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    Old 01-22-2020, 12:49 PM   #1
    Pbriga41
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    Question Psa prostrate Levels

    New to this forum:
    My husband went to GP as usual and receive Ed psa of 1.6 in Oct 2019..He recommend a urologist due to his slightly low testosterone.He is 57. With 4 months..last week and blood test revealed psa at 3.62...We thought it was an error and repeated it and sure enough it was correct. Can psa go up 2 points in 4 months? He has a recital exam and Dr. Said all clear. Obviously he isn't and we encouraged a biopsy that will be done Feb 4. He has no symptoms but we know that isn't indicative of pda level and prostrate cancer
    His pda levels from urologist has always stayed the same over 10 years and now a 2 point jump. We are trying to be proactive with increase in numbers as Dr. Wanted to wait 6 weeks to redo blood test
    Any thoughts or experiences and can be be in early stag of prostrate cancer with no symptoms and jump in psa?
    Pmp

     
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    Old 01-22-2020, 04:44 PM   #2
    ASAdvocate
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by Pbriga41 View Post
    New to this forum:
    My husband went to GP as usual and receive Ed psa of 1.6 in Oct 2019..He recommend a urologist due to his slightly low testosterone.He is 57. With 4 months..last week and blood test revealed psa at 3.62...We thought it was an error and repeated it and sure enough it was correct. Can psa go up 2 points in 4 months? He has a recital exam and Dr. Said all clear. Obviously he isn't and we encouraged a biopsy that will be done Feb 4. He has no symptoms but we know that isn't indicative of pda level and prostrate cancer
    His pda levels from urologist has always stayed the same over 10 years and now a 2 point jump. We are trying to be proactive with increase in numbers as Dr. Wanted to wait 6 weeks to redo blood test
    Any thoughts or experiences and can be be in early stag of prostrate cancer with no symptoms and jump in psa?
    Pmp
    PSA can jump from benign enlargement, inflammation, or infection. It can easily go above 10 from any of those issues.

    About 65 percent of initial biopsies are negative. Try not to get too far ahead of what is known.
    __________________
    In Active Surveillance program at Johns Hopkins since July 2009.

    Six biopsies from 2009 to 2019. Three were were positive with 5% Gleason(3+3) found.

     
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    Old 01-22-2020, 04:45 PM   #3
    OrygunDan
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    Re: Psa prostrate Levels

    There are many reasons for a PSA test to temporarily read a little high, did he ride a bicycle or motorcycle or have sex during the preceding 3 days before the blood test? If so, then a retest in a few weeks is a good idea and it's too early to be thinking biopsy. There are risks to a biopsy and should not be rushed into until these other possibilities are considered.

     
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    Old 01-22-2020, 05:16 PM   #4
    DjinTonic
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    Re: Psa prostrate Levels

    My understanding is that the first step after any unexpectedly large PSA increase is a repeat test, to rule out lab error. Often sufficient blood is taken that a repeat test can be run simply by calling the lab and without having to go in for another blood draw.

    Djin
    __________________
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg. for PCa, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Nodule negative for PCa. Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX, G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Dry; ED OK with sildenafil
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
    uPSA: 0.010 (3 mo.)...0.013 (2 yr. 10 mo.)

     
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    Old 01-22-2020, 05:18 PM   #5
    Pbriga41
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    Re: Psa prostrate Levels

    Thank you....I am thinking ahead and have an experience with colon cancer..but trying to stay positive
    P

     
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    Old 01-22-2020, 06:18 PM   #6
    Pbriga41
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by OrygunDan View Post
    There are many reasons for a PSA test to temporarily read a little high, did he ride a bicycle or motorcycle or have sex during the preceding 3 days before the blood test? If so, then a retest in a few weeks is a good idea and it's too early to be thinking biopsy. There are risks to a biopsy and should not be rushed into until these other possibilities are considered.
    Can you give me what possible risks there are with biopsy? I know there are some effects after biopsy but I didn't think it was long lasting or permanent.. Again I am new to this site..sorry for all my questions

     
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    Old 01-22-2020, 07:29 PM   #7
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by Pbriga41 View Post
    Can you give me what possible risks there are with biopsy? I know there are some effects after biopsy but I didn't think it was long lasting or permanent.. Again I am new to this site..sorry for all my questions
    There some risks with trauma, infection, and even sepsis from trans-rectal prostate biopsies, which are still used by about 90 percent of urologists.

    Two of my six caused trauma and a tripling of my PSA, which lasted up to six months. The rate of infection has been rising, and about 6 percent result in hospitalization for sepsis. I just read a new study tonight, and those rates have been increasing, probably due to the resistance to antibiotics.

    Now, if a biopsy is indicated by PSA, DRE, MRI, etc., you really don't have a choice, as only a biopsy can extract cells for pathological examination. There are some patients who desperately avoid biopsies. IMHO, they are foolish, if other tests show the need.
    __________________
    In Active Surveillance program at Johns Hopkins since July 2009.

    Six biopsies from 2009 to 2019. Three were were positive with 5% Gleason(3+3) found.

     
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    Old 01-24-2020, 06:59 PM   #8
    OrygunDan
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    Re: Psa prostrate Levels

    ASAdvocate describes the risks very well. It is surgery and infection is a serious thing these days in a medical setting. A friend has to take an antibiotic daily for the rest of his life because of an super-infection he got from the hospital during surgery. At those PSA numbers it would be premature to me to undergo biopsy at this time. My best to both of you as you move forward.

     
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    Old 01-25-2020, 07:05 AM   #9
    Pbriga41
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by ASAdvocate View Post
    There some risks with trauma, infection, and even sepsis from trans-rectal prostate biopsies, which are still used by about 90 percent of urologists.

    Two of my six caused trauma and a tripling of my PSA, which lasted up to six months. The rate of infection has been rising, and about 6 percent result in hospitalization for sepsis. I just read a new study tonight, and those rates have been increasing, probably due to the resistance to antibiotics.

    Now, if a biopsy is indicated by PSA, DRE, MRI, etc., you really don't have a choice, as only a biopsy can extract cells for pathological examination. There are some patients who desperately avoid biopsies. IMHO, they are foolish, if other tests show the need.
    Went on Thursday for swap. Asked all questions regarding Dr. Percentage of sepsis .. He has had zero..swap taken and sent in for what type antibiotics will be used prior on and after biopsy. Spoke with nurse in length regarding psa and she would not give me any concrete answers who h I didn't expect but said one reason for jump in psa by 2 pts in 4 months ..may be an aggressive cancer..i faction or nothing g. If it is an aggressive cancer with level of 3.6 from 1.62..is the possible and would it be treatable and curable if caught early

     
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    Old 01-25-2020, 07:21 AM   #10
    DjinTonic
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by Pbriga41 View Post
    Went on Thursday for swap. Asked all questions regarding Dr. Percentage of sepsis .. He has had zero..swap taken and sent in for what type antibiotics will be used prior on and after biopsy. Spoke with nurse in length regarding psa and she would not give me any concrete answers who h I didn't expect but said one reason for jump in psa by 2 pts in 4 months ..may be an aggressive cancer..i faction or nothing g. If it is an aggressive cancer with level of 3.6 from 1.62..is the possible and would it be treatable and curable if caught early
    Hi Pbriga. We all know waiting is difficult, but learning and thinking about all the possible ramifications of a positive biopsy, treatments, and outcome statistics would likely keep you busy until well after the biopsy! Lots of info that won't be applicable.

    Just a word about aggressive cancers. They can be successfully treated, especially when diagnosed early. It's thought that prostate cancer is, like those old movie spectaculars "years in the making." Just as important as the nature of the cancer is whether it is presently confined to the prostate. If so, all the cancer can usually be treated by removing or irradiating the prostate. Some low-risk cancers do not need to be treated, and can be monitored by active surveillance. Men on AS have a better than 50-50 chance that they won't need treatment in their lifetimes.

    We're here for you both.

    Djin
    __________________
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg. for PCa, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Nodule negative for PCa. Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX, G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Dry; ED OK with sildenafil
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
    uPSA: 0.010 (3 mo.)...0.013 (2 yr. 10 mo.)

     
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    Old 01-25-2020, 08:05 AM   #11
    Pbriga41
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by DjinTonic View Post
    Hi Pbriga. We all know waiting is difficult, but learning and thinking about all the possible ramifications of a positive biopsy, treatments, and outcome statistics would likely keep you busy until well after the biopsy! Lots of info that won't be applicable.

    Just a word about aggressive cancers. They can be successfully treated, especially when diagnosed early. It's thought that prostate cancer is, like those old movie spectaculars "years in the making." Just as important as the nature of the cancer is whether it is presently confined to the prostate. If so, all the cancer can usually be treated by removing or irradiating the prostate. Some low-risk cancers do not need to be treated, and can be monitored by active surveillance. Men on AS have a better than 50-50 chancd that they won't need treatment in their lifetimes.

    We're here for you both.
    The wait I g is worse than diagnosis... How long have you had yours. What stage and prognosis is yours? If you dont mind me asking..your sge?
    Djin

     
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    Old 01-25-2020, 08:49 AM   #12
    Southsider170
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by Pbriga41 View Post
    Any thoughts or experiences and can be be in early stag of prostrate cancer with no symptoms and jump in psa?
    Pmp

    PSA scores aren't specific to prostate cancer, except for men who have already been treated for PC.

    Injury, trauma, infections (which may or may not cause symptoms) can all raise the PSA score.

    A sudden rise like your husband had in PSA should certainly have an eye kept on it, your being a little more proactive than most with your immediate move to a biopsy, but not that extreme.

    Early stages of prostate cancer are most usually asymptomatic, only DRE and PSA tests can give a doctor a clue as to when a biopsy might be required.

     
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    Old 01-25-2020, 11:24 AM   #13
    DjinTonic
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by Pbriga41 View Post
    The wait I g is worse than diagnosis... How long have you had yours. What stage and prognosis is yours? If you dont mind me asking..your sge?
    You can see the prostate-cancer "story" of Forum members who put their "signature" at the bottom of their posts. Since space is limited, there is often a fair amount of abbreviations, but as you read more signatures, you'll catch on quickly. As my sig. shows, I had my surgery on 8-7-17, about 5 weeks after my biopsy came back with the worst possible grade, a G10.

    Fortunately, it turned out that my cancer was entirely prostate-confined, my PSA levels afterward have been very low, and genomic testing of the removed prostate indicate that the propensity of any missed cancer cells to metastasized is theoretically fairly low.

    Like ALL men after treatment, I'll have to watch my PSA levels for years to come, but so far, so good. Thanks for asking.

    Djin
    __________________
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg. for PCa, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Nodule negative for PCa. Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX, G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Dry; ED OK with sildenafil
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
    uPSA: 0.010 (3 mo.)...0.013 (2 yr. 10 mo.)

     
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    Old 01-25-2020, 01:49 PM   #14
    Pbriga41
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by DjinTonic View Post
    You can see the prostate-cancer "story" of Forum members who put their "signature" at the bottom of their posts. Since space is limited, there is often a fair amount of abbreviations, but as you read more signatures, you'll catch on quickly. As my sig. shows, I had my surgery on 8-7-17, about 5 weeks after my biopsy came back with the worst possible grade, a G10.

    Fortunately, it turned out that my cancer was entirely prostate-confined, my PSA levels afterward have been very low, and genomic testing of the removed prostate indicate that the propensity of any missed cancer cells to metastasized is theoretically fairly low.

    Like ALL men after treatment, I'll have to watch my PSA levels for years to come, but so far, so good. Thanks for asking.

    Djin
    That is wonderful... I wish you continued success with this " monster" I am in the waiting game..very difficult .
    Esp after previous situation with cancer... Did you have symptoms prior to going in for pda test
    Pam

     
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    Old 01-26-2020, 04:31 AM   #15
    IADT3since2000
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    Re: Psa prostrate Levels

    Quote:
    Originally Posted by Pbriga41 View Post
    ...Did you have symptoms prior to going in for pda test
    Pam
    Hi Pam,

    I'm sure Djin will reply, but I had no symptoms prior to my first ever PSA came back 113.6 (soon confirmed, December 1999), with the DRE revealing a rock-hard prostate. Unfortunately, the vast majority of us do not have symptoms that sound an alarm for this disease; that is why screening with the PSA test is so important to signal that something (usually BPH, infection, or cancer) is going wrong in the prostate. I was diagnosed with life-threatening prostate cancer. I have worked hard against the cancer and have been lucky, now likely cured.

    You have had a lot of good replies. Obviously your husband needs medical attention, and we are not doctors here, but I suspect he probably has a short-term prostate infection that is driving his PSA up and not cancer.

    Good luck.

    Jim

    - - - - - - - - - - - - - - - - - - - - - - - -
    Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
    Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
    Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low at <0.01; apparently cured.. Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs.

     
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