High psa

Worrykid - Good for you to be looking after your Dad. I'm relatively new here also, but will share what I know.

The PSA is definitely a concern, others can share whether there is an explanation for the high level other than cancer.

It's great that your Dad is in great shape and healthy, it will serve him well in recovering from any treatment that may be required. Its pretty common to give patients an antibiotic and re-test for PSA to rule out infections. You mentioned a possible infection, do you know if there is a plan to do another PSA test prior to the biopsy?

As for the biopsy, mine was uneventful, much less dramatic than I was expecting. I've heard it described as feeling like a rubber band being snapped against your skin, which I think is accurate. Make sure he gets local numbing to minimize the discomfort. There are potential complications that your Dad will be made aware of. Side effects will be blood in the semen and potentially blood in the urine for several weeks after the biopsy. You will get your results a couple of days after the biopsy, at which time (if cancer is found) you should have the slides sent to Dr. Epstein at Johns Hopkins for a second opinion. All of the details are in the "read this first" sticky at the top of this forum.

>If he doesn't have symptoms he's fine right?

No. I was completely asymptomatic prior to my diagnosis. But don't assume it's a death sentence either. There are many effective treatments for prostate cancer that can help cure it or keep it at bay.

Not knowing what you're dealing with is stressful. The biopsy will bring some clarity to the situation, at which time you can transition from worrying about the unknown to dealing with it. For me, that was a turning point where I took control of my disease.

Good luck, and please come back and let us know how it goes.

Kit
San Diego, CA

I had a biopsy in July, 2015. It was uncomfortable, but not real painful. Afterwards, like Kit said, blood in semen for awhile. My ejaculations were very weak, only a couple drops. Erections were less than before. Results were negative though. Two years later, blood in back, looks brown. PSA has gone way up, 7.5 to 11+. I have an MRI schedule for tomorrow. Might have to get a second biopsy. I think I am in good shape, exercise daily, don't eat too much red meat, but not out of the woods yet. Because your dad is in good shape, recovery should go well. Keeping my fingers crossed for him. Jack.

Knocked out is good. Some of us had near painless biopsies others like me thought it hurt like hell.

So, knocked out is good.

The combination of PSA and the DRE exam l would bet point strongly to cancer.

By itself PSA is only an indicator something is off and needs to be studied.
BPH is an enlarged prostate, the whole thing is swollen. Your dad had a hard lump.

But breathe, PCa by and large is manageable. Take time to make decisions. Read up and ask questions. People like Tall Allen are remarkable in their knowledge and research skill.

I was in a similar situation as you can see in my signature. PSA 59 with a lump. My doc said most likely cancer and it was confirmed by the biopsy. We treated it effectively and seven years later I just got another undetectable PSA. So I went from 59 to essentially zero and have stayed there. My treatment choices were effective and I have no lasting negative side effects. So please do not worry.

Your next step is to do the biopsy which is uncomfortable, but for most men, not much more than a bit of an inconvenience.

Then, most importantly, do not rush to a treatment decision or just do the first thing that is suggested.

You must do your research which must include multiple opinions from different specialists. There is no single best way to treat prostate cancer and you will be overwhelmed with choices. Stay relaxed and understand that it is fine to take three or four months to research and decide what to do.

We are all here to help by providing you with our individual experiences and some may be able to direct you to great doctors in your area.

First of all, I want to point out that 65 isn't old. When you get a little older you will see this, too. More to the point, as others have said there is a chance that it isn't cancer, and if it is, there is a chance that it won't need to be treated. But the high PSA makes it more likely that it is cancer and, if cancer, that it will need to be treated. My cancer was completely without symptoms until I had surgery. I think that is very common. That's why before the PSA test prostate cancer was a "silent killer." Now that it can be detected before symptoms emerge, it can be very effectively treated. The mortality from prostate cancer has dropped 50% since the advent of PSA testing.

>What are the risks of no treatment?

You won't know until you know what he is dealing with. The biopsy will shine the light on that.

'No treatment' is a viable option for some low risk prostate cancers. Others require immediate treatment.

The kid said...
Is it possible that one could have prostate cancer and as long as you never get a PSA or DRE test you will never know and it will never affect you?

Yeah, that's a thing for sure. The PSA test does a fair job of detecting prostate cancer when it's there but it is given to false positives. It also detects cancer in men with little dabs of insignificant cancer that will never give them any trouble if they live to be 100. Lots of men are needlessly biopsied and many men receive treatments with horrible side effects (incontinence, impotence, etc.) for a disease that never would have bothered them, all because they had a PSA test and it came back a little bit high.

Of course, there are other guys who do need the treatments and a timely PSA check saves their lives. You never get to know ahead of time which way any given man will go.

So there's that. But, in your dad's case, his PSA is high enough that its pretty clear he needs to know what is going on, especially in light of what his urologist said about his DRE.