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rise in PSA & PCA3...

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Posted 7/8/2013 3:28 AM (GMT 0)
My dad is 78 years old. For the last few years, his PSA level has been rising. Just last January (2012) it was 3.22. His urologist also did a PCA3 test which was elevated, his result was 40 and normal is 35 and below. His doctor decided to not do anything and continue to monitor my dad. This past January (2013) his PSA was 2.87 and his PCA3 increased to 45...again, his urologist said we will keep a close eye on him. So...I took my dad to another doctor and he ran another PSA which came back as 4.06!!! The new urologist also did a PSA % free test and that result was 26%. The DRE test was normal. New urologist wasn't too concerned. Tuesday, we will get back the results of the PSA test he had done last week. Why aren't these doctors being more aggressive with their approach? Is the PCA3 a valid test??? Any advice???
Posted 7/8/2013 3:44 AM (GMT 0)
Worried daughter,
Please don't worry, your dad is jut fine. At 78 his PSA is normal, and at 78 he wouldn't want to do anything about it anyway. Treatment for a 65 year old man does not increase life span and your dad is way beyond that. The best way to ruin his life would be to treat it. At 78 he should never had had a PSA test to begin with. The best course of action is just to stop getting PSA tests and have him live his remaining years free of worry. His chances of dying of prostate cancer is very slim even if he has it. If you need to worry about something worry about his heart, as that is the most likely thing to kill him.
If he had a large nodule or a psa over 20 you might have some concern; but what you mentioned is nothing to be concerned about. Please don't wreck your dad's life by taking him to other doctors, because if you look long enough you will find a doctor that will treat him. Your current doctors are being very prudent and you should listen to them.
JohnT
Posted 7/8/2013 4:49 AM (GMT 0)
worried daughter2, for you, the advice JohnT just gave is counter-intuitive to those that do not know this disease. It is sound advice and well documented in the medical community. Also do not let the term "remaining years of his life " spook you. He is referring to the remaining years of his life with or with PCA., as it will be basically the same, regardless of cancer. As he said you will find a doc who will treat himt and the side effects of that treatment will the greater of 2 evils for a man your fathers age. If you want to talk to the doctors and mention what has been said and have them give you the rationale behind the advice you getting here. Insist that they tell you what they know. To keep the the balance sheet square, find one who thinks he should be treated and have him lay out his case. Have well recommended docs in either scenario. Having said all that. In the last analysis my advice mirrors John T's to a T. Regards
Posted 7/8/2013 5:13 AM (GMT 0)
Those PSA numbers look normal for a man at 78. That's why they're not being aggressive.

and PSA does not equal bad. It's just an indication of prostate activity and size. It simply shows whether or not there is some there to be checked out - high PSA can be caused by so many things - cancer is very low on the list.
Posted 7/8/2013 12:35 PM (GMT 0)
Plus one to the advice.. those numbers would be envied by many on here.
But, there are some proactive things that you could do.. eg. Start on a program of regular Anti-Oxidants... and other Prostate healthy supplements.
I have taken OPC for years now, and I found that it caused my PSA to drop, but a greater power ensured that I did as I was told and got cut..
Through taking a broad spectrum antioxidant/bioflavanoid mix, your dad will find that there are many tangible improvements for life...
..
.
Posted 7/8/2013 12:41 PM (GMT 0)
I agree with JohnT above. No reason to put your father through any treatment based on the info you have supplied.

david
Posted 7/8/2013 12:44 PM (GMT 0)
Worried Daughter I too agree with what others have stated - those statistics for a man of 78 years old would not be something that I would be worried about, they are normal. And, I also believe the medical professionals he has been seeing should be commended for NOT recommending any form of treatment - no reason to put your father through the rigors of treatment and risks for life changing side effects.

The best thing he could do is focus on his dietary habits and exercise, protect the heart and live long!

Best to you both.
Posted 7/8/2013 4:30 PM (GMT 0)
Dear Worried:

As you know we are not doctors here but there is a great knowledge base. I agree with the others who have posted here as well as with your doctors. It seems that your dad is being given sound medical advice and I would be even more worried if someone was suggesting aggressive treatment.

Jim
Posted 7/15/2013 8:55 PM (GMT 0)
Thank you so much for all your responses and advice. The PSA level my dad had last week was 3.22. I am curious...why does the PSA change so much? In the last 1 1/2 Years my dad's levels have been 3.22, 2.87, 2.87, 4.06 and most recently, 3.22. Is this normal???

Also is the PSA % free test a good one to have done inconjunction with the PSA? How reliable is the PCA3 Test???

Post Edited (Worried daughter2) : 7/15/2013 2:58:01 PM (GMT-6)

Posted 7/15/2013 8:59 PM (GMT 0)
PSA can be affected by inflammation, infection, prostatitis, sexual activity, prostate enlargement. It typically trends up in older men.
Posted 7/15/2013 9:10 PM (GMT 0)

Worried daughter2 said...
 I am curious...why does the PSA change so much? In the last 1 1/2 Years my dad's levels have been 3.22, 2.87, 2.87, 4.06 and most recently, 3.22. Is this normal???

Yes

 

Your father's PSA is within the age-adjusted normal range.  The variation he is seeing is similar to results published by Dr Peter Scardino about the spontaneous rising and falling of PSA in-and-around the normal range.  One of the well-known weaknesses of the PSA test is that it is NOT prostate cancer-specific...lots of things other than prostate cancer can cause it to go up and down, and often without an assignable cause.

Posted 7/15/2013 9:13 PM (GMT 0)
Psa fluctuates daily and also by season. An experiment on YANA, Terry took his Psa daily for 30 days and the fluctuations were 30 %.
A steady consistent rise over a year or two would be a concern.
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