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Posted 6/3/2019 4:10 PM (GMT 0)
Hello, new to this site and first time post. I recently had a PSA test and total PSA was 4.4 with Free PSA of 7.5. I am 49 years old. My urologist told us to look for a score higher than 10 with Free PSA %. We have another visit tomorrow. I have read this puts me at 56 % chance of cancer. Any advice on PSA #s? I have had a few symptoms like leg swelling and not feeling completely empty when going to bathroom. Frequent trips also. Thanks so much.
Posted 6/3/2019 4:22 PM (GMT 0)
Welcome to HW.

Have you had more than one PSA test? PSA history is important. PSA isn't a test for cancer, but your freePSA isn't good. Your doctor might want to consider the PHI (prostate health index test) which would give more information. PSA alone can't diagnose PC, but it can help decide if you need a biopsy along with other tests, like a DRE or imaging.

You symptoms could be anything including an enlarged prostate (BPH) which might be helped with some medication. leg swelling is unlikely unrelated to your prostate - you might have a couple of issues going on.

Before you think of PC, you need to eliminate all other possible causes for elevated PSA.

Do let us know what your URO says. I wouldn't be surprised if you get a recommendation for a prostate biopsy or if you get a med or two to try.

Andrew
Posted 6/3/2019 4:38 PM (GMT 0)
Welcome to the forum ... I was 48 and had a PSA of 4.45 when diagnosed. I had symptoms of frequent bathroom visits as well.

That’s not to scare you but you are doing the right thing not ignoring.

Let us know your DRe results that your doc should be performing. An MRI / Biopsy are good next steps.

Don’t overthink or think too far ahead. Take one step at a time.
Posted 6/4/2019 7:47 PM (GMT 0)
Low free psa percentage may due also due to prostatitis. Your symptoms may confirm that, but your doctor may recomment more test depending on your clinical details. I hope you will not have to come here more often in the future. Good luck.
Posted 6/4/2019 9:29 PM (GMT 0)
Thanks guys. Just got back from the Doc. Will have a biopsy soon. The doc said he is concerned but IF it is cancer all indications are it has been caught early. We don't know for sure but will do the biopsy just to be safe.
Posted 6/4/2019 10:09 PM (GMT 0)
based on the one number it's hard to say, but generally, the lower the PSA, the earlier you caught it.

The biopsy will tell the tale.

Andrew
Posted 6/6/2019 2:12 PM (GMT 0)

Phil070 said...
Hello, new to this site and first time post. I recently had a PSA test and total PSA was 4.4 with Free PSA of 7.5. I am 49 years old. My urologist told us to look for a score higher than 10 with Free PSA %. We have another visit tomorrow. I have read this puts me at 56 % chance of cancer. Any advice on PSA #s? I have had a few symptoms like leg swelling and not feeling completely empty when going to bathroom. Frequent trips also. Thanks so much.

I had similar numbers, even the same symptom (frequent bathroom, no swelling), and my doctor immediately order an MRI and biopsy.
Posted 6/7/2019 12:07 AM (GMT 0)
Hi Phil.. welcome to the site. Yes, reading that PSA is elevated and PSA free number is low can cause you and your doc concern. Probably not a bad idea that you are doing a biopsy. Initially my first PSA was 3.8 and then 4.1 on a recheck. On second PSA a PSA free was done which was 13. That is how my journey started. After a 6 core random biopsy that was negative, then within 6 months my PSA went to 6.1 and PSA free to 5, Uro gave me 18 core biopsy and it was also negative. Then a MRI was ordered... negative. Then URO told me to come back in 6 months. He told me “my insurance doesn’t pay for any more test and that my prostate is small and we put a lot of holes in it so there is no cancer there”. After my own research and discussions on HealingWell and with a local PCa support group, I knew my numbers were going in the wrong direction too quickly and I was advised to get a targeted biopsy which I did (a color Doppler ultrasound)... bingo my G9 cancer was found.

I’m not telling the story to worry you, just that if the PSA is elevated and PSA free is dropping, then there is a higher indication of cancer even if the random biopsy is negative. Like Andrew mentioned above, PSA history is important. If PSA continues to climb and PSA free continues to decline, then additional test maybe needed and I would recommend a targeted biopsy.

Anyway, good luck and I hope you don’t need to join this club at your young age. Take care. -JR
Posted 6/27/2019 1:01 AM (GMT 0)
Hi guys, biopsy was today. Not as bad as I thought.....still no fun. Fair amount of blood but drinking good bits af water. Now the dreaded wait on results. Hope all is well with everyone.
Posted 6/27/2019 4:35 PM (GMT 0)
Phil,
I hope the biopsy turns out well and you have no need to return. If it doesn't turn out that way, don't go into panic mode - just head on back for some guidance and support.

Good luck!
Posted 6/28/2019 6:13 PM (GMT 0)
Sending good karma your way...
Posted 7/2/2019 9:43 PM (GMT 0)
Received our test results today and my first biopsy was negative, that was a relief. My doctor is still concerned but was also happy. Will see him in 6 months. I know a large number of initial biopsies turn out as a false negatives. Should we ask for an MRI or just wait for the next round of test?
Posted 7/2/2019 10:11 PM (GMT 0)
Congrats on the negative biopsy! As to false negatives, they certainly exist, but I don't think it's possible to quantify how likely they are. This site certainly has a fair number of guys with initially negative biopsies, but we're also not a representative group--the guys that are fine have no reason to hang around here.

I'm no doctor, but I think you're good to go (and not worry) for six months. At that point, if your uro suggests a second biopsy, an MRI-guided biopsy could make sense.
Posted 7/2/2019 10:31 PM (GMT 0)
You need to wait about 3 months before a mri is done to avoid artifacts due to the biopsy. Therefore, you may relax for the suggested 6 months. After a negative biopsy, you deserve this at least.
Posted 7/2/2019 11:09 PM (GMT 0)
How many cores did the doctor take for the biopsy? I had twenty cores sampled; I've seen men who only had ten. I've also seen plenty of men get several biopsies before cancer was detected. A biopsy can often be a shot in the dark as far as I am concerned. Men who have had their prostate removed are upgraded, or downgraded, after a pathologist takes a look at the gland - I think the stats could be as high at 30%, if I remember correctly.

Check this out:

"Chicago Prostate Cancer Center has developed Stereotactic Transperineal Prostate Biopsy or STPB. This is the most comprehensive, sophisticated prostate biopsy technique available, diagnosing 40% more cancer than the standard office procedure—cancer that would have otherwise gone undetected.

"Many of the cancers missed by the standard transrectal biopsy are in the apex of the prostate gland. The apex of the prostate gland is located at the bottom of the gland. The apex is pointed down to the perineum as opposed to the base which is wider and located next to the bladder."

https://www.chicagoprostatecancer.com/pages/prostate-biopsy

Post Edited (Buddy Blank) : 7/2/2019 5:14:32 PM (GMT-6)

Posted 7/2/2019 11:11 PM (GMT 0)
Forgot to add: a MRI, with your PSA, would likely show nothing re: PCa, and be a waste of time and money.
Posted 7/2/2019 11:13 PM (GMT 0)
Congratulations! While the biopsy results are not a guarantee, they are the best results possible. Good for you.
Posted 7/2/2019 11:25 PM (GMT 0)
Thanks guys! Buddy Blank it was a 12 Core Biopsy. My doc would also concur. He he wanted to see me again in 6 months. I told him I just recently learned Prostate Cancer runs in the family on my father's side. I did not know my father well but leaned that atleast one cousin and ALL of Uncles have had Prostate. He thought about checking me every 3 months but elected to go with 6 months but he told me to call if I continue to notice symptoms or develop new symptoms.
Posted 12/14/2019 8:46 PM (GMT 0)
Hello, it has been a few months from my last post. I had a biopsy around June and it was negative. My PSA then was 4.4 and free PSA was 7.5. DRE was normal. I have a family history so the doc is checking me frequently. All of my uncles and atleast 1 cousin has had PC.
My latest results was a 4.66 PSA which was tested on DEC 3. The Lab guy took off and did not know the doc had ordered a free psa as well. I was tested again on DEC 10. My PSA went from 4.66 to 5.3 and my free PSA % is now 5.5. I am 50 and am concerned about this. I will have an MRI guided biopsy once all the paperwork goes through. Any advice would be appreciated.
Posted 12/14/2019 9:15 PM (GMT 0)

Phil070 said...
Hello, it has been a few months from my last post. I had a biopsy around June and it was negative. My PSA then was 4.4 and free PSA was 7.5. DRE was normal. I have a family history so the doc is checking me frequently. All of my uncles and atleast 1 cousin has had PC.
My latest results was a 4.66 PSA which was tested on DEC 3. The Lab guy took off and did not know the doc had ordered a free psa as well. I was tested again on DEC 10. My PSA went from 4.66 to 5.3 and my free PSA % is now 5.5. I am 50 and am concerned about this. I will have an MRI guided biopsy once all the paperwork goes through. Any advice would be appreciated.

you are doing the right thing by staying on top of it. I had prostate cancer at your age but didn't get tested until I was 53. i'm very fortunate to be disease free. good luck to you.
Posted 12/14/2019 9:54 PM (GMT 0)
I second F8’s suggestion to stay on top of it. Get the best Drs and tests available to you. There are no do-overs for those who don’t act timely. I was 53 at Dx with a PSA of only 3.5, 3 cores positive and G-8, not contained to the prostate. PSA doesn’t always tell the story. You’re doing the right thing. Stay the course and best of luck to you!
Posted 12/15/2019 5:47 PM (GMT 0)
That is a trend worth the targeted biopsy, especially with the family history. Good luck and keep us posted. -JR
Posted 12/15/2019 8:50 PM (GMT 0)
Thanks guys. Will keep you posted.
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