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High PSA - Now what

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Posted 5/16/2013 4:18 PM (GMT 0)

Just found this site yesterday and am overwhelmed with the info available. Thanks to all. Still working on my signature, so I hope this isn't overkill.

Background - My dads PSA has been over 8.0 for 10 years. He has had 4 biopsies and all negative. He is 77.

Here is my info:

56 yrs old, excellent health -

Feb '11 - DRE - enlarged PSA 6.0

Feb '11 - DRE - enlarged PSA 8.8

Mar '11 - Biopsy 12 of 12 Negative

Sept '11 - DRE - enlarged PSA 11.5

Dec '11 - DRE - enlarged PSA 5.9 Free PSA 13%

Aug '12 - PSA 7.1 Free PSA 13%

May '13 - DRE - enlarged PSA 7.9 Free PSA 13%

 

Can the PSA numbers just be high, and not show cancer???? Doctor says my prostate is "LARGE" and that may contribute to high numbers. He is willing to wait another year and test then.

 

Should I be OK with this??

 

Posted 5/16/2013 4:59 PM (GMT 0)
Between September 2011 and December 2011, did he have any explanation for why your PSA dropped from 11.5 to 5.9? Did he give you antibiotics or something during that time frame?
Posted 5/16/2013 5:07 PM (GMT 0)
Hi, welcome aboard!
Glad you found us, we have been waiting for you turn
Hopefully you are just visting for now.

I had an enlarged prostate back in mid-90's.
My PSA had been between 5 and 9 for 12 years before I was diagnosed with Prostate Cancer last year. I had a biopsy in 2000 and one in 2004 and both were negative. I went from 2004 until 2012 without any testing so the good news is you are testing every 6 months at least.
The bad news is my surgeon said I probably had PCa for the past 10 years because my tumor was so large. A high PSA is a sign that something is going on so you are doing the right thing by getting your test and talking to a doctor.
I am sure some of my other brothers will join me by welcoming you and they will give their take on your stats.

Good luck

Bill from Florida
Posted 5/16/2013 6:53 PM (GMT 0)
Skooley - There is no explanation for the change. No antibiotics, and nothing I knowingly did.

My concern is I am reading a lot of posts and reading the attached signatures. LOTS of cancer with PSA numbers way lower than mine. I was feeling pretty good with my doctor saying to wait another year, until I started reading.

Could a normally "large" prostate be the reason for high numbers or am I just living in limbo?

Thanks

Posted 5/16/2013 6:59 PM (GMT 0)
Hello.
If they do find cancer, he may be too old for surgery, according to some doctors.
Older patients are more often treated with radiation, sometimes hormone therapy, depending on the situation.
The Free PSA is not especially good.
I think I read about a doctor in NYC who did MRI guided biopsies, which cost more, but were better at finding cancer.
Anyway, good luck to you folks.
Posted 5/16/2013 7:05 PM (GMT 0)
Greg - are these your numbers or the "my dad" that you mentioned in the first post?

Anyway, I had a friend in his late 70's that had a PSA in the 12'ish range for over ten years... and also had several negative biopsies...

Last biopsy came back with enough proof that he did radiation.
Posted 5/16/2013 7:40 PM (GMT 0)
Steve n Dallas - The numbers are mine.

 

Posted 5/16/2013 8:33 PM (GMT 0)
What about having another biopsy done since it has been two years since your last biopsy? I mean, my dad's psa was slowly rising and when it went to 4.5 they biopsied him. I don't know what his pre-op gleason score was but his post-op was a 9. A gleason between 8 and 10 is an aggressive cancer. So just saying that yeah, as you are seeing in people's signatures, there can be cancer even with lower psa values.

What kind of doctor are you working with right now? a general physician or a urologist?
Posted 5/17/2013 12:24 AM (GMT 0)
Show-Me Greg -

Are you being treated for your enlarged prostate? I think it's wise to eliminate BPH as the source of the high PSAs before proceeding. Proscar or Avodart might bring your PSA numbers way down, and set a new more reliable baseline for you. (There's also some evidence they prevent low grade PC too.) Your %freePSA is in that midrange that tells you little. If it were me, I'd get on Avodart and re-test in 6 months and again 3 months later. If it goes low and is stable, all well and good. If it doesn't go down, or goes down and rises again, it may be time for another biopsy (maybe one of the image-guided or saturation biopsies). These are all reasonable proposals to make to your urologist.
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