Should I be concerned with PSA of 1.3 and only being 38

Good day to you all.. Very informational forum, glad I stumbled upon it. At the beginning of this year I noticed some pain between the anus and testicles. Really was uncomfortable when I bent over! Went to the uro and said it was most likely a car of Prostatitis. Took the rounds of medicine and nothing happened. The pain went away, but the frequent urination kicked in. Along with the frequent urination is an extremely weak stream. We did a PSA and it came back with a score of 1.4. He said I was all good because it came back under 4. He prescribed me Flomax due to BPH. After 4 months I decided to get a second opinion because everywhere I read, 38 was way to young to have an enlarged prostate. New doc ordered a PSA as well as the PCA3. The ratio came back a 7, which came back negative. (New PSA was 1.3). We also did an ultrasound of my kidneys due another issue and during this he said my prostate was a normal size. How could I have BPH with a normal size prostate?? The last thing he said was that he doesn't like the fact my score is that high (considering my age). Said we will do the "watchful waiting approach"

The Flomax seemed to work a little bit at first, then it wore off. Also tried CIALIS, which was great for the sex, but not for my wallet. It did little to help with the frequent urination. That's really the only compliant I have is the inability to have a strong stream and frequency.

Did anybody's PC start out like this.... Or should I stop worrying and stay off this forum??

I agree with Andrew. Prostatitis very likely, cancer very unlikely.

Good luck to you and report back on how it goes!

Mr yardmaster,
As my uncle (58) is going thru something like you....a severe prostate and testicular infection with PSA coming out 145 ,which went down to 44 after 2 weeks of antibiotic treatment.
2 more weeks of antibiotics have been prescribed. And PSA to be checked again after 1 month.

The most common cause of high PSA in men below age 40 is....prostatitis..infection of prostate gland.
Do not worry..99.9% chances are that you do not have prostate cancer.
Normal value of PSA is up to 4. If you have no family history of prostate cancer and donot eat a lot of meat
your risk even more low. Chill and enjoy your life, man. its a false scare.

Watchful waiting is sensible but the "watchful" part is essential.

The time trend of PSA readings is very different for prostatitis and prostate cancer. If you have prostatis then it will likely come down pretty quickly once you get on the right antibiotic. Or it might jump around if it is resistant to antibiotics, or if it recurs. The one thing that prostatis is NOT likely to do is give you a PSa that grows slowly and steadily.

If you have prostate cancer you will likely see a fairly continuous though slow rate of rise. I would definitely NOT go away for five years and then test it again but although PC is quite rare in men your age it does occur, and when it does, it needs to be detected and treated.

For example, if you get a follow PSA test every six months, and let's say it goes up somewhat steadily 10-20% each time, never going down much, then after four tests like this that would be a pretty good indicator of cancer or a very unusually early onset of BPH. Either way it would be justification for a more extensive investigation, whether a biopsy or MRI or some of the advanced blood tests that are available these days.

The usual cutoff is 4 but that is a very arbitrary number, and your doc is right to be concerned given your number at your young age. 4 makes sense as a cutoff in a 60 year old. But the time trend gives you a lot of information and should not be ignored just because the number is less than 4.

it is extremely unlkely that your symptoms are PC related, because symptoms generally only emerge when people's psa is way higher yours - 10x or 100x or even more in some cases. However, there are a few rare cases of prostate cancer that don't throw much PSA. so it is not impossible, just very rare. But if you keep working with your urologist to find out why you are having the symptoms you are having then you'll figure it out.

FWIW, my annual numbers over six years were like this: 1, 1.3, 1.6, 2.0, 2.7, 3.6. At that point, given the time trend I got biopsied and found I had PC. The urologist said that my GP should have referred me out sooner given the regularity of the time trend.

Post Edited (proscapt) : 11/4/2016 12:58:29 AM (GMT-6)

Watch it carefully, get regular PSA tests. If it doubles in a year or two get further testing.

At 49 mine was 4.0, doc ignored it because it was in the "safe" zone.

MHO
Continue to track it, if it doubles in less than two years ask for a biopsy or some other test to see if there are abnormalities. MRI, ....