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  • Fast Rising PSA

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    Old 09-12-2019, 03:12 PM   #1
    PPAMAN
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    Fast Rising PSA

    69 years old
    9/16 psa 4.5 free psa 27%
    9/17 psa 4.9 29%
    9/18 psa 5.2 27%
    2/19 psa 6.0 30%
    9/19 psa 7.2 25%

    A 38% increase in one year and its been pretty much linear. I have BPH and all normal DREs although the last one was done a year ago. I was told my prostate size was 40cc 3 years ago but I read that doctors tend to underestimate size from a DRE. I have no symptoms of prostatitis other than the urinary symptoms of BPH. I have had LUTS for about 5 years now and no other progressive symptoms more specific to cancer like bone pains, swollen lymph nodes, etc. Whats the likelihood of the 2.0 increase in psa over the last year being caused by something other than cancer? I dont think BPH would cause it. Whats more significant the 25% free psa level or the 2.0 velocity in the past 12 months? These 2 readings conflict with each other. Thanks for any input.

     
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    Old 09-13-2019, 08:11 AM   #2
    mikeyb333
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    Re: Fast Rising PSA

    Hi there,
    I have BPH but mine is 120cc which is said to be quite large.
    My consultant told me that my PSA could be as high as 10 due to the size of the prostrate, but as I say, mine is 120cc.

    My PSA is 5.6 now, but as been as high as 9.8.
    I could well have PC but it hasn't been found yet.

    I have also had bone pain and I was thinking it could be Agreesive PC but apparently I only have athritis of the hip and back (strange I know)

    So it could be that your prostrate is growing and your PSA is rising accordingly, but of course, you should get expert opinion on that!

     
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    Old 09-13-2019, 10:15 AM   #3
    IADT3since2000
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    Re: Fast Rising PSA

    Hi PPAMAN and welcome to the Board!

    Are you already seeing a urologist, perhaps for the BPH and the LUTS (Lower Urinary Tract Symptoms)? The information you have provided warrants further workup to lower the risk of undue delay in treating the kind of prostate cancer that needs treatment, but Iím suspecting the workup will suggest a combination of BPH and infection as responsible for that elevated and increasing PSA.

    While not conclusive, free PSA results as strong and steady as yours are a good indication that you do not have cancer. In fact, free-PSA can be decreased in the presence of infection, and even that is not in evidence. The value of free-PSA is mushy when it is near or in the teens, but your levels are usually in the range of pretty reliable indicators of no cancer, as I understand it as a layman.

    Iím thinking your elevated PSA reflects a continued benign growth. A prostate of 70 cc in size would account for the PSA level you are now seeing, as would a combination of some lesser growth plus a mild infection, and an increase in size to 70 cc from the previous estimated level, over three years and at your age, would not be uncommon. (Are you doing anything for the BPH and LUTS?) These days, a multiparametric MRI scan is often done to see whether a biopsy would be wise. There are also additional tests that can be done to give clues about the likelihood of prostate cancer and need for a biopsy.

    The bottom line is that your concern can probably be low, but not enough to let your guard completely down and neglect further investigation. Sometimes, even with favorable clues, the dangerous types of prostate cancer can be stealthy and pass under the early warning radars. On the very good side, survival of most prostate cancer cases is outstanding, the best of any major cancer, and we now know that men with mild prostate cancer can do "active surveillance", hopefully deferring treatment forever.

    Good luck!

     
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    Old 09-13-2019, 02:52 PM   #4
    PPAMAN
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    Re: Fast Rising PSA

    Thank you IADT3 since 2000 for your response. I respect your opinion and its good to get the viewpoint of a layman that has experienced prostate cancer. I have been seeing a urologist for 3 years and I have an annual appointment on 9/23. We have taken a conservative approach in the past because of the slow rise in psa and the high free psa numbers. However, the 2.0 increase in the past year changes things, at least in my opinion. I have been taking tamsulosin for LUTS for 3 years. My line of thinking has been that since I have had LUTS for 5 years and no additional symptoms of cancer that the BPH is causing the symptoms. It is my understanding that most of the time urinary symptoms don't show up until the cancer is advanced, in which case I would be in pretty bad shape 5 years later, which is not the case. Of course I could be wrong since this is such a confounding disease. The Urologist has suggested getting an MRI and that will happen soon. No biopsy thus far. Thanks again.

     
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