Jul;156(1):103-5.

The effect of bicycle riding on serum prostate specific antigen levels.
Crawford ED 3rd, Mackenzie SH, Safford HR, Capriola M.

Department of Urology, Presbyterian St. Luke's Hospital, Denver, Colorado, USA.

PURPOSE: We determined if bicycle riding causes an increase in prostate specific antigen (PSA) levels. MATERIALS AND METHODS: Baseline PSA levels were measured from all 260 volunteers before a 250-mile bicycle ride. After this 4-day race PSA was again measured and this level was compared to the pre-race levels. RESULTS: The overall change from baseline to post-race PSA in all 260 men was 0.069 ng./ml. The change for the 256 men with normal baseline PSA (0.0 to 4.0 ng./ml.) was 0.044 ng./ml. The 4 men with an already elevated PSA (more than 4.0 ng./ml.) showed a large change of 1.65 ng./ml. CONCLUSIONS: There is no statistically or clinically significant increase in PSA after bicycle riding. However, the few participants with an initially elevated PSA had an increase after bicycle riding, although this change does not represent the population and more research is warranted to define further its clinical implications.

 
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