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    Old 12-17-2008, 12:40 PM   #1
    eddief1
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    psa numbers

    can a moderate enlarged prostate cause psa number to be as high as 3.2

     
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    Old 12-17-2008, 01:04 PM   #2
    daff
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    Re: psa numbers

    The PSA figure you mention may or may not be "high". Depends on your age and the trend/doubling time. The prostate often gets enlarged as we age, and an infection is something that can cause PSA readings to increase. If you provide you age and any trend from past PSA tests (when taken), there might be a little more info to give you.

     
    Old 12-17-2008, 02:16 PM   #3
    eddief1
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    Re: psa numbers

    my psa 9 months ago was 2.5 with a free psa of 32% now it is 3.2 with a free psa of
    29% dr urolygist said it was moderately enlarged i am 63 years old

     
    Old 12-17-2008, 02:59 PM   #4
    daff
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    Re: psa numbers

    Quote:
    Originally Posted by eddief1 View Post
    my psa 9 months ago was 2.5 with a free psa of 32% now it is 3.2 with a free psa of
    29% dr urolygist said it was moderately enlarged i am 63 years old
    The high free PSA percentage is a good thing-- and your overall PSA is in range for your age. My doctor got concerned when, at about your age, my PSA went from 2.9 to 3.9. He advised me to get another test three months later, which came in at 4.2. I then got a biopsy to learn that I did test positive for prostate cancer.

    If your doctor performs a DRE prior to your blood test for PSA, that stimulation can cause the PSA level to be higher than it normally would be. Also, sexual activity or bicycle riding within three days or so of the PSA test can also cause the level to be higher.

    It doesn't sound as if your doctor is overly concerned, but if you are, just getting PSA tests as often as every three months wouldn't be a bad thing.

     
    Old 12-19-2008, 07:48 PM   #5
    snuggles071
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    Re: psa numbers

    my husbands psa is 5.9 his dr wants him to see a urologist what does this mean.he is 57.am worried becky

     
    Old 12-20-2008, 04:53 AM   #6
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    Re: psa numbers

    Quote:
    Originally Posted by snuggles071 View Post
    my husbands psa is 5.9 his dr wants him to see a urologist what does this mean.he is 57.am worried becky
    It's always possible that the elevated PSA is being caused by an infection in the prostate. He may be a good candidate for a biopsy at this time. Do you know what the trend of his PSA has been annually? Or if there's a free PSA figure (expressed in a percentage) that the doctor also provided. If you want to learn more about all this, it's not a bad time to read at least the first couple chapters of a book such as the recent one by Dr. Patrick Walsh-- guide to surviving prostate cancer. It's certainly too soon to jump to any conclusion one way or the other, but it's not a bad idea to understand more so you'll be able to communicate with the urologist better.

     
    Old 12-24-2008, 11:04 AM   #7
    eddief1
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    Re: psa numbers

    Quote:
    Originally Posted by daff View Post
    The high free PSA percentage is a good thing-- and your overall PSA is in range for your age. My doctor got concerned when, at about your age, my PSA went from 2.9 to 3.9. He advised me to get another test three months later, which came in at 4.2. I then got a biopsy to learn that I did test positive for prostate cancer.

    If your doctor performs a DRE prior to your blood test for PSA, that stimulation can cause the PSA level to be higher than it normally would be. Also, sexual activity or bicycle riding within three days or so of the PSA test can also cause the level to be higher.

    It doesn't sound as if your doctor is overly concerned, but if you are, just getting PSA tests as often as every three months wouldn't be a bad thing.

     
    Old 12-24-2008, 11:08 AM   #8
    eddief1
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    Re: psa numbers

    if i understand a psa that goes from 2.3 to 2.9 to 3.2 in 15 months and the free psa is 30% the free psa doesent mean anything right?

     
    Old 12-24-2008, 11:28 AM   #9
    daff
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    Re: psa numbers

    Quote:
    Originally Posted by eddief1 View Post
    if i understand a psa that goes from 2.3 to 2.9 to 3.2 in 15 months and the free psa is 30% the free psa doesent mean anything right?
    It does mean something- and is a good thing. I just looked at the lab report on me just before I got my biopsy, which was 4.2 along with a free PSA of 21%.

    There was a table printed on the report which gave probabilities of my having prostate cancer based on my age, PSA, and free PSA. For PSA of between 4 and 10, with a free PSA of 20% to 25%, the probability of my having prostate cancer was shown to be 16%. (Of course I was in that 16% group so that's one time a longshot coming in was not a good thing.)

    The figure next to a % free PSA of greater than 25% said the odds were only 8%. Looking at you, with a high free PSA and overall PSA less than 4, the probability is likely even lower. So maybe this type of information is what your doctor is basing his evaluation on? Seems to me that you'll just need to get frequent PSA tests and hopefully the results won't change all that much.

     
    Old 12-24-2008, 11:40 AM   #10
    IADT3since2000
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    Re: psa numbers

    Quote:
    Originally Posted by eddief1 View Post
    if i understand a psa that goes from 2.3 to 2.9 to 3.2 in 15 months and the free psa is 30% the free psa doesent mean anything right?
    Hi Eddie,

    No, on the contrary, as daff has been posting, a free PSA of 30% is a very good thing in your circumstances!

    A free PSA that high suggests fairly strongly (but does not guarantee) that there is no significant prostate cancer. Daff has already explained this well, but sometimes it helps to hear it from others also, so I'll echo his point that your PSA is not bad at all for a man of 63 as it is likely that some enlargement of the prostate is producing extra PSA. Ideally, a man from 60 to 69 would have a PSA of just 1.4 (per expert Dr. William Catalona), but that counts on no benign enlargement of the prostate or cancer or infection. Since you already have some enlargement, it's pretty reasonable that the enlargement is what has boosted your PSA above the average (median) of 1.4.

    Sorry, but it looks like we will not be able to admit you to our club of prostate cancer survivors.

    That said, it would certainly be wise to continue keeping an eye on the PSA; that 15 month rise would be a key concern if you did not have that evidence of enlargement and that fine free PSA number. It's possible there is some cancer, but as a savvy layman veteran of this disease, I think that's unlikely, and if it is there, it is probably very small and non-aggressive. Tests like the free PSA and our vastly improved understanding of the disease are now paying huge dividends for many men and their families, like you.

    If you are still concerned, the PCA3Plus test would provide additional information about the likelihood of prostaste cancer. You might also want to check on what's been posted about the mild drugs finasteride and Avodart, as well as about diet, nutrition, supplements, exercise and stress reduction to help prevent prostate cancer.

    Please don't hesitate if you have followup questions.

    Take care,

    Jim

     
    Old 12-24-2008, 11:50 AM   #11
    IADT3since2000
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    Re: psa numbers

    Quote:
    Originally Posted by daff View Post
    ... I just looked at the lab report on me just before I got my biopsy, which was 4.2 along with a free PSA of 21%.

    There was a table printed on the report which gave probabilities of my having prostate cancer based on my age, PSA, and free PSA. For PSA of between 4 and 10, with a free PSA of 20% to 25%, the probability of my having prostate cancer was shown to be 16%. (Of course I was in that 16% group so that's one time a longshot coming in was not a good thing.)

    The figure next to a % free PSA of greater than 25% said the odds were only 8%. ...
    Hi Daff,

    Looks like we were both reading from the same sheet of music at about the same time. Eddie should be reassured.

    Thanks for providing those odds numbers for the free PSA test. I knew that 30% was a really good number, but I had never seen an explanation with odds by the numbers 20% to 25% and greater than 25%. That's good to know!

    Now if we could just get the same kind of information for the PCA3Plus test!

    Jim

     
    Old 12-24-2008, 12:30 PM   #12
    daff
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    Re: psa numbers

    Quote:
    Originally Posted by IADT3since2000 View Post
    Thanks for providing those odds numbers for the free PSA test. I knew that 30% was a really good number, but I had never seen an explanation with odds by the numbers 20% to 25% and greater than 25%.
    Jim-
    Just so you can get the full picture, I'll supply the rest of the figures on that table I was referring to. Again, this is where the DRE doesn't point to something suspicious for prostate cancer and a PSA of 4-10:

    % free psa/ prob of prostate cancer
    0-10% / 56%
    10-15% / 28%
    15-20% / 20%
    20-25% / 16%
    >25% / 8%

    The above does not break down the age groups- just says men over 50 years old. I probably should have used the second table in my lab report instead. As one might expect, the odds of having prostate cancer are higher for the 65 to 75 yr old group. So-- figures for the five categories I showed above, starting with 0-10% free psa show the odds of having prostate cancer for the 50-64 yr old group are 56%, 24%, 17%, 10%, and 5%.

    For the 65-75 yr old group: 55%, 35%, 23%, 20%, and 9%.

    Have I confused things too much? I don't really know where these
    data came from either-- no notes on the report.

     
    Old 12-27-2008, 06:21 PM   #13
    eddief1
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    Re: psa numbers

    I seen on a post were you said not having a enlarged prostate meant if you
    had pc it would be a1 because of a normal prostate. for
    iadt2000

    Last edited by eddief1; 12-29-2008 at 11:21 AM.

     
    Old 12-27-2008, 06:23 PM   #14
    eddief1
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    Re: psa numbers

    I seen on a post were you said not having a enlarged prostate meant if you
    had pc it would be a1 because of a normal prostate. for iadt

    Last edited by eddief1; 12-27-2008 at 06:28 PM.

     
    Old 12-27-2008, 06:27 PM   #15
    eddief1
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    Re: psa numbers

    [QUOTE=eddief1;3830763]I seen on a post were you said not having a enlarged prostate meant if you
    had pc it would be a1 because of a normal prostate. QUOTE]

     
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