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PSA reading concern/first post

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Posted 4/20/2009 10:07 PM (GMT 0)

Hello everyone,

I don't know if I belong on this board with those of you who are dealing courageously with the illness. Don't know yet if there is a problem. I am 57, caucasian. Had a psa reading today of 4.2. Two years ago, Spring 2007 it was 2.91 and one year ago, Spring 2008 it was 3.25. Prostate is smooth and has been very slightly enlarged for several years. My doctor, an oncologist, advises retesting over the coming months.  How concerned should I be and is there any advice you have for me?

Posted 4/20/2009 10:15 PM (GMT 0)
Jnew330, Of course you're welcome here. My advice would be patience, patience, & more patience. Read all you can & ask ?'s.
Posted 4/20/2009 10:18 PM (GMT 0)
Welcome Jnew and thanks for stopping by our wonderful family here at HW. At this stage of the game I think you should follow the advice of your doctor. I had a friend recently that had an excalating PSA and after a saturation biopsy it turned out to be an infection. Just be patient if you can and continue to go for those PSA test as scheduled. I hope you never have to deal with PCa but if you do we will be your biggest supporter. Hang around and join in the conversation. Remember we care.

peace and love
dale
Posted 4/20/2009 11:06 PM (GMT 0)
Your doctor should be able to estimate the size of your prostate and calculate the psa that it is generating. If your psa is greater then it would be a concern.
Also did you have a PCA3 urine test or a free psa?
If these are abnormal it would also be a concern and a biopsy would be the next step.
If all tests are normal then I wouldn't worry and just kepp getting your psa checked every 3-6 mos.
JohnT
Posted 4/20/2009 11:28 PM (GMT 0)
Hi jnew,
Welcome to HealingWell. You are most welcome. And great 1st post. I think more people should post before their diagnosis. It show's you are proactive and eager to learn. I hope you do not have this disease. I would wish it upon nobody. But don't be afraid to take the necessary steps, and don't rush to anything if you are positive for a malignancy. Prostate cancer is slow in going and you should take the time to learn as much as you can about treatment modalities. Good luck, and ask anything you wish...

Tony
Posted 4/21/2009 4:51 PM (GMT 0)
jnew330,

You went from a 2.9 to a 4.2 in 24 months, and your doctor wants to wait another few months to test again.
I went from 2.5 to 3.7 in a little less than 24 months - with no other symptoms. My urologist said my prostate "was possibly slightly enlarged." He also said "anything above 3.5 means a biopsy" (at least in my case). And, as it turns out, I had a serious case of PCa going on.

I'm not sure how concerned you should be, but man, we sure got different advice about what appears to be a very similar case.

(On the other hand, I was also told that I had an 80% chance of having a negative biopsy.)

Good luck,
kcragman
Posted 4/21/2009 10:39 PM (GMT 0)
I think kragman has a good point. If it was me I would ask for a biopsy right now. My PSA went from 1.9 to 2.85 in one year and the urologist said that was too much of an increase, had to have biopsy. As indicated below the second biopsy came back positive for prostate cancer. Worst case scenario, a positive biopsy would at least give you a Gleason score so you could know if you had a slow growing cancer (gleason score of 6 or less) that you could think about eventually treating versus a more aggressive cancer (gleason score7-10) that would call for immediate attention. I'd do the biopsy now....
Posted 4/22/2009 12:09 AM (GMT 0)
jnew,

The Prostate Cancer Research Institute's web site has a few articles on PSA calculations in determining PC.
Click on "Papers" then the "undiagnosed section". there is a lot of info in the puplished papers by top professionals.
JT
Posted 4/23/2009 2:49 AM (GMT 0)
In 2005 my psa was 2.6. In 2006 it was 3.5. In 2007 is was 4.6, I was urinating a number of times at night due to the prostate being enlarged, and I was told I should get a biopsy. I got one and was found to have a few cancer cells in one corner of my prostate. Since it was caught super early, and the cells were still inside the prostate, I had my prostate removed, and the cancer was thus all gone. I'm just glad I had the biopsy and got the ball rolling early. Just my take on it.

Posted 4/23/2009 3:51 AM (GMT 0)

Hello jNew. Good questions and now that you are sensitized to the issues you must continue the research. The John-Hopkins website has alot of info and also has a "White Paper" that candidly addresses many of the threshold questions that you will be asking. Also there are a few books that help in decision making including one by Hopkins surgeon Patrick Walsh. Frankly, the position that you are in is hard because it is scary and you don't know which way to turn if you are like me. Painful as it was, I read everything that I could (so did my wife which was very helpful) and we then at least had a baseline of knowledge and had good questions to ask the docs. There is also alot of crap on the internet regarding treatments so you must review credible information from credible sources.

Based on what you numbers are, it appears that your doc is suggesting "wait and watch" which will be maddening until the next test. If the PSA continues to rise, the next step is a biopsy. Some experts believe that a doubling of the PSA w/in a year or 18 months is significant cause for a biopsy. The state of the art in diagnosing the cancer and then in classifying it as aggressive or not as advanced as we would like. In making decisions to test and what treatment to pursue if you are affected, there are numerous variables including the lab results, age and fitness, along with other medical issues that you may have. The only way to walk through the matrix is to educate yourself.

Best wishes,

TeddyG

Posted 4/23/2009 6:06 AM (GMT 0)

Look at my age and numbers - very similar to yours.  Listen to your doctors, but I'd push to get a biopsy to give you peace of mind, or let you know what to look for next.  Good luck

Posted 4/23/2009 3:32 PM (GMT 0)
My opinion is "find out". I would want a biopsy. I had a negative DRE and was told I'm not a good candidate for PCa. Even after my biopsy came back with positive cores my Doc was super surprised (I was too) but at least I knew.

We all have to do what is right for ourselves and for me it was the biopsy and then the surgery as quick as possible. Others will disagree. The biopsy was a surprise in performance and how little it hurt. I was expecting something so much more barbaric...

Good luck with your decisions 

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