PSA Question

Not my PSA, my blood draw is next week. This is about my son. I've mentioned him before.
Because of the fact that both me and my dad had Prostate Cancer, my son began testing at around age 37. He is now 41. I dont have exact dates, but i know i am pretty close, here is his PSA history....

January 2018 - .7
January 2019 - 1.0 (I think, not 100% sure, this was a different lab, but it made me nervous)
June 2019 - .88
January 2020 - .7
And now May 2021 - .86
He is being tested by a urologist, not his PCP, and he had a DRE that was perfectly normal last week.
I'm assuming the DRE was done after the blood draw, not before, but it just occured to me as i write this, that i should ask him. Also he said the 1.0 might have been the day after sex because back then he didnt know he shouldve abstained for a couple days. But not sure of that.

So i think i am ok with this, he seems a bit concerned, thinking that .7 to .86 is a big jump. He asked the nurse about it, she just responded "the doctor signed off on the results so it shoujld be ok.
My feeling is that its not a big jump considering the tests were 16 months apart. But i told him that if hes concerned he should call the Urologist and ask to be retested in 6 months, rather than 1 year. I also wonder, is this level a little high for his age, 41? I know the good news is it seems to be stable.

I'd like to ask opinions of the group. Am i giving him the right advice? Is this nothing to be concerned about, or is it something that needs to be watched more carefully?

As you know, I'm not an expert on PSA trends. But the differences strike me as a pretty ordinary fluctuation over time. If you were to map this in Excel, I'd guess that that any trend line would be barely up. And keep in mind how many things affect PSA that have nothing to do with PCa.

That said, this is certainly worth keeping a close on eye on this.

Ken, this sure looks like normal fluctuations. He's 41, and his PSA is floating around in the <1 range, and he has a prostate that is completely functional. Sure, keep checking it....I started annual PSAs at 40 for similar reasons, and I don't even know what the values were until they went above 1--at 54.

Doubling time, with an intact and functional prostate, is meaningless at PSA below 1.

Our son started testing when he was 28 he's 32 now. Testing has fluctuated from as low as .63 to .83 and back down again. Started testing super early so we'd have a really good baseline.

You're a great advocate for your son, Pratoman --- certainly wise for fellows to get a rapport built with a trusted doctor, and maintain that bond, as far as yearly physicals, and so forth.

Great that he has a baseline already built, in terms of P.S.A. --- it's something to be tracked, as years go by, for every fellow.

There are fellows walking down the street --- right now --- who currently have prostate cancer --- and that simple lab test could lead them to valuable treatment.

There have been times I have been at a staff meeting --- or a large social event --- or a restaurant --- or a grocery store -- or a sports event --- and I have had this thought running silently through my mind:

"SOMEONE in this group --- some unsuspecting fellow --- has prostate cancer --- right this very moment --- and they don't even know it today!"

We must all find ways to quietly the beat the drum --- with our neighbors, colleagues, friends, comrades, and brothers --- and advocate the importance of men's health.

Thanks for being a health advocate --- a steadfast messenger --- and trusted compadre --- for all fellows !

A good day ahead,
CYCLONE ~~~ # Iowa State University

Post Edited (Cyclone-ISU) : 5/6/2021 2:29:45 PM (GMT-6)

Pratoman said...
I hope my sons baseline stays where it is for many years, but i know he needs to be vigilant.

That's right, Ken -- he needs to be vigilant, not you. You've done your part. And it sure sounds like he's being vigilant, so you did a good job. Now move on.
--Richard.

JFL, I was also fortunate with my PCP--at my Dad's suggestion, I asked for it starting (I think) at 40 or 45, along with a DRE annually. He was kind of like, "That's not really recommended at your age, but given your history I understand, and it's no biggie."

And, when it hit 3.2, at age 56, he said, "You need to make an appointment with Dr. N____, we will send your records over to him." This was a small town, with one urology practice. I did so, and here we are today.

nice try...Saipan...Sigh.....oh well we all have our neuroses....they keep us...well...vigilant??

Prato my main man,
I do not agree with garyi. But much respect to my brother gary to the i.....Disney's "Frozen" songs are not creed. Ignorance is not really bliss.

I would have loved to have my relatives worry about me and urge me to get tested, because I took it upon myself and ignored and not worry, and it cost me dearly.

Nothing wrong with being "overprotective" or "worrisome" or even anal in this case IMHO.
Even as I say that,.... with those results...I will flippantly say "Don't worry, be happy",!!! Okuna Matata... Now THAT song IS creed! Seems like normal values for a young man.
Winging it in So Cal

As a non expert i would agree with others that the change is not a big deal just got to look at longbterm trendline. Also might look at prostate size and get psa density but that may be overkill
Also another note when i got my g6 dx with AS tx whrer they wanted to monitor psa change i decided to get checked every month for 8month had to psy out of pocket used this info to understand variability and decided for me a change of 0.5 is noise level. Many say i am crazy(maybe i am for other reasons) but as an analytical chemist it makes sense and more important gives me a number based on data to be concerned about not just something the doc says so
Get tested now every mo per AS protocol and track on spreadsheet
So much for my 2cents for whatever its worth