HealingWell
Search Close Search
☰

Possible to have PC with very low PSA?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 2/2/2010 6:25 PM (GMT 0)
I have a friend that has a PSA level below 2.0.  But his doctor felt something suspicious when he did the DRE.

I know the PSA velocity is important, but since this was his first PSA test he doesn't know if there is any velocity.

So, my question is: Can you have PCa without the PSA looking suspicious?  I told my friend he should have a biopsy, but he is of the opinion that since his PSA is so low, a biopsy would be a waste of time and money.  Plus it would hurt.

Any opinions or references that might enlighten us would be greatly appreciated.

Thank you.

Dave

Posted 2/2/2010 6:35 PM (GMT 0)
Please encourage your friend to get the biopsy.  I had a PSA of 1.3 when the urologist felt something that didnt feel right last summer.  As it turned out I did have prostate cancer and had surgery earlier this month. 

Ray

Posted 2/2/2010 7:02 PM (GMT 0)
DITTO. My PSA never got above 1.3....but I too had nodules.

Posted 2/2/2010 7:05 PM (GMT 0)

The National Comprehensive Cancer Network (NCCN) offers an excellent online document called "Practice Guidelines in Oncology--Prostate Cancer Early Detection."  Find it here:

http://ccme.osu.edu/docs/20090218_ProstateDetection.pdf

Shortcut to page 7, which says that a positive DRE should be followed by a biopsy, regardless of PSA results.

Hope this helps...

 

---------------------------------

I re-wrote my original posting.  I originally posted about getting a "% free PSA" test, but then recalled that this test is for patients in the "diagnostic gray zone" of between 4 & 10 ng/mL.  I deleted everything I wrote about the "free PSA" test, and left only info on the NCCN document.

Post Edited (Casey59) : 2/2/2010 1:07:52 PM (GMT-7)

Posted 2/2/2010 7:18 PM (GMT 0)

Dave:

1.  If your friend has not seen a urologist, he should.  His PCP is most likely unprepared to deal with this.  And, yes, it is possible to have PCa with a low PSA.

2.  Getting a % free PSA is also probably a good idea however...if a urologist feels something suspicious it is likely that a biopsy will be recommended whatever the free %.

3.  A biopsy does not have to hurt.  Many of us here have had them under IV sedative and there is no pain involved.  My urologist describes this as a "civilized approach".

Tudpock

Posted 2/2/2010 7:31 PM (GMT 0)
With any kind of positive DRE, a biopsy is in order, and most don't hurt real bad, the pain part can be disucssed with the dr. ahead of time and there are options there too. This is a case where the PSA number isn't the real issue, the positive DRE is, which means something can be felt.
Posted 2/2/2010 7:40 PM (GMT 0)
Dave,

My PSA was 0.9 and during my annual physical the doc felt a little something on the DRE. I had a biopsy and they found 3 positive PCa in 12 samples. I had surgery in August 2008.

Posted 2/2/2010 9:20 PM (GMT 0)
I was diagnosed at Ft Leonard Wood Hospital at psa: 4.6 but the VA Hospital only saw 1.3, but the biopsy was positive on one in twelve needles.
Posted 2/2/2010 10:04 PM (GMT 0)
I was diagnosed with a PSA of 3.5 (on retest was 2.7) - but it was up from 1.8 the previous year. I must be the oddball here, but the only pain I felt from the biopsy was the needle with the anaesthetic on the prostate - I could then feel the biopsy needle enter the prostate, but no pain - just the loud click! Afterwards it was sore, but not painful - what I did not like was the blood in the urine for three days, and in the semen for up to a month. I was terrified before the first biopsy - the second was almost routine. Fear of a biopsy is not a reason to put it off, especially if the doctor felt a nodule.
✚ New Topic ✚ Reply