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  • Causes of high total PSA other than aggressive cancer

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    Old 10-10-2021, 05:36 AM   #1
    Taylor C
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    Causes of high total PSA other than aggressive cancer

    Are there factors other than aggressive prostate cancer that could cause a total PSA level of 20?

    If so, how could these factors be diagnosed and treated (or not)?

    I'm 62 years old, and in very good health. No obesity, diabetes, heart conditions, etc.

    About 2 months ago my PSA was tested for the first time as part of my now yearly physical exam. The report showed a total PSA of 25.4. Upon a visit to a urologist a couple of weeks ago, PSA was tested again and returned a result of 19.8. I had an MRI done a dew days ago without and with contrast. My urologist is on a week long vacation right now so I won't know the MRI results until he returns.

    I know from the reading I've done that there are factors other than cancer that can cause high PSA levels in the blood but I have not been able to find information regarding how high the levels can go due to these factors.

    Thanks very much,
    Taylor C

     
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    Old 10-10-2021, 12:16 PM   #2
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    Re: Causes of high total PSA other than aggressive cancer

    Benign prostate hyperplasia, inflammation, bacterial prostatitis, chronic non bacterial prostatitis all can cause elevated PSA.

    Generally, PSA from prostate cancer is a steady rise, whereas PSA from benign causes will fluctuate. Your fluctuation is a good sign.

     
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    Taylor C (10-11-2021)
    Old 10-11-2021, 12:45 AM   #3
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    Re: Causes of high total PSA other than aggressive cancer

    Either way, not a good sign. A steady rise may be occurring among fluctuations indicating both cancer and inflammation from other causes.

     
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    Old 10-11-2021, 06:28 AM   #4
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    Re: Causes of high total PSA other than aggressive cancer

    Quote:
    Originally Posted by Prostatefree View Post
    Either way, not a good sign. A steady rise may be occurring among fluctuations indicating both cancer and inflammation from other causes.
    You are assuming a worst case scenario that, while possible, is not supported by the two data points he provided. Certainly, he needs to keep following up his consultations and tests.
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    Old 10-11-2021, 07:34 AM   #5
    Taylor C
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    Re: Causes of high total PSA other than aggressive cancer

    I greatly appreciate the responses I have received thus far to my thread. I do want to hear the good, the bad and the ugly.

    I was hoping that someone here could tell me if a total psa of 20 could be completely due to perhaps a combination of factors that DO NOT include cancer. Possibly everyone here has had a bout with cancer so might not know the answer to that question.

    I assume that my urologist is going to recommend a biopsy regardless not just out of concern for me but also to protect himself from potential litigation if he doesn't recommend the biopsy and it turns out that I do in fact have cancer. However, I'd like to eliminate all other possible causes of a psa that high before I submit to the biopsy because I'm well aware of the potential complications from that procedure. Obviously, I'd like to avoid those complications if possible.

    I've been familiarizing myself with prostate issues, their causes and treatment options, having read hundreds of pages from the web. I do however realize I've barely scratched the surface as it's an extremely information dense subject.

    Thanks very much,
    Taylor C

     
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    Old 10-11-2021, 07:45 AM   #6
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    Re: Causes of high total PSA other than aggressive cancer

    Those are very high numbers. I appreciate cheerleading and a positive attitude, but those are very high numbers. 25 is a high spike above normal. Not likely, imo. Did I say those were very high numbers?

    Normal for his age, depending on ethnicity is <1.0 to 3.0. Good news if it returns back to those numbers. I doubt it.

    Lack of data in this situation is not a call for positive thinking, imo. It's a call to get real. My interpretation is he's hovering around 20 and 25 was the spike. That's the best news I see without more PSA test data.

    The biggest clue is the lack of PSA sceeening at this age. It implies poor healthcare/mindset. Time to get real.

    Finally if someone else comes here reading these posts seeking to confirm their bias, a denier will take your comment and make it work for them. Not helpful, imo.

    Postive thinking will not cure cancer. The best plan forward, imo, he has cancer until it can be ruled out.
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    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2
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    7-9-21 PSA less than 0.02; zero club 5yrs

     
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    Old 10-11-2021, 08:27 AM   #7
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    Re: Causes of high total PSA other than aggressive cancer

    PF - He will be following up with his urologist to review his MRI results. I was aware of that, so I fail to see how you can dismiss my input as "not helpful"?

    Except, you have been doing that with me for years.

    Won't change...we go on.
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    Old 10-11-2021, 09:24 AM   #8
    Taylor C
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    Re: Causes of high total PSA other than aggressive cancer

    I agree that wishful thinking won't cure cancer. I accept that I may indeed have cancer. I simply want to rule out other potential causes of those high psa levels before I submit to having the biopsy.
    It makes perfect sense to me.

     
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    Old 10-12-2021, 11:28 AM   #9
    Hiker2020
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    Re: Causes of high total PSA other than aggressive cancer

    My PSA level steadily increased with a few minor decreases for a number of years. It was similar to yours mostly in the high teens and low 20's (see signature below). During this time I was under Active Surveillance by my Urologist with fairly frequent PSA tests and an annual biopsy. During this time my symptoms did not get worse. My biopsy results showed cancer with a Gleason score of 3+3, which baring other symptoms put me on the verge of treatment. Without the biopsy I would not have known it was cancer but with the consistently high PSA levels I knew something was going on and it wasn't going to get better (PSA was not going down). I chose treatment (radiation) because the Gleason scores showed a 'low' level of cancer that had not spread. After years of Active Surveillance I decided on early treatment even though not warranted by symptoms rather than waiting for the cancer to envelop more of the prostate and potentially escape outside of it.

    I am not sure what treatments (antibiotics?) a Urologist will recommend to identify or treat non-cancerous causes for your high PSA but I do know that a biopsy is the definitive standard for establishing the presence of prostate cancer. As far as biopsies go, they are uncomfortable but the pain is of short duration and from my perspective the risk is low when compared against the risk of prostate cancer spreading. In addition, the MRI results will identify any 'suspicious' areas or absence of such areas that will help you make a decision on a biopsy. Please let us know the results of the discussion with your Urologist.
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    Biopsy results: 10/17-Gleason 3+3=6- Group 1; 11/18-Gleason 3+3=6- Group 1; 11/19-Gleason 3+3=6- Group 1 Increases in PSA even with no change in biopsy results indicated the need to begin treatment. Decided on IMRT.
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    Radiation treatment began 9/15 and ended 11/06: 39 sessions at 200cGY per session
    Side effects of radiation general fatigue and painful frequent urination treated successfully with Flomax. Stopped using Flomax after 2 months due to it causing a severe dry cough. A cough is a listed side effect. Switched to saw palmetto with no decrease in effectiveness. All in all not a bad marathon to run.

    Last edited by Hiker2020; 10-12-2021 at 12:03 PM. Reason: clarification

     
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