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Posted 11/17/2017 5:53 PM (GMT 0)
As many of you know here- I am getting my first biopsy--Wed- 30 Nov

OK--Talked on the phone with my Urologist--
He mentioned something very interesting..& enlightening & I never heard before-

Knowing I have- a "Very big Prostate" (He quoted the size..I forgot )...BUT,,,he,,did say....that a very large prostate....can equate to a high PSA...equivalent to...the size ratio-!

For instance....a prostate...say....4 times--the average size....can make a PSA...of 16...where it can be extrapolated--to a "4" with a normal sized one ! (Like 4 times...a 4 = 16 )

Again--interesting...& curious if anyone ever heard anything like this- before ! How about Tall Allen...?

Get back,
R*
Posted 11/17/2017 6:23 PM (GMT 0)
I don't know if its linear that way, but a larger prostate, i.e. BPH will tend to put out more PSA
Posted 11/17/2017 6:37 PM (GMT 0)
I think John-T has posted several times about the mathematical relationship between prostate size and PSA. PSA density, which equals PSA/prostate size is a better indicator than PSA alone. for the average man, PSA density is about 0.15 ng/ml/g (with a std deviation about as large) . Densities much higher than that raises suspicion of prostate cancer. Densities below that may be due to normal tissue or BPH.

For men with BPH, the overall PSA density is 0.12 ng/ml/g, but the PSA density in the transition zone, where BPH principally occurs, is about 0.3-0.5 ng/ml/g. The PSA density of tissue invaded by prostate cancer is about 1.9 ng/ml/g. Because prostate cancer usually occurs in the peripheral zone, some believe that peripheral zone PSA density would be a better measure in patients taking Proscar or Avodart (which preferentially shrinks the transition zone and the PSA coming from it).

/www.ncbi.nlm.nih.gov/pmc/articles/PMC3814120/
Posted 11/17/2017 10:41 PM (GMT 0)
Yes, a large prostate can generate plenty of PSA, and prostatitis can ramp that up even more. I hung my hopes on that even after I had my biopsy done, and my URO told me not to worry, that a prostate my size could easily generate my PSA numbers of almost 12. But alas, it did no good for me to have that hope.
Posted 11/19/2017 1:21 PM (GMT 0)
I had a 79 cc Prostate and a PSA of 7.9. Back then, it was of some comfort to know that the large prostate might account for the PSA increase; however, I still needed the biopsy to determine if I had cancer.

Removal of the prostate did correct a lot of the problems associated with a large prostate ..... frequent urniation, waking up several times in the night, long stays at the urinal and weak slow stream, etc.

Good luck with the biopsy ..... sure hope it is negative.
Posted 11/20/2017 2:01 PM (GMT 0)
Wotan - I, too, was temporarily comforted that my rising PSA could have been the result of my BPH. Over a few years, we watched my PSA rise and my prostate growing. Once my PSA went over 4, we started looking at PSA density, free PSA and a few other stats. Ultimately I had a biopsy when my PSA hit 5.69, and we found several cores of very low volume G3+3 and one low volume G3+4. The rest, for me, is history.

In my case, I had been suspicious but not worried for a couple of years, as PSA rose. Once it was time for biopsy, I didn't have any real expectations one way or the other, but I got myself prepared. . . just in case. When I got "the call," I wasn't really surprised. I was in shock, as most of us were, that I had Cancer. The folks here quickly got me past the shock and into research mode so I was able to decide my own best path forward.

Hang in there. As I keep reminding myself, "There's nothing wrong until you know there's something wrong."

P.S. Don't forget to ask for the peri-prostatic nerve block prior to the biopsy!
Posted 11/20/2017 5:50 PM (GMT 0)
I had a similar experience but in the other direction. Before my biopsy my PSA never went beyond 4 which is the standrad that comes back on the routine blood test. When I had an ultrasound by the Uro, he told me that for the size of my prostate, my standard PSA should have been less than 2.4
Posted 11/20/2017 9:00 PM (GMT 0)
Hi,

The psa numbers generated by benign prostate tissue is addressed by the following paper:

https://www.ncbi.nlm.nih.gov/pubmed/9743696

In particular, the following quote from the paper covers the point:

"The TZ [Transition Zone] expressed approximately 2.7-fold more t-PSA than the remaining CPZ [Central and peripheral zones] median 0.14 vs. 0.052 ng/ml/g, respectively."

This paper indicates that BPH which affects the Transition zone predominately can generate higher than normal PSA numbers which may not indicate underlying prostate cancer.
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