HealingWell
Search Close Search
☰

47 Years Old - PSA Test Result of 3.3

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/30/2019 5:24 PM (GMT 0)
Hello,
I've read through some threads including this one that highlighted a somewhat similar case:
https://www.healingwell.com/community/default.aspx?f=35&m=2379464

I just feel the need to start my own. I appreciate already the support that I can see this forums offers.

Brief history:
Father died at age 79 of prostate cancer. I believe his was first diagnosed in his early 60s.
I had my first PSA test at age 41 and my doctor did not express concern with my result of 1.73. He has since tested me every 2-3 years.

So I had my blood-work today and get a call from my doctor just a couple hours later. He seemed quite concerned as he informed me that my result was 3.3 up from 2.4 two years ago. Given that trajectory and my family history, he wants me to see a urologist and get fully tested.

I know that 4 is the usual level of concern but I have the added risk factors of trajectory and family history. So, I'm swallowing this news and pretty much preparing for the worst.

Then, on a hunch, I went to the patient portal of my doctor's site to look for other results. This is what he said about my 2.4 result from 2017:
"Last PSA from 3 years ago was 3.69 so this is improved".

HUH????! So five years ago my PSA was almost .4 higher and NOW he's concerned? What about when it went from 1.73 to 3.69? Why no concern then?

To summarize:
Age 41 - PSA 1.73
Age 42 - PSA 3.69
Age 45 - PSA 2.40
Age 47 - PSA 3.30

What do you guys think? Do I really need to see a urologist and have the biopsy that he'll likely recommend? Would you insist on another PSA test first?

I really would appreciate any feedback. Thank you.
Posted 10/30/2019 5:37 PM (GMT 0)
Hello Jason and welcome. Prostate cancer is usually indicated by a steadily rising PSA. The bouncing around that you are seeing is more indicative of a prostate infection. My advice would be to get a course of antibiotics to try and treat the infection and re-test your PSA in a couple of months to see what happens. Prostate biopsies are generally routine but not totally w/o risk. Also make sure no sex, bide riding or strenuous exercise for 48 hours before your test as those activities can inflate the PSA numbers.

Good luck. Stick with us and we will help any way we can.

Jim
Posted 10/30/2019 5:52 PM (GMT 0)
Thanks for your response. I was not informed about exercise or sex before I had the PSA test as part of my physical. I did heavy weight lifting the night before and had sex.

I happen to be on antibiotics right now for a sinus infection. All these factors seem to weigh in favor of retesting in a month rather than running to a urologist.
Posted 10/30/2019 5:56 PM (GMT 0)
I wouldn’t put too much weight into the “PSA of 4 and under as normal”. At 48 my pSA of 3.2 resulted in a biopsy that showed intermediate risk prostrate cancer.

Your generally trending higher so would definitely see a urologist. He will perform a DRE.

I would encourage you to get a more sophisticated PSA test done soon to get your free PSA score - it’s called the PHI or prostrate health index test. The Free PSA reading is a better indicator of prostrate cancer or the lack of.

Don’t worry, you have come to the right place , but do take the necessary steps.
Posted 10/30/2019 6:04 PM (GMT 0)
Thanks for your advice. Do you recommend that I wait and see a urologist before getting the free PSA test? Or do you think I should insist that my primary care doctor set one up immediately? He told that his office has contacted a local urologist and will be referring me. Not sure how long the process will take.
Posted 10/30/2019 6:07 PM (GMT 0)

JasonB176 said...
HUH????! So five years ago my PSA was almost .4 higher and NOW he's concerned? What about when it went from 1.73 to 3.69? Why no concern then?

.

My thoughts are age and probabilities. With a fellow who'd just basically entered his forties I could see a doctor thinking "prostatitis". And it going down just confirmed his suspicions.

Now pushing 50 with an increase, he's not so sure of his diagnosis.

Just a thought. Only he knows for sure.

I'm not real big on doctors keeping their thoughts to themselves. (Mine's done that in the past). I like doctors who think out loud to their patients. Builds trust. But that's me.
Posted 10/30/2019 6:17 PM (GMT 0)
Jason, Only going from my experience but I tell all the new guys pretty much the same. You want to become your own advocate which you are starting to do Find a good team and a good facility. You never mentioned any symptoms so don't know if you are experiencing any of these. I would find a good urologist who I am sure would want you to do another psa check and as the guys have said take it easy a couple of days before. If you do have a biopsy and the results don't look good remember you have time to do a lot of research and check out all your options. Hopefully you will come back here and just tell us it was a case of prostatitis.

Larry


.
Posted 10/30/2019 6:32 PM (GMT 0)

Skypilot56 said...
Jason, Only going from my experience but I tell all the new guys pretty much the same. You want to become your own advocate which you are starting to do Find a good team and a good facility. You never mentioned any symptoms so don't know if you are experiencing any of these. I would find a good urologist who I am sure would want you to do another psa check and as the guys have said take it easy a couple of days before. If you do have a biopsy and the results don't look good remember you have time to do a lot of research and check out all your options. Hopefully you will come back here and just tell us it was a case of prostatitis.

Larry


.

I've had some mild ED but am not sure if that is known symptom. Otherwise, I'm the picture of health. I'm not overweight, run, cycle, and do strength training. I recently won a 5K race for my age category. I know that prostate cancer can affect those seemingly healthy but I'll admit that I'm finding it hard to believe I can run at that level and be seriously sick.
Posted 10/30/2019 7:21 PM (GMT 0)
Your mild ED symptoms are a concern - Esp with above than normal PSA for your age. I had mild ED symptoms as well.

Many urologist somehow either don’t know or don’t prescribe the PHi test - it may be because of business reason.

I would get a prescription from your primary care doc and not wait for the URO. As someone said above - you have to be your own advocate.

..and resonating from above , don’t just go to a URO , get to the best URO you can find.
Posted 10/30/2019 9:35 PM (GMT 0)
Jason, you've gotten good advice above, i just want to say welcome to the forum. Generally speaking its the trend more than the absolute number. Typically, PCa manifests itself with a very slow but steady rise.
Get a good uro and good luck
Posted 10/30/2019 9:36 PM (GMT 0)
Welcome to HW. Doesn't look like a PC pattern to me.

Retest, but each time you test, no sex, heavy lifting, etc a couple of days before.

PC has no symptoms in its early stages. ED can be caused by may things. If it bothers you, see a URO.

While getting a URO consult is okay, don't feel like you have to rush out and do that. You have some weird numbers, but I don't see a lot of urgency in them.
Posted 10/30/2019 10:14 PM (GMT 0)
Jason - I would think visiting a good urologist would not hurt. They have an experienced finger that can feel things that regular doctors do not. It is also good to get another opinion on your situation from a different doctor who might know more. My guess is that a urologist would want to do DRE and maybe blood and urine tests looking for infections. Maybe even a scan. I doubt a biopsy would be the first thing to do given your odd history but that will be your decision if it comes up.

A PSA over 2.5 for men under 50 is usually worth investigating per current criteria and also considering your family history. Your mind will want to get to the bottom of this at some point so no hurry but you are heading in that direction if you are here.
Posted 10/30/2019 10:24 PM (GMT 0)
Thanks to everyone who has offered such helpful advice and also been so welcoming.

I asked my doctor about the higher result from before and he replied that that was taken at a different lab so he said that it was "not comparative". I'm not sure why different labs would produce that much of a difference but I trust that he is familiar with the testing and that was his reason for not being concerned before.

News can't be unheard so for my own peace of mind at this point, I see no other option that to go to a urologist. My doctor recommended Dr. Daniel Blander. An Internet search seemed to confirm that he has lots of experience and generally good reviews. I'm really hoping that he'll be on the conservative side and do more tests and the exam before a biopsy. I would really prefer to have confirmation of my situation before going that route.

I've read in some threads here about the need for a catheter. Please tell me there is no chance of this from the biopsy test!
Posted 10/31/2019 12:23 AM (GMT 0)
Biopsies rarely require a catheter. Things have to go really wrong for that.

But, you're a long way from needing a biopsy. Retest, get PHI, freePSA, etc. The doc will do the famous DRE and might recommend some imaging.

Only after that should a URO think of a biopsy.

Andrew
Posted 10/31/2019 12:39 AM (GMT 0)
PSA 4.0 is simply a reference point. When my PSA rose from 2.0 to 3.4 over a period of about 2 years, my primary care doctor referred me to an urologist. A biopsy found Gleason 3 + 3 prostate cancer when I was 70 years old. It was very low volume cancer, only 10% in 2 cores out of 12. I had brachytherapy and expected that to be the end of my cancer. Then 2016, I had a extra-capsular recurrence that was treated with cyberknife and ADT. Then in 2018, my cancer became metastatic involving many lymph nodes. Now at the age of 79, I am on Lupron + Casodex.

It would be wise to watch for the next few months how your PSA behaves. Then now there is more sensitive MRI and scans that can detect prostate cancer.
Posted 10/31/2019 12:51 AM (GMT 0)
The benchmark value of 4 is just a reference point ...its also not really applicable for guys in their 40s unless you have an infection or BPH. 4.0 in a 45 year old is certainly more suspicious than one who is 65 and will typically have a larger prostate.

I had no family history and was diagnosed @ 44 with a PSA of 2.8....so I'd err on the side of caution and follow up.
Posted 10/31/2019 4:59 PM (GMT 0)
I was 49 when diagnosed with prostate cancer. PSA was 3.3.
Posted 10/31/2019 5:12 PM (GMT 0)
There have been multiple responses from those who were diagnosed with prostate cancer in their 40s with a PSA level around mine or even lower. So, short of the test being really off, how can it be that my diagnosis will be anything but cancer? There was mention of an infection that could cause an abnormal reading but I’m guessing this is quite unlikely.

I feel it’s important for my mind to be ready to accept that I have cancer sooner rather than later. Unless the test was off and the infection possibility, all the signs are pointing to cancer. Am I missing some other possibility? There should be no other reason for a PSA value of 3.3 in a 47 year old man from what I have gathered.
Posted 10/31/2019 7:28 PM (GMT 0)

JasonB176 said...
There was mention of an infection that could cause an abnormal reading but I’m guessing this is quite unlikely.

Actually, it's pretty common. One way to sorta-kinda tell the difference is that PSA from prostate infections or chronic prostate inflammation will jump around -- go up one test and down the next. Prostate cancer shows as a steady PSA rise, often not very fast and not necessarily higher than you see with an infection.

You need to keep an eye on your PSA because of your family history but some sort of prostatitis could easily explain your PSA history.

One other observation: Erectile dysfunction is not usually a symptom of prostate cancer -- its just something that happens to men around the same age as prostate cancer become more prevalent. If your ED is bothering you you can talk to your urologist about it as a separate issue. The drugs in the helpful pills are going generic one-by-one and the prices are coming way down, especially for sildenafil (the drug in Viagra). Sometimes insurance doesn't like to cover ED drugs but if you shop around they aren't that expensive to pay for yourself if you need to.

A final observation: While ED isn't a common effect of prostate cancer it is a common side-effect of prostate cancer treatments. In the not-at-all-certain event that you are diagnosed you don't want to rush willy-nilly into signing up for the first treatment you hear about. There are a number of options that will work equally well in terms of disease control but they can differ wildly in terms of side effect probabilities.
Posted 10/31/2019 7:49 PM (GMT 0)
the "benchmark" of 4 is bogus. run from any doctor who tells you you are fine as long as your PSA is below 4.
Posted 10/31/2019 8:48 PM (GMT 0)

PeterDisAbelard. said...


Actually, it's pretty common. One way to sorta-kinda tell the difference is that PSA from prostate infections or chronic prostate inflammation will jump around -- go up one test and down the next. Prostate cancer shows as a steady PSA rise, often not very fast and not necessarily higher than you see with an infection.

You need to keep an eye on your PSA because of your family history but some sort of prostatitis could easily explain your PSA history.

One other observation: Erectile dysfunction is not usually a symptom of prostate cancer -- its just something that happens to men around the same age as prostate cancer become more prevalent. If your ED is bothering you you can talk to your urologist about it as a separate issue. The drugs in the helpful pills are going generic one-by-one and the prices are coming way down, especially for sildenafil (the drug in Viagra). Sometimes insurance doesn't like to cover ED drugs but if you shop around they aren't that expensive to pay for yourself if you need to.

A final observation: While ED isn't a common effect of prostate cancer it is a common side-effect of prostate cancer treatments. In the not-at-all-certain event that you are diagnosed you don't want to rush willy-nilly into signing up for the first treatment you hear about. There are a number of options that will work equally well in terms of disease control but they can differ wildly in terms of side effect probabilities.

Thanks for that info. The not knowing is eating me alive but it's helpful to know there is at least a chance that the diagnosis won't be cancer. Even if it is cancer, I can then proceed onward with a plan.
Posted 11/1/2019 12:41 AM (GMT 0)
Jason - Ahhhh, but you don’t have anything yet. You can have a negative biopsy and still have PCa but think you are fine. This happens more that you would think with the lower levels of PCa when you consider the limitations of a standard biopsy. Try not to think too far ahead on this or you will want it removed by Christmas to be safe.

One step at a time with a good urologist to discuss concerns with is your best plan. You can’t speed it up much other that start the process and see how it shakes out. Plenty of time to worry about things later.
Posted 11/1/2019 1:13 AM (GMT 0)
Hello Jason,
I was diagnosed with PC 1.5 years ago on my 49th birthday and had PSA 2.4 at the same level for several years. I recommend finding a good uro who can perform DRE and has more experience than regular PCP. With steadily rising PSA it looks like biopsy is on the horizon. When you go for PSA next time try not to do any physical activity 24 hours before bloodwork. It is also a good idea to educate yourself. I recommend a very simple to understand book: "prostate cancer: a new approach to treatment and healing".
Posted 11/7/2019 9:27 PM (GMT 0)
My primary referred me to the urologist when my PSA doubled within 2 years....going from 1.8 to 3.8. The urologist decided to wait an additional year with an intermediate PSA test at around 6 months. DRE was negative. Six months later my PSA popped to 5.2, Then a confirmatory 5.5 two months later. I asked for a definitive test and they did the biopsy. I skipped all of the imaging prior to the biopsy. After the biopsy they scanned me for bone mets.

I was a Gleason 8 (4+4) in 4 of 12 cores. All of it on one side of the prostate. They never felt it with a DRE.

So my (newbie...and I am a newbie) advice is go to the urologist and push on the biopsy. It is real data. You always make better decisions with real data. There is a part of me that wishes I had the biopsy done a year sooner.
Posted 11/8/2019 12:23 AM (GMT 0)
My 7 cents (inflation):

> See a Uro, for gosh sakes. Your dad died of PCa, that puts you at higher risk. Your PSA numbers are squirrelly. Consult a specialist.

> Highly unlikely you'll need a catheter if you ever have a prostate biopsy. All invasive procedures have risks, and you'll hear plenty of biopsy horror stories, but for the vast majority of guys it's just a pain in the ass.
✚ New Topic ✚ Reply
12