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PSA 3.6 Questions

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Posted 5/14/2009 11:28 AM (GMT 0)
Hi Everyone -

I am usually on the Lyme Disease forum for my husband.

We were just informed that my husband needs a biopsy - he just turned 50 in December and his PSA was 3.6 - the doctor said this is elevated for his age -

Any thoughts, insight or knowledge would be greatly appreciated.

                                                   HopeFloats

Posted 5/14/2009 11:32 AM (GMT 0)

That is an elevated number...I'm guessing that he also had a digital exam and that it was OK???

A biopsy isn't a bad idea, but he could maybe wait 3 months or so and do another PSA test and go from there.

Posted 5/14/2009 11:41 AM (GMT 0)

Greetings, Hopefloats.  It all depends on what his previous PSA was and when it was taken.  For example, my PSA was 3.2 - but my previous one taken a year earlier was 1.5.  It had doubled in a year so raised questions.  As it turned out I had Gleason 4+3 cancer.  On the other hand, there are a number of non-cancer reasons for an elevated PSA - an infection for one and even sexual activity the day before the blood work. 

Talk to your doctor and determine the best course of action - it may be as simple as taking a new test, or seeing if there is an infection that could be treated with meds.  The good news is that even if it were prostate cancer, you have lots of time.  There is no need to make quick decisions since it grows so slowly. 

Look at all the options and possibilities.  David

Posted 5/14/2009 11:51 AM (GMT 0)

Hi Hope:

A couple of thoughts/questions:

1.  Was this his first PSA test?  If not, has there been a change in his PSA over time?

2.  Was anything felt on a DRE?

3.  Does he have any urinary symptoms like frequency or urgency or getting up a lot in the night?  Has the doc considered prostatitis and tried a treatment to see if the PSA comes down?

4.  Is this a urologist saying he needs a biopsy?  If not, he should go to one.  If so, why was he seeing a urologist...was it a referral because of the PSA?

5.  Did he have sexual activity prior to the PSA test, which can cause a rise?

6.  Did he have a free PSA % test and, if so, what were the results?

I would suggest answering these questions and, depending on the answers, perhaps consider another PSA test and free % before proceeding to the biopsy.

Tudpock

Posted 5/14/2009 12:59 PM (GMT 0)
Hi Hopefloats...as others have said, I think the biopsy is in line with what most doctors would recommend with this level of PSA. Hopefully it is just some inflammation, but if it does turn out to be cancer hopefully it will be in the earliest of stages giving you and your hubby options to consider.

Good luck and let us know the results.
Posted 5/16/2009 5:53 AM (GMT 0)
What would be helpful would be a record of previous PSA measurements. What seems to be most suggestive of cancer is the rise of PSA with time (PSA velocity). A baseline of 3.6 that remains steady at 3.6 may be acceptable, whereas a PSA that rises significantly between readings argues for a biopsy. At least that is what I've been lead to understand. I am a bit older than your husband but have a PSA of 3.6 myself, but that seems to be my baseline and two urologists did not want to do a biopsy. Obviously this is your decision among your family and physicians. Don't be afraid of getting a second medical opinion.

Best of luck and let us know what you decide.
Posted 5/16/2009 9:18 AM (GMT 0)

Hello Hopefloats,

I  have wondered what would have happened if I would have scheduled a biopsy when my second rising PSA test came back at just 3.7 instead of waiting until 4.4.  It may or may not have changed my prognosis for the better.  There are lots of reasons why a PSA can be elevated but we are really only interested in the one question “is there cancer of not” and I would find out now.  I have become an advocate of testing earlier and getting a head start on treatment if needed.  The other real benefit is to be able to sleep at night knowing the tests were negative.   I think your doctor has your best interests in mind and I would follow them if nothing more than for peace of mind.  Good luck and stay positive.

Age 61 at diagnosis

PSA Jan 2006 2.8, PSA Jan 2007 3.7, PSA Jan 2008 4.4

DRE Normal, Biopsy positive 1 core in 10,

Clinical T1C, Pre surgery Gleason 3+4=7

Bone scan Normal, Cat Scan Normal

da Vinci robotic Surgery April 30, 2008, Fremont Nebraska

Post surgery Gleason 3+4=7, Pathological P2C

Lymph nodes clear, Margins clear

Hospital stay 2-days, Catheter out 10 days

1-pad a day for 3 weeks

Back at work 7-days after surgery, desk job

Both Nerves spared, 100% with assistance of sildenafil citrate

Post 3 month PSA-undetectable, Post 9 month PSA-undetectable

Posted 5/16/2009 11:23 AM (GMT 0)

Thanks to you all for your responses.

This is his first PSA, nothing felt on DRE, no urinary symptoms, he does see a urologist and there was no sexual activity before his visit.  He also has chronic neurological lyme disease.  He has been fighting that battle for 13 years.

We go 5/29 for a biopsy.  The doc is doing it right in his office.  I will let you allknow how we make out.

                                          HopeFloats

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