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What's a "big deal" in a change in PSA?

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Posted 9/4/2012 5:41 PM (GMT 0)
My Primary Care Doc referred me to a Uro after my PSA jumped from 4.0 to 4.6 in six months. On my first visit with my Uro he asked me if I knew my most recent PSA and I said 4.7. He said no it's 4.6 and that the difference between a 4.6 and a 4.7 in a guy my age was a "big deal". That's my recollection at lest. He's also the guy who after asking if I had any ill effects from the biopsy, then said, "you have cancer", so I do have some foggy recollections of him.

Anyways, so just what is a big deal in changes in PSA results?
Posted 9/4/2012 5:52 PM (GMT 0)
How old are you?
Posted 9/4/2012 6:27 PM (GMT 0)

A rise in PSA was my wakeup call.  One year it was 2.2 and the following year 3.2.  Even though PSA was still under the majic number of 4.0, I suspected something was wrong.  I referred myself to a Uro who performed a few test and found out I had PCa.  I would recommend the RNA type urine molecular test prior to having a biopsy.  It's not evasive and very good at ruling out cancer. 

Posted 9/4/2012 6:28 PM (GMT 0)
I was 57 at time of dx
Posted 9/4/2012 7:05 PM (GMT 0)
It's stated in many sources, that even a PSA rise of .35 per year can be significant. Especially if there is a steady consistent rise based upon several yearly readings.

david
Posted 9/4/2012 7:40 PM (GMT 0)
Bill sounds like he might have been a little "over reacting."

Since you have had surgery - it almost doesn't matter. What have been your PSA numbers since surgery?
Posted 9/4/2012 8:03 PM (GMT 0)

BillinChicago said...
He said no it's 4.6 and that the difference between a 4.6 and a 4.7 in a guy my age was a "big deal".

This difference is less than the naturally occurring variation that has been observed in back-to-back PSA tests.

Posted 9/4/2012 8:19 PM (GMT 0)
I'll know in a few weeks. Haven't had a test yet.
Posted 9/4/2012 8:26 PM (GMT 0)
Should add, what I said was meant to be prior to diagnosis and/or any treatment.
Posted 9/4/2012 9:10 PM (GMT 0)
He may have meant the jump from 3.9 to 4.6 or 4.7 was a big deal in six months. Like I said, this discussion is a little foggy in recollection.

I have recalled it now because with the suggestions for waiting it gets me wondering what's the natural variation in PSA scores versus significant "big deals"? And over what periods of time with what frequency?

My delta was certainly a good predictor of ca, but I just wondered what would have been a "natural" variation had I waited versus "man, this is becoming a bigger deal"?

Considering the stories I hear about everyone needing a good trend of PSA scores before even making a decision to biopsy, I just wanted to know if anyone had a sense of the numbers considering all of us unique. Just what kind of variation is normal and what isn't?
Posted 9/4/2012 10:25 PM (GMT 0)

BillinChicago said...
He may have meant the jump from 3.9 to 4.6 or 4.7 was a big deal in six months. Like I said, this discussion is a little foggy in recollection.

I have recalled it now because with the suggestions for waiting it gets me wondering what's the natural variation in PSA scores versus significant "big deals"? And over what periods of time with what frequency?

My delta was certainly a good predictor of ca, but I just wondered what would have been a "natural" variation had I waited versus "man, this is becoming a bigger deal"?

Considering the stories I hear about everyone needing a good trend of PSA scores before even making a decision to biopsy, I just wanted to know if anyone had a sense of the numbers considering all of us unique. Just what kind of variation is normal and what isn't?

I am pretty sure that is what the doc was talking about. A rise in excess of 0.75 in a year is a trigger that sets off alarm bells and is suspicious even when the PSA is fairly low. As your PSA increase was over six months it equates to a rise of at least 1.4 in a year.

http://www.aboutcancer.com/psa_velocity.htm
Posted 9/4/2012 11:33 PM (GMT 0)

BillyMac said...


I am pretty sure that is what the doc was talking about. A rise in excess of 0.75 in a year is a trigger that sets off alarm bells and is suspicious even when the PSA is fairly low. As your PSA increase was over six months it equates to a rise of at least 1.4 in a year.

http://www.aboutcancer.com/psa_velocity.htm

Thanks. This is exactly the information I was looking for.
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