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  • PSA Fluctuate from 6 --> 4. Help!!

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    Old 03-09-2010, 03:22 PM   #1
    micro
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    Exclamation PSA Fluctuate from 6 --> 4. Help!!

    Hey all,

    I posting this on behalf of my dad.

    He recently had a routine physical and blood work revealed a PSA level of 6.

    The GP was concerned and immediately had another set of blood work done 7 days after the first.

    The PSA returned to 4. My dad is currently 53 years old. He has had no other relevant medical history aside from cholesterol and hypertension, all of which are under control. Each year, his PSA level is steady at around 2. Digital rectal exam revealed nothing significant. No pain, nothing.

    The GP said it could be infection. So he prescribed antibiotics for a week. He is also scheduled for a scan soon.

    I have no idea what to think now... I'm very scared and I would love to hear some advice and input on what I can do now.

    Thanks!

     
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    Old 03-09-2010, 03:24 PM   #2
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    One other thing.. I do notice that over the years, my dad's urine stream isn't as fast at times.

    Most of the times it is very normal. Other times, urine trickles out. Maybe it's an enlarged prostate?

     
    Old 03-09-2010, 07:53 PM   #3
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    Quote:
    Originally Posted by micro View Post
    He recently had a routine physical and blood work revealed a PSA level of 6.
    The GP was concerned and immediately had another set of blood work done 7 days after the first. The PSA returned to 4. The GP said it could be infection. So he prescribed antibiotics for a week. He is also scheduled for a scan soon.
    I have no idea what to think now... I'm very scared and I would love to hear some advice and input on what I can do now.
    Thanks!
    The increase to 6 and then very quickly back to 4 sounds more like a possible infection than anything else. My understanding is that prostate cancer makes the PSA go in one direction - up - and usually fairly slowly. The antibiotics should help determine if it is an infection.
    Do you know what kind of a scan is being done, or is that unrelated to the prostate issue?

     
    Old 03-09-2010, 08:51 PM   #4
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    The GP wants to scan his bladder as well. I have no clue what kind of scan.

    I'll find out tomorrow and report back. Thanks for the reply!

     
    Old 03-13-2010, 10:35 PM   #5
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    Hello,

    Finally got some updated info from my dad. He's getting an ultrasound on Tuesday. The doctor wants to check his urinary bladder, kidney, and prostate (via transrectal ultrasound).

    Here are the numbers that I have:

    PSA Serum 4.4
    PSA Free 0.64 ng/ml
    % Free PSA 14.5%
    Negative Urine culture.

    I have no idea how to interpret it. On the lab report, it does state that there is a 1 in 4 chance for cancer. He just started Cipro. Going back for another PSA test in a few weeks.

    If the culture is negative, does this absolutely rule out infection? I honestly don't know what they cultured for. Secondly, a benign enlarge prostate can also affect the PSA scores right? The DRE that the GP performed...he stated no abnormality was felt.

    Ideas?

    Thanks for reading!

     
    Old 03-14-2010, 10:26 AM   #6
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    Quote:
    Originally Posted by micro View Post
    He's getting an ultrasound on Tuesday. The doctor wants to check his urinary bladder, kidney, and prostate (via transrectal ultrasound).
    My understanding is that an ultrasound is not sensitive for prostate cancer, except for some really specialized ultrasound equipment at a few specialized centers. However, it can be used to aim a biopsy needle when a biopsy is being done. I don't know its value for bladder or kidneys.

    Quote:
    PSA Serum 4.4
    PSA Free 0.64 ng/ml
    % Free PSA 14.5%
    Negative Urine culture.
    A PSA of 4.4 is just on the high side of normal, although it depends somewhat on age. A free PSA of 14.5 is in a "gray" area. If the PSA stays in this range after the Cipro, the doctor may want to do a biopsy. Chances are still somewhat more in favor of it not being cancer; but there is some risk it might be. There is really no sure way to tell without doing a biopsy, and even then some cancer may be missed. If free PSA is higher than 25, it's an indication against cancer. Below 10 or so is an indication "for" cancer. Just to use my own PSA as an example, I'm 67 and my PSA has been running between 4 and 5 for several years and my free PSA was measured at ~17, so my situation is very similar. I have had two negative biopsies over the past two years.

    Quote:
    If the culture is negative, does this absolutely rule out infection? I honestly don't know what they cultured for. Secondly, a benign enlarge prostate can also affect the PSA scores right?
    I'm not sure. Some others on this board are probably more knowledgable.

     
    Old 06-19-2010, 01:18 PM   #7
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    Hey all, I just wanted to give an update.

    My dad went in for a blood test earlier in the week. Just got the results today. The latest PSA value is still @ 4.

    This is after taking a few weeks worth of cipro. My dad's GP told him not to worry at this time and that he should get another blood test in 3 months.

    If anyone has ever been in a similar situation or know of what to expect or how to approach this situation, any insights would be greatly appreciated.

    Thanks!

     
    Old 06-19-2010, 07:55 PM   #8
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    Hi Micro,

    Holler has been providing some good answers. I'll fill in a couple of items. You wrote:


    Quote:
    Originally Posted by micro View Post
    ...
    Negative Urine culture.

    I have no idea how to interpret it. On the lab report, it does state that there is a 1 in 4 chance for cancer. He just started Cipro. Going back for another PSA test in a few weeks.

    If the culture is negative, does this absolutely rule out infection?

    No, definitely not. Sometimes infections are very difficult or impossible to pin down. Different antibiotics can be tried; a low dose antibiotic can be tried for an extended period; or different cultures can be tested.

    I honestly don't know what they cultured for. Secondly, a benign enlarge prostate can also affect the PSA scores right?

    Right. The rule of thumb, based on research, is that each cc of healthy prostate will account for about 0.066 units of PSA. The urologist can get a pretty good estimate of the size just from the DRE. An ultrasound can give a precise size. You or your dad could contact the urologist to see if he recorded a size estimate.

    The DRE that the GP performed...he stated no abnormality was felt.

    Ideas?

    Thanks for reading!
    Good luck to you and your dad, and take care,

    Jim

     
    Old 06-19-2010, 07:57 PM   #9
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    Thanks for the reply!

     
    Old 06-19-2010, 07:58 PM   #10
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    Re: PSA Fluctuate from 6 --> 4. Help!!

    You're welcome!

    Jim

     
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