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43 y/o PSA jumped 1.5. Worried

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Posted 2/15/2015 2:59 AM (GMT 0)
I am 43 y/o and started having urinary symptoms with pain a year ago. PSA at that time was 0.9 and now a year later (with continued symptoms) my PSA is 2.4. I was treated with 6 weeks of Cipro a year ago but really did not help symptoms. Had Physical therapy to see if it would help the pain and symptoms. Still not much relief. Had a cystoscopy done about 7 months ago and it was clear. DRE has been pretty normal except some boggy feeling in the center. Ultrasound a year ago was also normal. Revisit to urologist after getting the results of the increase of PSA and he wants to "wait and watch". Wants to repeat PSA in 3 months. The pain for a year plus increase in PSA has me worried. Anxious!
Posted 2/15/2015 3:07 AM (GMT 0)
Welcome to HW, sorry you need to be talking to us.

First, PSA isn't a test for cancer and PC rarely has symptoms in the early stages. While that PSA is higher than normal, it just means something might be wrong and more testing is needed. Waiting for three months to confirm the result is wise.

Not sure why you're having pain, others might have better answers.

There might be a biopsy in your future, but that's just speculation.

Hang in there,
Andrew
Posted 2/15/2015 3:13 AM (GMT 0)
Welcome CB! You'll find some good people here to help you along. I wouldn't be to worried about PCA. The elevated PSA and symptons don't really sound to be connected more like two separate issues. The PSA can be elevated by lots of things (and you are well within a normal range). The symptoms, also can be explained by mutiple things. I would focus on the pain, maybe consider talking to another Urologist, something just doesn't sit right with me. Keep us informed!

Cheers, Doug
Posted 2/15/2015 3:24 AM (GMT 0)
Some UTI's can be very persistent and they are able to resist the common antibiotics like Cipro..I would investigate that possibility before I started worrying about cancer...Several things can elevate PSA test results. Learn what they are and avoid them before your next test...You pain means there is something wrong. Urologists get paid a lot of money. Make yours earn it....
Posted 2/15/2015 3:54 AM (GMT 0)
I agree with the others above.

I had cancer at 48 and not a single symptom. It'd be surprising to me if you have prostate cancer, but I'm not a doctor. I'm a stock broker!
Posted 2/15/2015 10:01 AM (GMT 0)
Welcome to HW GB5. Sorry that you feel the need to be here and hope that your stay will be short.

Some good information above already and as you are experiencing pain I would lean towards thinking it could be something like Prostatitis. It can be very difficult to detect and just as hard to treat. Often a biopsy is the only true way too find out and if your problems continue then your doctor may suggest this.

Good luck and please keep us posted with any further developments.
Posted 2/15/2015 2:35 PM (GMT 0)
I'd switch Urologists. Like others have said, my Prostate cancer had no pain, no symptoms.
Bladder or Urinary Track infection is more likely, Hopefully not a STD. Infections can raise PSA.
Posted 2/15/2015 2:55 PM (GMT 0)
Hello CB5,

Welcome to the forum. Sorry your problem has brought you here but glad you found us.

I have to be careful how I sympathize with you. If I say that I have been where you are you might worry that you will wind up where I am. That doesn't follow. Statistically, men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome are not much more likely to have prostate cancer than the overall population. I had symptomatic prostatitis for a number of years before I was diagnosed with prostate cancer but that is mildly unusual. The typical urogenital symptoms of prostate cancer are ... none.

I don't usually include a diagnosis in my first response to a new members first post -- I am not a doctor, after all -- but in your case it is fairly easy because you have a "syndrome". A "syndrome" is nothing but a bag of symptoms that seem to go together often enough to have been given a name. You mentioned enough of those symptoms in your short post to qualify.

If you read medical papers on the syndrome you will find that they mostly contain some sort of apology to the patients. Yes, they say, we know your problem is real -- OK, for most of you guys it's real, there are always a few merely neurotic patients in any syndrome -- and we got nothing for you.

Chronic Prostatitis does tend (sometimes) to elevate PSA levels which makes the usual screening/diagnostic tests for prostate cancer more difficult to interpret. It tends to respond to antibiotics, which prostate cancer does not, and a common first response to a man with an elevated PSA is to try antibiotics to see if the PSA goes down -- which would indicate prostatitis, not cancer. I did the antibiotics thing several times and my PSA always went down -- but never quite enough.

My advice would be to make sure you have a urologist you like and trust, follow his/her advice and try not to worry. Worrying is your urologist's job.
Posted 2/15/2015 7:25 PM (GMT 0)
Thank you for all your responses. It has decreased some of my anxiety. I wish you all well. The pain(actually a discomfort) for a year with increase in PSA is really messing with my head. My PMD ruled out any STD's ( just to be safe), as I have been married for years. PMD also ordered MRI of lumbar and pelvis. Did show some mild disc problems but nothing in pelvis. Last PSA result was from Jan and was repeated a couple of days ago with no results yet, ordered by PMD. Uro ordered one for May. I would really like to find the cause of my discomfort and urinary symptoms. I feel very overwhelmed after a year of dealing with this. I appriciate all your time and great advise. Would like to get a second opinion. Anyone have or know of a great uro in California? Thanks again
Posted 2/15/2015 7:29 PM (GMT 0)
CB5, just wondering out loud, I'm not a Dr and don't want to try playing one. But is it possible that what you are feeling could be reflective pain from the disc issues you uncovered in the lumbar scans? Nerves from the spine can reflect all over the place. Might be worth asking, maybe with a neurologist?
Posted 2/15/2015 7:34 PM (GMT 0)
Yes I have an appt. with PMD to go over MRI results. Was just so worried about the PSA went straight to uro the next day. Will keep all posted. Thank you
Posted 2/15/2015 7:36 PM (GMT 0)
Uro looked at MRI but didn't seem concerned or recommend anything. I'm just frustrated.
Posted 2/17/2015 4:18 AM (GMT 0)
CB5, have you considered the new blood tests such as 4k score or PHI? the 4K score claims to have a 94% negative predictive value for not having aggressive cancer (gleason >=7). I think if you have a very low 4k or PHI score, it could put your mind at ease a little bit. Your urologist should know about these 2 tests.
Posted 2/17/2015 10:51 AM (GMT 0)
CB,

Sorry you are here. Pain is quite uncommon with PCa, as others have said, and I don't want to make you worry more, but I also had frequent pain/discomfort over an 18 month period prior to being diagnosed. In fact, just two weeks post op. the level of pain/discomfort is about the same as what I experienced before surgery, though it is getting better every day.

Waiting three months to re-test seems wise to me. The PSA could be elevated for a number of reasons. If it's still elevated, then a biopsy is probably in your future.

Best of luck. Keep us posted.
Posted 2/17/2015 7:25 PM (GMT 0)
So sorry to hear of your worry, but it is good that you are doing your own research and inquiries so that you are better able to discuss your situation with your doctor.

As all above have cautioned, we are not doctors and any advice we might give has to be taken with a BIG Shaker of Salt. I am not giving any advice here, but rather offering my experience, which I do without any suggestion that it might apply to you.

At age 72, my PSA was "normal" when looked at as a single PSA reading. However, with PSAs taken over a period of two years that increased from 3.2 to 4.8 to 5.8, I ended up with Prostate Cancer. Comparison of successive readings are known as PSA Velocity, and unfortunately, my 3 doctors at the time were not familiar with the term until it was too late and my cancer had spread to my bones.

So here is a recent Bulletin from John Hopkins that describes the study it conducted. Your doctor should be familiar with this term of PSA Velocity and can better explain it to you.

JOHN HOPKINS BULLETIN, February 12, 2014:
Latest Research of PSA Velocity
as a Predictor of Prostate Cancer
Clinical studies involving carefully selected groups of men have indicated that measuring PSA velocity -- that is, the rate at which prostate-specific antigen (PSA) levels rise over time -- is a more accurate predictor of whether a man may have prostate cancer (and require a biopsy) than the results of a single PSA test.
To test this theory in a "real world" setting, researchers tracked 219,388 men who were members of the Kaiser Permanente health plan in southern California from 1998 to 2008. On average, each man had five PSA tests during that period.
By the end of the study period, 10,035 men had developed prostate cancer. PSA velocity accurately predicted which men would develop prostate cancer and was significantly more accurate than a single PSA measurement in predicting which men would develop aggressive disease.
Takeaway message. Current guidelines recommend against using results from a single PSA screening test to diagnose prostate cancer. Nevertheless, these findings offer strong evidence that PSA velocity provides additional useful information that could impact management decisions.

Keep up with your research, and Good Luck.

Houseboy
Posted 2/18/2015 3:51 AM (GMT 0)
CB5, Sorry to welcome you.

sounds like you are on the right track. Get the PSA retested, if it comes back at same level or higher, I suspect that your doc will order a biopsy.
I was as scared as you just over a year ago when I was diagnosed with PC. Thankfully, You haven't been diagnosed. There are many other reasons a PSA level can be high. Keep doing your research and stay on top of it. This site will offer a ton of information and support.

I am 43 years old now, and was diagnosed with PC in Sept 2014. I had surgery to remove it Dec 2014.
I have been cancer free for over 1 year now

Best of luck to you!
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