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54 year old PSA 5.04

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Posted 10/7/2015 6:25 PM (GMT 0)
I am a 54 year old male. My blood test in August showed a PSA of 5.04 . My GP said that it had doubled since the last blood test one year previous. I was sent to a urologist who did a rectal exam and said it was enlarged but he could not feel anything unusual but that means nothing. He sent me for another PSA and the result was the same. now they want to do a biopsy of my prostate.

I have definitely had a weaker urinary flow and more frequency, especially overnight. I am up at least 2x a night. There have been a few times recently where I had a hard time getting the flow started. I have a active sex life and have no problem getting an erection but do take Viagra to keep it working throughout.

No family history that I am aware of.

if it is not cancerous, what causes the prostate to enlarge so quickly. Should I be worried in this situation?
Posted 10/7/2015 6:49 PM (GMT 0)
It's called BPH (benign prostatic hyperplasia) and it happens to many guys your age, causing those symptoms you describe and causing PSA to rise. Did he say how big your prostate is? PSA divided by prostate size equals "PSA density" which is about .15 in the average man - if it's a lot higher, then PC or prostatitis might be the cause.

There are three kinds of drugs used to treat BPH:
1) alpha-blocker (e.g., Flomax)
2) 5-alpha reductase inhibitor (5ARi) - Proscar or Avodart
3) Cialis

5ARis shrink the prostate and should reduce PSA that is due to BPH (but not PC). So if you take Proscar and your PSA does not go down or continues to rise, it's definitely time for a biopsy. I personally think it's a good idea to try this for about 6 months first, in order to avoid an unnecessary biopsy. I think that other causes of PSA rise (BPH, prostatitis, urinary retention, sex or bike riding before test) should be eliminated first before men are rushed into biopsy.
Posted 10/7/2015 6:54 PM (GMT 0)
Based on the information given, the advice to get a prostate biopsy (or MRI-guided biopsy) is correct.
Your urologist should tell you about the precautions to take (e.g. no sex, no bike riding etc.)
If done by a competent urologist, a prostate biopsy isn't a big deal, although there are some horror stories on the Internet.

PS: a somewhat similar thread with useful info:
www.healingwell.com/community/default.aspx?f=35&m=3061904

Post Edited (Sr Sailor) : 10/7/2015 1:05:04 PM (GMT-6)

Posted 10/7/2015 9:52 PM (GMT 0)
tmichael,

PSA can be caused by prostate infection or inflammation among other things (cancer). To rule our infection usually a round of antibiotics are prescribed prior to another PSA test. Did they place you on antibiotics prior to your second PSA test to rule our infection?
Posted 10/7/2015 10:45 PM (GMT 0)
No. They just sent me off to get another PSA. When the results were the same, he scheduled a ultrasound and biopsy.

I should mention that they did a urine test at my first visit and then a ultrasound. They said my bladder was comoletly empty after urinating.
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