Rapid PSA rise

I have taken PSA tests for just above three years. The values have jumped up and down in the interval 3.4 to 7.8 with quote about 0.20 mostly. When the PSA rose from 4.0 to 7.8 in 8 months I had a biopsy in May 2014 with 12 needles which was negative. Just recently I got a PSA of 27 with quote of 0.20!! My urologist thinks that the rapid rise has to do with some infection and that it is very rare that it would be caused by Prostate Cancer. I asked for a CPR infection test but that was negative. My urologist suggests a new PSA in one month as follow up. Has anyone experienced something similar? What is happening?

PSA history
-13 Sept 4.0 Q 0,21
-14 May 7.8 Q 0,17
-14 May Biopsy 12 all negative
-14 Sept 3.4 Q 0.24
-14 Dec 4.8 Q 0.20
-15 May 6.2
-15 Dec 6.5
-16 May 4.5 Q 0.24
-16 Dec 27 q 0.20

Your doc is correct. PSA generated by cancer rises at a consistent rate that correlates with the growth rate of the tumor plus the psa generated by the volume of normal tissue which rarely changes.
Psa that fluctuates widely up and down is usually caused by an infection. See the article below.
"What every doctor that treats men should know" By Dr Stephen Strum

http://www.yananow.net/DonnasDoctor.shtml

John T

Thanks for the responses! I feel comforted that you all beleive that my raised psa is caused by some kind of infection. This is in line with what my urologist told me. He did not offer any medication to cure the suspected infection.

He said it could be caused by different kinds of infections including even a cold and not necessarily prostatitis. I have been told before that it is not sure that a prostitis is curable by antibiotics. It could be virus related he said. I am just not sure that if I do have some kind of infection in the prostate that it is settled after a period of one month so maybe I will get a new similar PSA which of course would be quite disturbing.

I do not have any pain that is typical of prostatitis but I have read that one can experience protastitis without much symptoms. Do you agree with that?

Concerning the term quote that was questioned by ASAdvocate. Yes I am outside of the USA. The term PSA quote can be attained in the PSA test and it is defined as the free PSA divided with the total PSA. I have read that if the quote value is above about 18 % the chance is lower that there is a PC at least for PSA in the range about 3 to 10 or even up to 20.

I am grateful for all the comments that I received. I am scheduled to take another PSA test in about a week so it will be about one month from last test. I just wonder if anyone has any experience of such a substantial change in PSA from 4,5 to 27 in six months?

If I have some kind of infection in the prostate how likely is that the PSA is back to normal in one month which will be the interval from my last PSA to the next scheduled in about a week? My urologist did not suggest any particular treatment for any infection since I did not show any typical prostitis symptoms. He did state that some other infection could cause a PSA rise. I do not want to take anoter biopsy if the rise is infection related but if the level does not decrease I suspect that my urologist will suggest another biopsy.

Do let us know what the results of the next test are. When we hear of rapid changes in PSA, most often it is prostatitis. It doesn't always respond to antibiotics and can be difficult to treat.

At this point, you best course is to get the retest and then decide on the next steps. I know you want answers, but all there is a the moment is speculation.

Hang in there, it's difficult waiting for answers.

Andrew

Last week I took a repeated PSA test and it showed 7.1 and a normal ratio of free to total PSA. So the PSA dropped from 27 to 7.1 in about 5 weeks! Great! My urologist said be believed the sudden rise in previous test from 4.5 to 27 in 6 months was caused by some kind of infection although he was not more specific than that. Just prior to the repeated PSA test I also managed to talk my urologist into getting an MR scan although he did not suggest that. The MR scan which I took just prior to the repeated PSA test showed no abnormalities.

I am now scheduled for a follow up PSA test in 3 months. My PSA has moved up and down earlier but not nearly as high as this last peak. If it is my prostate that has some kind of chronic infection I do not quite understand how I will be able to use PSA testing over time to monitor possible PC. Nevertheless I am happy that my PSA dropped so quickly!

Likely you have something chronic and your PSA will be 'bouncy'.

PSA isn't all that good of an indicator for PC. It gets used a lot because it's a simple blood test. In your case you'll have to track over a long period and watch what happens to the low numbers. If the overall trend is towards higher lows and higher highs then you might need another biopsy.

All you can really do is watch and wait. Frustrating.

Andrew

Prostatitis is almost always relapsing and remitting. For many men, once they've got it, they have it for life. It seldom shows any discernable pathogen or response to antibiotics. The only thing to be done is to wait it out. It's just something you have to live with. You might be able to get a Prostate Health Index (PHI) test, which is a little less sensitive to prostatitis, compared to PSA or % free PSA. But it is still thrown off by high PSAs.

Thanks for your comments! I realize that worrying is not very helpful but sometimes it is hard to avoid. I have not even got the diagnosis Prostatitis but that is what I myself speculate possibly could explain fluctuating PSA. My urologist said that many different kind of infections could cause impact on PSA. I asked him about Prostatitis but he did not think I have that. I do not know what he bases that statement on. I have heard that you can experience Prostatitis without distinct symptoms and that would fit my case.
The way my PSA jumps I do not understand how it can be used as a tool in monitoring possible PC. Very frustrating! The percentage of free PSA droppen fr.o.m. 20% to 15% in my latest PSA-test. (While PSA as mentioned increased from 5.0 to 10 in the latest 6 month period)

I am scheduled to take a renewed PSA-test in a few days. As you can see in my first input on this thread my PSA dropped earlier from 27 to 7 in one month. about a month ago the PSA was again up ( from 5 to 10 ) in a period of 6 months. If my PSA turné out not to have droppen significantly in one months time since last PSA test should I go for another Biopsy? As you see in my initial description of my case I have a historia of PSA jumping up and down. Should the test for possible infection through a blod test have showen up in case I do have Prostatitis (without symptoms)? I would really appreciate any response!