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Posted 12/11/2019 10:11 PM (GMT 0)
Some might remember me as I first posted in October. I had several threads. This was my introductory one:
https://www.healingwell.com/community/default.aspx?f=35&m=4161449

A really quick summary is that I'm 48 years old now and I have a family history of prostate cancer and had a 3.3 PSA score from my blood-work in October. My PCP called and told me to see a urologist. I saw a urologist and the DRE was clear and he told me to get retested. I did so today and my PSA came back at 2.5! The nurse said this was in the normal range.

I had ejaculated and lifted heavy weight within 24 hours of my previous test in October as my doctor did not inform me that I wasn't supposed to do this. For my test today, I had not done those things.

I'm supposed to have a follow-up visit with my urologist next week but I'm not sure if I'm going to go. I think a re-test for my next physical in 11 months would be the way to go. What could the urologist tell me that I don't know? I'm not going for a biopsy with my PSA dropping.

Age 41 - PSA 1.73
Age 42 - PSA 3.69
Age 45 - PSA 2.40
Age 47 - PSA 3.30
Age 48 - PSA 2.50

Thoughts?
Posted 12/11/2019 10:59 PM (GMT 0)
I doubt he would try to talk to you into a biopsy. It may be good idea to have your annual PSA/DRE with urologist rather than a PCP. A urologist would almost certainly be more skilled at detecting DRE abnormalities.
Posted 12/11/2019 11:33 PM (GMT 0)
After six years, if they’re was an aggressive cancer, you’d think you’d know it by now.

I’m with mattam on the urological visit.

footnote: a “FWIW” goes without saying in all my posts
Posted 12/12/2019 12:58 AM (GMT 0)
Considering your family history, I agree that seeing a urologist in the next six months or so is a good idea. But so far, so good; great!
Posted 12/12/2019 3:04 AM (GMT 0)
Another vote for adding the urologist to your team. The family history part is compelling to stay on top of it. Just make sure you follow the same ritual for every PSA test and always get them at the same place to get comparable results. At some point, for peace of mind, you may decide the biopsy is the only way to get some better info. Until then, just keep the discussions going and get checked on a regular basis.
Posted 12/12/2019 5:05 AM (GMT 0)
I’d get an MRI. My husband ended up as stage T3a . His
Psa in June 2018 was 2.3 . January 2019 PSA was 1.9 , DRE negative.
Paid for an mri out of pocket for ($1200) for peace of mind. It found a PIRADS 4 lesion... rest is history ...
Posted 12/12/2019 7:32 AM (GMT 0)
I'd suggest an mri as well. They're very informative. Then if something is questionable get a guided biopsy to confirm or rule out.
Posted 12/12/2019 7:59 AM (GMT 0)
A lower PSA is always reassuring. But the current level of your PSA is significantly higher than the average for your age. It may be due to two benign causes, prostate enlargement or prostatitis. As others said, only an urologist can determine the precise cause and give you piece of mind. Or indicate further test if necessary.
Posted 12/12/2019 2:33 PM (GMT 0)

Leah77 said...
I’d get an MRI. My husband ended up as stage T3a . His
Psa in June 2018 was 2.3 . January 2019 PSA was 1.9 , DRE negative.
Paid for an mri out of pocket for ($1200) for peace of mind. It found a PIRADS 4 lesion... rest is history ...

It sounds like your husband did not have years of PSA readings showing an elevation. I don't see a real correlation to my case because if I had cancer when I was 41 with a PSA reading similar to your husband's, I think I'd know about it now 7 years later.

In some ways I'm glad to have readings back to age 41 as against just getting the 2.5 result now. In my other threads I was told that a generally rising PSA was the greatest concern whereas my readings have bounced around.

I just had a DRE last month performed by my urologist. I'm by no means ruling out seeing him again. I just don't know what else he would have for me at this point as he was not going to prescribe a biopsy even at 3.3 so he wouldn't change his mind now that it's at 2.5 I wouldn't think.

Perhaps I'm taking a chance but with fairly similar readings for 7 years now, I'm inclined to wait 11 months and see where my PSA is at that time. If it's elevated to a new level, I think I'd immediately go back to my urologist at that time.

Thanks for all the input.
Posted 12/12/2019 3:28 PM (GMT 0)
Maybe your urologist did not informed you about your prostate size. A DRE gives a very rough estimation of it, but an abdominal (non-"invasive") ultrasound test is much more accurate and it takes 5 minutes. A good parameter if the PSA density, PSA divided by size. He can also order a free PSA test, another useful parameter. These are examples of simple and cheap tests the urologist may order to know more than you know now.
Posted 12/13/2019 12:07 AM (GMT 0)
I agree with jmadrid...those #s are on the high side unless you have an enlarged prostate. If the Primary doc is using a PSA of 4 as a cutoff for biopsy recommendation regardless of age then I think you might want a new one...A PSA of 3 in a patient at 45 vs 65 yrs old are not apples to apples...
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