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Posted 12/14/2015 12:30 AM (GMT 0)
Hello new to the forum

I am a 51 year old male. My recent PSA test come back at 1.9. Up from 1.3, 12 months ago. It has been at 1.3 for the last couple of years. I am freaked out that the increase was so large. I have an appointment with my Urologist this week and wanted to know if I should insist to have a biopsy right away or be retested in a couple of weeks. I think I had sex roughly 48 hours prior to the test.

Could this be a one time spike?

I have had a weak urine flow for a number of years and I dribble after I urinate. So some urination issues for at least 5 years. I also get up and pee during the night. I am roughly 220 pounds and pre diabetic. 6 feet tall. trying to lose weight!!

So what should I do? insist to have a biopsy if he recommends that I wait and get retested in a couple of weeks? can I afford to wait?

Thanks!
Posted 12/14/2015 12:50 AM (GMT 0)
Welcome to HW.

I vote for a retest - it's likely a spike. It's also not a very high PSA. Sex is known to raise PSA. Also, PSA is not a test for cancer. It's only an indicator of prostate activity. An elevated PSA could also be an infection, enlarged prostate (BPH), recent sex, bike riding and so on. Cancer is very low on the list.

Generally you don't get a biopsy until you've ruled out all other causes. The symptoms you describe could be any number of things, but PC isn't high on that list. An enlarged prostate is more likely to cause that. Also infection (prostatitis) is more likely to rapidly raise your PSA than PC.

But I am not a doctor, just some random guy in the internet.

What you should do, is get your URO to do a complete exam, repeat the PSA and possible order some other blood tests like freePSA or the PHI (prostate health index). At this point, a biopsy shouldn't be on your radar.

You might need some meds for BPH or possible a course of antibiotics to rule out infection.

and PC is a very slow growing cancer, even if you had it (which I doubt), you have a long time to figure it out (months, years). Don't rush into anything.

Andrew
Posted 12/14/2015 12:50 AM (GMT 0)
Hi, Jr.

"Could this be a one time spike?" Yes!

"So what should I do?" RELAX!

Jr--- a PSA is just that---a PSA. It only indicates that _something_ is causing it to elevate. Frankly, yours isn't all _that_ high for your age. It falls within the norms for your age group and may have been the after effects of having sex, as well as an enlarged prostate, which may be your other problem.

Your uro will give you advice. but almost all seem to start with a round of antibiotics, a DRE, and a PSA re-test after the antibiotics round.

Insist on a biopsy? Are you into sadomasochism?! Kidding.... If it comes down to that, which I seriously doubt at this point, ask about a 3t mpMRI before having the procedure, as well as a fusion biopsy if something is found that's 'suspicious.' Before that happens, ask about a PCA3 test, as well as a PHI test.

Curious, but where are you located, and do you have a family history of PC?
Posted 12/14/2015 1:02 AM (GMT 0)
Thanks guys for your quick replies!! I live in the east bay of San Francisco so I have good access to great medical facilities (UCSF is one of them). I do not have a family history of PC but both my parents died of cancer (my dad of kidney cancer and my mom breast cancer). So I have seen first hand what cancer can do if a person waits to long. My mom waited to long and by the time she was diagnosed she had stage 4 cancer. So I guess I am very sensitive.

So I will go to the appointment with an open mind and just follow his advice. I think I will at least ask for the freePCA test and PHI test now. Thanks again
Posted 12/14/2015 1:58 AM (GMT 0)
1.3 to 1.9 is an insignificant rise over 12 mos. the alarmists and perfectionists will disagree...so be it. Put it out of your mind and get a psa test in another year. If you are worried and the uro knows it and have good insurance...trust me you will not need to insist on a thing...you will have every test devised thrown at you and will then be entangled in the medical system which few escape unscathed. If this rings true to you...heed it. If not... Welcome to healing well. fwiw! Oh Pca is not your fathers or mothers disease...no way near it. Put that bugaboo away permanently. Editorial...not necessarily related to you Jr.: Why is the human species so obsessed with their "sins" that they are so sure disease is their due punishment. It is their dis- ease over that...that is the culprit. We are all special...but not so special that the universe is in some sort of conspiracy against us.. Pogo..." we have met the enemy and it is our selves " Can anyone honestly look at most "troubles" and not see the truth in this. Ok gibberish...pontifical...I forget the other one... vent over. I am allowed that as I am a gleason 9 survivor...without portfolio...honk honk EDIT I noticed that my, fwiw, could very well mean, by those so inclined, to refer to Healingwell. It does not!! thats as much as I need to say about that
Posted 12/14/2015 2:22 AM (GMT 0)
Boy howdy, even a causal student of PCa knows this one time increase means next to nothing..that is not rocket science. You don't have to be an expert to know that another psa in a year ..6 months if you insist on it..is all you have to do. I'm not a medical professional either, no one here is, but you don't need to be to understand this.
Posted 12/14/2015 4:36 AM (GMT 0)
PC is not like other cancers and rarely is so aggressive that it requires immediate action.

and you most likely have something else that needs treatment.

Get to the URO, but you don't need to run. A fast walk will do.

Andrew
Posted 12/14/2015 10:06 PM (GMT 0)
Saw my Urologist today. He did a DRE and said everything was normal. He also showed me my PSA scores since 2011. 2011=1.59, 2012 1.21, 2013, 1.31, 2014 1.32, 2015 1.92. So he said he saw nothing alarming in my trend data. And my scores just fluctuate. I pushed him a couple of times on what I should do next and he said nothing. Get retested in a year.

I think that is to long and probably will have another PSA in a couple of months. He did not want to do any further testing at this point so I guess that is a good sign. Thanks again all.
Posted 12/14/2015 10:11 PM (GMT 0)
He's right, retest in a year. That more than soon enough.

all you have is an interesting set of numbers and nothing to worry about.

Andrew
Posted 12/15/2015 1:41 AM (GMT 0)
I vote for relaxation and a retest in a year or six months if you're really worried. Your numbers are similar to mine and I was pleased my Uro pushed for an early biopsy.
Posted 12/15/2015 2:41 AM (GMT 0)

jr2312 said...
Saw my Urologist today. He did a DRE and said everything was normal. He also showed me my PSA scores since 2011. 2011=1.59, 2012 1.21, 2013, 1.31, 2014 1.32, 2015 1.92. So he said he saw nothing alarming in my trend data. And my scores just fluctuate. I pushed him a couple of times on what I should do next and he said nothing. Get retested in a year.

I think that is to long and probably will have another PSA in a couple of months. He did not want to do any further testing at this point so I guess that is a good sign. Thanks again all.

I think I had sex roughly 48 hours prior to the test.

Wouldn't be too concerned, retest in a year sounds reasonable to me. My PSA has been up and down for the last four years so I have learned to not get too anxious every test.

And maybe abstain from the rough sex for more than 48 hours before the next test smilewinkgrin
Posted 12/15/2015 3:51 AM (GMT 0)
I don't think any competent urologist would even give you a biopsy with a PSA that low. The standard (NCCN) is to retest in 1-2 years. They only advocate biopsy if the PSA rises over 3, and then only after a re-test, a DRE, and all other causes are ruled out.

I would be more concerned with your urination problems, which probably are due to BPH. If so, your urologist can quickly determine that with an ultrasound, and he can give you some medicine for that.

- Allen
Posted 12/15/2015 9:48 PM (GMT 0)
Wow; total agreement among all those responding!
Posted 12/15/2015 11:17 PM (GMT 0)
You're not even in the most conservative range for a biopsy. ("SPIKE" is a pretty loose definition of what your psa is doing...or in your case...not doing).

Just keep having sex roughly.
Posted 12/16/2015 12:39 AM (GMT 0)
Thanks all I appreciate the good advice and humor. My wife will appreciate the giving up on the rough sex part. But only before any retest :)

I think the hardest part is waiting to get retested again since my lastest PSA was 1.92 and I keep thinking it is continuing to go up. Oh well I will have a couple of drinks and forget about it.

My Urologist did order a flow test for next month since my urine flow is pretty weak. Not sure what that will help determine except maybe an enlarged prostate or muscle weakness.

If anything changes I will let you all know.
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