Hi Worried Daughter, - Let me reassure you about
your questions regarding your Dad.
First let me tell you that it is VERY likely that your Dad's Prostate is doing exceptionally well for a man that is 80 years of age, ASSUMING that he has had no diagnosis and/or treatment of or for Prostate problems. From what you Posted, certainly Prostate Cancer (PCa) is highly UNLIKELY to be a cause of the limited symptoms you described. Specific answers to your questions follow:
First your Dad should try to always get his PSA test run by the same Laboratory, if at all possible. This would make the comparison of PSA results far more reliable and any trends that might develop to be far more meaningful. This is necessary for ensuring comparable accuracy in relating test results from one to another because the assays (test components) used vary by manufacturer and laboratory Standards based upon either original Hybritech results or WHO (World Health Organization) standards, which result in 23% lower readings, on average.
Prostate enlargement is EXTREMELY common in men over 40 years old, as the Prostate ages along with the rest of a mans body. Its effects vary widely by individual, but some degree of increasing size is found in the vast majority of men as they continue to age after 40 y/o. It is so common in fact, that as more has been learned about
the relevance of PSA testing over the years since the introduction of PSA testing, most experts agreed that this fact should be recognized by establishing "normal" ranges that increase by decades of age.
One such schedule, cited in the AUA 2009 update of their "Best Practice" PSA guidelines, cited the following example of acceptable "norms" for American age-specific references;
40-49 yrs Whites=0-2.5 ng/ml Blacks=0-2.0 Asians=0-2.0
50-59 yrs Whites=0-3.5 ng/ml Blacks=0-4.0 Asians=0-3.0
60-69 yrs Whites=0-4.5 ng/ml Blacks=0-4.5 Asians=0-4.0
70-79 yrs Whites=0-6.5 ng/ml Blacks=0-5.5 Asians=0-5.0
Most recent recommendations say that there is no specific number that represents the "normal" PSA in a specific patient but MEDIAN (half above/half below) readings reported in American men in one highly recognized Study found median readings of me in their 40's=0.7, 50's=0.9, 60's=1.2 and 70's=1.5 ng/ml respectively, as a point of reference.
A Free PSA test is usually used to help evaluate the need for Biopsy recommendation, when elevated PSA results exceed those anticipated by clinical findings and must be run on the same blood drawn for a Total PSA. The percentage ratio of Free to Complexed (Bound) PSA, the combination of which makes up the Total PSA, can help determine such need when considered with other clinical findings.
So, in my opinion, your father APPEARS to be a man with Prostate findings that are well within the norm expected for men of his age. Further, it is likely that he could reasonably stop getting PSA tests since he exceeds the age of 75 years which is usually the cut-off recommended for such routine PSA screening, UNLESS there is some specific reason for continuing such screening. Hope this has helped address your concerns in a pragmatic way. -
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