How concerned should I be?

Hello and welcome to the Prostate Cancer forum. Hopefully your stay with us will be short. The absolute value of your PSA is not worrying at all for a 78 year old man. The fact that it increased during the last year may be due to a variety of things that are NOT prostate cancer. In particular your prostate may have become enlarged (generating more PSA) or you may have a prostate infection. The nodule may be benign.

Going to a urologist now is the wise move. He/she will likely order another PSA test to see if the previous one was an anomaly. You will undoubtedly get another fun DRE but your urologist will likely be more experienced. Depending on the PSA results and DRE you may get a course of antibiotics to see if any infection can be controlled. Ultimately your urologist may recommend a biopsy and/or other scans. A PSMA pet scan is quickly becoming the standard of care to help assess situations like yours. Anyway, please come back here after your urologist visit and we'll be glad to answer any questions and offer advice.

Good luck and remember we are here to help.

Jim

P.S. Hopefully you're right about those 15 more years!

onthefence,
Go see your Urologist and talk.

Although you need to have another PSA test for a true comparison your PSADT (doubling time) is well longer than two years.
That rate generally isn't troubling, it becomes troubling when it's under a year.
Some of us has here have had it as quick as two weeks.
" PSA jumped from 2.7 to 3.7 in 13 months."

I'd bet considering your age the Uro might want to wait another 6 months to a year and take another PSA test.
A scan or two won't hurt anything either.

I guess what I'm saying is take a breath, at this point it's not particularly aggressive. But do see a Urologist.

Who was it that sang: Tiiiiiime is on my side, yes it is.
Oh yeah, big lips and the Rolling Stones

I wish you luck on the next 15 years, you must have good longevity with the men in your family…

Your prostate “check engine” light just came on as some are fond of saying so a couple of things can happen: 1) put black tape over light, 2) blow it off and drive with light on, 3) hope light goes off next time you restart car, 4) research possible causes of check engine light for your older vintage model, or 5) see mechanic who unlocks secret diagnostic codes and explains where your money will be going.

Probably time to see the mechanic for system evaluation.

Other than putting up with 18 months of ADT and daily drives to UCLA for radiation, I'd have to say I have an excellent QOL. And I'm willing to bet that 80%+ of the guys here would say the same thing about their QOL. I get where you're coming from, but I certainly wouldn't assume the worst regarding treatment and its after effects.

Plus...who knows? 1) You may not have PCa or 2) You may be a candidate for Active Surveillance. Unfortunately, there's lots you don't know yet and you'll just have to hang tight for now. But as someone that's been through this, it's not all that bad even if it doesn't seem that way at first.

Fence, that’s a good question. But one to evaluate after you figure out what’s going on. If a G6 or light G7 you may want to just do active surveillance. Or, if a little worse you may want to select a treatment plan that’s not very invasive like LDR or HDR Brachy. But if it’s really bad news (unlikely with your PSA) you may want to aggressively treat as dying of metastatic prostate cancer is not pretty.

But we’re way ahead of ourselves. There will be plenty to discuss once you have some data.

BYW, waiting in til Nov. 30 seems way too long to me. Is this the only urologist you can see? Maybe you can find someone with an earlier appointment. I was way too impatient once my PSA was up and insisted on getting to a urologist right away…

Jim

Thanks guys for the encouraging words. Even though it's a long wait, I'm keeping my Nov 30 appointment because I've been to him before and he has my past history. I'm not ruling anything out, my last post was more or less just thinking out loud. If he wants to do a biopsy right away I might suggest a confirmatory PSA and DRE first, and take it from there. Thanks again to all for sharing your insight, knowledge and experience.

while life is not fair, the reality is no one knows just how long we will be on this earth

at 78, your symptoms should be checked no doubt, but it could be anything other than prostate cancer.
however at this age, it is not unusual either.

we are not immortal. If anything, you have seen family and friends pass on, so as we age, we begin to accept this
i was diagnosed at 74. I told my Oncologist, see that I make it to 85, after that, it will be a bonus.
she said, I will make it.
after my first bout, it came back. had brachy and while i was told it was looking good, there was always a possibility.
when it came back, its was more a virulent type,(gleason score, over 8)
they discovered one small area and zapped it out
at the same time , they did a bone scan and a pet scan.
one lesion on a rib.
that was zapped out.
went on a trial for erleada. results were that no other lesions found anywhere, the last 18 months, but I went off erleada because of anemia. i was so weak, I huffed at walking 10 steps.
it was determined i was badly anemic . enough to say to stop and see.

the very next day, unbelievably, I felt 100 % stronger. I had strength to walk up 85 stairs where i live which is at a 65 degree angle. I had to stop at the 70th step. huffed and puffed. out of shape obviously, thanks to covid restrictions where i live.

that is my story. anything is possible, we are all different and react differently to treatment.
there are newer and newer drugs today, one exciting that actually attacks the cancer cell only and kills it. must be 3rd generation
so with all that, prepare to live another 15 years.
good luck.
btw, i am 81.5 years old. my psa is 0 and my testosterone is non existent.
I am a eunuch but alive. lol

Post Edited (racquetball77) : 10/24/2023 6:32:13 PM (GMT-8)

Tudpock18 said...
…..waiting in til Nov. 30 seems way too long to me. Is this the only urologist you can see? Maybe you can find someone with an earlier appointment….

I think it depends on where one is and the system they are working with. I have an AUS and either it or my urethra is failing. I called to get an appointment with any urologist and the next open one is over 2 month away. I asked if I could be put on a wait list for cancellations and was told, no, that all cancellations are held for potential emergencies.

Discuss with your uro the causes of PSA rise (and fall) other than prostate cancer including acute and chronic prostatitis

Djin.